Motivations to Participate in Transdisciplinary COVID-19 Projects

Transdisciplinary projects claim to be driven by societal needs and hence it would be expected that motivations are driven by the societal and project beneficiaries. Projects conducted in respect of COVID-19 instinctively meet transdisciplinary status with societal benefit being paramount. This paper presents an analysis of six transdisciplinary COVID-19 projects, assessing the motivations of twenty-nine participants involved. Primary data was collated through semi-structured individual interviews and thematic analysis was used to evaluate the reasons for individual participation. The findings show that of the motivations for participation, ethical motivation was 16%, personal fulfilment was 21% and being able to help was 19%. The extrinsic motivations such as expected rewards and benefits was still present but remained very low at 6%. The qualitative responses from the interviews give an indication that although a societal challenge, the motivations remained more of a personal nature aligning with the societal need. © 2022 The authors and IOS Press.

Improving Efficiency and Patient Safety at The Point of Admission;The Introduction of Portable Procedural Equipement Stations

Introduction: Admitting acutely unwell patients to the intensive care unit (ICU) can represent a busy and challenging time, particularly out of hours or in the context of surge into areas not usually utilised for delivery of intensive care. It is usual for the team to perform a number of procedures at the point of admission in order to stabilise the patient. Objectives: During the Covid-19 surge it was noted that efficiency and potentially patient safety were being compromised by the time taken to locate essential equipment required to carry out the frequent and specialist procedures that are often performed at admission. This quality improvement project set out to address this short fall by introducing mobile workstations that were fully stocked with the required equipment and provided a working surface. Four different stations were introduced a general station (Intravenous, central, and arterial access, blood cultures, nasogastric tube insertion, urinary catheter insertion) and 3 specialist procedure stations an intercostal chest drain station, airway station and a percutaneous tracheostomy/lumbar puncture station. A spare general station was kept stocked in a storeroom so that after use stations could be replaced immediately. Laminated contents lists with photographs of drawer layouts were attached to allow restocking. General stations were sealed before being positioned in designated positions, marked on the floor, in each of the different clinical areas. The stations were designed to be easily cleaned to conform to infection control protocols. Methods: Medical staff performed an electronic questionnaire before and after the introduction of the equipment stations. Results: The 12 responders reported performing, on average 4 procedure per admission. Pre-intervention the average reported time taken to find equipment need was reported to be 22.5 minutes, with a further average 18.5 minutes taken by a second member of staff, usually bedside nursing staff. Post intervention these reported times fell to 7.5 minutes and 7 minute respectively, at time saving of 40.7 minutes (65%). In 2018/2019 our unit admitted 788 patients, therefore over a year we could potential save up to 535 hours, with the financial implications being obvious. The post intervention questionnaire contained a significant number of positive comments regarding the stations from staff. Conclusion: This simple intervention is clearly able to improve patient safety, reduce frustration amongst staff as well as save time and money. The mobile nature of the stations allowed them to be used in other areas when required such as theatre, recovery and the emergency department, a feature which has been particularly beneficial during the Covid-19 surge. Other units may want to consider this set up as a way of improving safety and efficiency.

PPE fit of healthcare workers during the COVID-19 pandemic.

Historically, PPE (Personal Protective Equipment) has generally been designed around the size and shape of an average European or US white man's face and body. There is little academic evidence to support anecdotal reports that women are at a greater disadvantage than men from ill-fitting PPE. This is especially relevant in healthcare settings where women make up at least 75% of frontline workers. The COVID-19 pandemic has exacerbated problems associated with the fit of PPE that until now have been mainly anecdotal. This research presents results and analysis of a quantitative and qualitative survey concerning the fit of PPE worn by 248 healthcare workers, in a variety of healthcare roles and settings, during the COVID-19 pandemic. The analysis of the survey results showed that women were less likely than men to feel safe carrying out their roles, with only 30.5% of women and 53.3% of men stating that they felt safe all of the time. A statistically significant link is made between women suffering more with poor fit than men with certain categories of PPE (gowns, masks, visors, goggles). Over four times as many women (54.8%) as men (13.3%) reported their surgical gowns being large to some degree and women were nearly twice as likely (53.5%) to experience oversized surgical masks than men (28.6%). However, it was recognized that PPE fit problems are not exclusive to women as many men also do not conform to the underlying shape and size of PPE designs. Survey results indicated that both sexes felt equally hampered due to the fit of their PPE and around a third of both women and men had modified their PPE to address fit issues. Oversized and modified PPE presents its own set of unintended consequences. Following strict processes for doffing and removing PPE is key to virus control but doffing modified PPE can fall outside of these processes, risking cross infection. In addition, wearers of critical items of PPE (such as respirators) currently undergo a "fit test"; however, fit does not reconcile with comfort and over-tightened PPE can cause headaches, discomfort and distraction when worn for long periods. Requirements and fit tests are also not setting-specific; qualitative responses from the survey give an indication that this must be a future consideration.