Management of donations of personal protective equipment in response to the massive shortage during the COVID-19 health crisis: providing quality equipment to health care workers.

BACKGROUND: In the COVID-19 pandemic context, a massive shortage of personal protective equipment occurred. To increase the available stocks, several countries appealed for donations from individuals or industries. While national and international standards to evaluate personal protective equipment exist, none of the previous research studied how to evaluate personal protective equipment coming from donations to healthcare establishments. Our aim was to evaluate the quality and possible use of the personal protective equipment donations delivered to our health care establishment in order to avoid a shortage and to protect health care workers throughout the COVID-19 crisis. METHODS: Our intervention focused on evaluation of the quality of donations for medical use through creation of a set of assessment criteria and analysis of the economic impact of these donations. RESULTS: Between 20th March 2020 and 11th May 2020, we received 239 donations including respirators, gloves, coveralls, face masks, gowns, hats, overshoes, alcohol-based hand rubs, face shields, goggles and aprons. A total of 448,666 (86.3%) products out of the 519,618 initially received were validated and distributed in health care units, equivalent to 126 (52.7%) donations out of the 239 received. The budgetary value of the validated donations was 32,872 euros according to the pre COVID-19 prices and 122,178 euros according to the current COVID-19 prices, representing an increase of 371.7%. CONCLUSIONS: By ensuring a constant influx of personal protective equipment and proper stock management, shortages were avoided. Procurement and distribution of controlled and validated personal protective equipment is the key to providing quality care while guaranteeing health care worker safety.

Implementation of a Warm Zone Model During the COVID-19 Pandemic.

ABSTRACT: In March 2020, in response to the coronavirus disease 2019 (COVID-19) pandemic, the executive leadership of an academic medical center in Atlanta tasked an interprofessional quality improvement (QI) team with identifying ways to improve staff and patient safety while caring for patients with suspected or confirmed COVID-19 infection. Additional goals of the initiative were to improve workflow efficiency by reducing the amount of time spent donning and doffing personal protective equipment (PPE) and to conserve PPE, which could be in short supply in a prolonged pandemic. The QI team developed a "warm zone model" that allowed staff members to wear the same mask, eye protection, and gown while moving between the rooms of patients who had tested positive for COVID-19. The risk of self-contamination while doffing PPE is well documented. Staff members were trained to conserve PPE and to properly change gloves and perform hand hygiene between exiting and entering patients' rooms. The warm zone model allowed multidisciplinary team members to reduce the times they donned and doffed PPE per shift while maintaining or increasing the times they entered and exited patients' rooms. Staff members believed that the model improved workflow and teamwork while maintaining staff members' personal safety. Daily gown use decreased on the acute care unit where the model was employed, helping to preserve PPE supplies. Once the model was proven successful in acute care, it was modified and instituted on several critical care COVID-19 cohort units.

Stemming COVID-19 in Cuba: Strengths, Strategies, Challenges Francisco Durán MD. National Director of Epidemiology, Ministry of Public Health, Cuba

Dr Durán is a native of eastern San-tiago de Cuba and his early medical career began in this mountainous re-gion, where he also headed provin-cial prevention and treatment of HIV/AIDS. He went on to become rector of the Medical University of Santiago de Cuba and provincial health direc-tor. Later in Havana, Dr Durán was director of medical education and vice minister at the Ministry of Public Health (MINSAP). Abroad, he served as advisor to Angola's Minister of Health, and on his return, as deputy director of Cuba's Pedro Kourí Tropical Medicine Institute (IPK). Dr Durán has been "battle-tested" over the years by his involvement in stemming dengue epidemics and other infectious dis-ease outbreaks, good preparation for his current position as National Direc-tor of Epidemiology. Today, his is the voice and the face on the 11:00 AM briefing carried daily by Cuban television, reporting the latest data on the un-folding COVID-19 pandemic globally, in the Americas and.

"We are Alone in This Battle": A Framework for a Coordinated Response to COVID-19 in Nursing Homes.

As of May 2020, nursing home residents account for a staggering one-third of the more than 80,000 deaths due to COVID-19 in the U.S. This pandemic has resulted in unprecedented threats to achieving and sustaining care quality even in the best nursing homes, requiring active engagement of nursing home leaders in developing solutions responsive to the unprecedented threats to quality standards of care delivery during the pandemic. This perspective offers a framework, designed with the input of nursing home leaders, to facilitate internal and external decision-making and collective action to address these threats. Policy options focus on assuring a shared understanding among nursing home leaders and government agencies of changes in the operational status of nursing homes throughout the crisis, improving access to additional essential resources needed to mitigate the crisis' impact, and promoting shared accountability for consistently achieving accepted standards in core quality domains.

US Physicians Trained in Cuba Battle COVID-19 at Home:A Personal Account from the New York City Epicenter.

Speaking remotely with US graduates of Havana's Latin American School of Medicine (ELAM), I found them at work on hospital floors, in ICUs and health centers across the United States, putting their professional and personal commitment to the test against COVID-19. Nowhere was that more evident than in New York City, the disease's epicenter, where one grad told me virtually every hospital has at least one MD from the Cuban school, which has provided free 6-year medical training for some 30,000 doctors since the school's founding in 1999. The student body comes primarily from low- and middle-income countries worldwide, but Cuba also provided 200 US students with scholarships. One of them is Dr Joaquín Morante (ELAM Class of 2012), who did his medical residency in internal medicine, followed by fellowships in pulmonary disease and critical care medicine. Triple-licensed in internal medicine, pulmonary and critical care medicine, he is now an attending physician on staff at Jacobi Medical Center in The Bronx, one of New York City's public hospitals, and considered a 'hot spot' due to its COVID-19 caseload. I spoke with him during a break at home in mid-April.Dr Joaquín Morante, ELAM Class of 2012: Pulmonologist, critical care attending physician at Jacobi Medical Center, New York City.

Stemming COVID-19 in Cuba: Strengths, Strategies, Challenges Francisco Durán MD. National Director of Epidemiology, Ministry of Public Health, Cuba

Dr Durán is a native of eastern San-tiago de Cuba and his early medical career began in this mountainous re-gion, where he also headed provin-cial prevention and treatment of HIV/AIDS. He went on to become rector of the Medical University of Santiago de Cuba and provincial health direc-tor. Later in Havana, Dr Durán was director of medical education and vice minister at the Ministry of Public Health (MINSAP). Abroad, he served as advisor to Angola's Minister of Health, and on his return, as deputy director of Cuba's Pedro Kourí Tropical Medicine Institute (IPK). Dr Durán has been "battle-tested" over the years by his involvement in stemming dengue epidemics and other infectious dis-ease outbreaks, good preparation for his current position as National Direc-tor of Epidemiology. Today, his is the voice and the face on the 11:00 AM briefing carried daily by Cuban television, reporting the latest data on the un-folding COVID-19 pandemic globally, in the Americas and.

COVID-19-associated shortage of alcohol-based hand rubs, face masks, medical gloves, and gowns: proposal for a risk-adapted approach to ensure patient and healthcare worker safety.

The coronavirus disease 2019 (COVID-19) pandemic has caused a huge demand for alcohol-based hand rubs, medical gloves, face masks, and gowns in healthcare and from the public. More and more hospitals face a serious shortage of these articles. We propose a risk-adapted approach to ensure adequate patient and healthcare worker safety for as long as possible.