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1.
PLoS One ; 17(2): e0245182, 2022.
Article in English | MEDLINE | ID: covidwho-1674002

ABSTRACT

BACKGROUND: Working under pandemic conditions exposes health care workers (HCWs) to infection risk and psychological strain. A better understanding of HCWs' experiences of following local infection prevention and control (IPC) procedures during COVID-19 is urgently needed to inform strategies for protecting the psychical and psychological health of HCWs. The objective of this study was therefore to capture the perceptions of hospital HCWs on local IPC procedures and the impact on their emotional wellbeing during the first wave of the COVID-19 pandemic in Europe. METHODS: Participants were recruited in two sampling rounds of an international cross-sectional survey. Sampling took place between 31 March and 17 April 2020 via existing research networks and between 14 May and 31 August 2020 via online convenience sampling. Main outcome measures were behavioural determinants of HCWs' adherence to IPC guidelines and the WHO-5 Well-Being Index, a validated scale of 0-100 reflecting emotional wellbeing. The WHO-5 was interpreted as a score below or above 50 points, a cut-off score used in previous literature to screen for depression. RESULTS: 2289 HCWs from 40 countries in Europe participated. Mean age was 42 (±11) years, 66% were female, 47% and 39% were medical doctors and nurses, respectively. 74% (n = 1699) of HCWs were directly treating patients with COVID-19, of which 32% (n = 527) reported they were fearful of caring for these patients. HCWs reported high levels of concern about COVID-19 infection risk to themselves (71%) and their family (82%) as a result of their job. 40% of HCWs considered that getting infected with COVID-19 was not within their control. This feeling was more common among junior than senior HCWs (46% versus 38%, P value < .01). Sufficient COVID-19-specific IPC training, confidence in PPE use and institutional trust were positively associated with the feeling that becoming infected with COVID-19 was within their control. Female HCWs were more likely than males to report a WHO-5 score below 50 points (aOR 1.5 (95% confidence interval (CI) 1.2-1.8). CONCLUSIONS: In Europe, the COVID-19 pandemic has had a differential impact on those providing direct COVID-19 patient care, junior staff and women. Health facilities must be aware of these differential impacts, build trust and provide tailored support for this vital workforce during the current COVID-19 pandemic.


Subject(s)
COVID-19/prevention & control , Guidelines as Topic/standards , Health Personnel/psychology , Hospitals/standards , Infection Control/statistics & numerical data , Personal Protective Equipment/statistics & numerical data , SARS-CoV-2/isolation & purification , Adult , COVID-19/epidemiology , COVID-19/psychology , COVID-19/virology , Cross-Sectional Studies , Europe/epidemiology , Female , Humans , Male , Patient Care/methods , Patient Care/standards
3.
Am J Emerg Med ; 53: 122-126, 2022 03.
Article in English | MEDLINE | ID: covidwho-1638161

ABSTRACT

BACKGROUND: Endotracheal intubation (ETI) is still the gold standard of airway management, but in cases of sudden cardiac arrest in patients with suspected SARS-CoV-2 infection, ETI is associated with risks for both the patient and the medical personnel. We hypothesized that the Vie Scope® is more useful for endotracheal intubation of suspected or confirmed COVID-19 cardiac arrest patients than the conventional laryngoscope with Macintosh blade when operators are wearing personal protective equipment (PPE). METHODS: Study was designed as a prospective, multicenter, randomized clinical trial performed by Emergency Medical Services in Poland. Patients with suspected or confirmed COVID-19 diagnosis who needed cardiopulmonary resuscitation in prehospital setting were included. Patients under 18 years old or with criteria predictive of impossible intubation under direct laryngoscopy, were excluded. Patients were randomly allocated 1:1 to Vie Scope® versus direct laryngoscopy with a Macintosh blade. Study groups were compared on success of intubation attempts, time to intubation, glottis visualization and number of optimization maneuvers. RESULTS: We enrolled 90 out-of-hospital cardiac arrest (OHCA) patients, aged 43-92 years. Compared to the VieScope® laryngoscope, use of the Macintosh laryngoscope required longer times for tracheal intubation with an estimated mean difference of -48 s (95%CI confidence interval [CI], -60.23, -35.77; p < 0.001). Moreover VieScope® improved first attempt success rate, 93.3% vs. 51.1% respectively (odds ratio [OR] = 13.39; 95%CI: 3.62, 49.58; p < 0.001). CONCLUSIONS: The use of the Vie Scope® laryngoscope in OHCA patients improved the first attempt success rate, and reduced intubation time compared to Macintosh laryngoscope in paramedics wearing PPE for against aerosol generating procedures. TRIAL REGISTRATION: ClinicalTrials registration number NCT04365608.


Subject(s)
Allied Health Personnel/statistics & numerical data , Intubation, Intratracheal/instrumentation , Laryngoscopes/standards , Adult , Aged , Aged, 80 and over , Airway Management/instrumentation , Airway Management/methods , Airway Management/statistics & numerical data , Allied Health Personnel/standards , Female , Humans , Intubation, Intratracheal/methods , Intubation, Intratracheal/statistics & numerical data , Laryngoscopes/statistics & numerical data , Male , Middle Aged , Personal Protective Equipment/adverse effects , Personal Protective Equipment/standards , Personal Protective Equipment/statistics & numerical data , Prospective Studies , Resuscitation/instrumentation , Resuscitation/methods , Resuscitation/statistics & numerical data
4.
J Infect Dev Ctries ; 15(12): 1816-1824, 2021 12 31.
Article in English | MEDLINE | ID: covidwho-1635712

ABSTRACT

INTRODUCTION: During the second wave of the coronavirus disease 19 (COVID-19) pandemic, Malaysia reported several COVID-19 clusters related to healthcare workers. Thus, addressing and understanding the risk of exposure in healthcare workers is important to prevent future infection and reduce secondary COVID-19 transmission within the healthcare settings. In this study, we aim to assess exposure and prevention practices against COVID-19 among healthcare workers at the Hospital Canselor Tuanku Muhriz, a university teaching hospital based in Kuala Lumpur, Malaysia. METHODOLOGY: A total of 571 healthcare workers at COVID-19 and non-COVID-19 wards as well as the emergency department and laboratory staff at COVID-19 testing labs were recruited. The presence of novel human coronavirus (SARS-CoV-2) and IgM/IgG antibodies were confirmed in all healthcare workers. The healthcare workers responded to an online Google Forms questionnaire that evaluates demographic information and comorbidities, exposure and adherence to infection prevention and control measures against COVID-19. Descriptive analysis was performed using Statistical Package for the Social Sciences 24.0. RESULTS: Three healthcare workers (0.5%) tested positive for SARS-CoV-2, while the remaining 568 (99.5%) were negative. All were negative for IgM and IgG antibodies during recruitment (day 1) and follow-up (day 15). More than 90% of the healthcare workers followed infection prevention and control practices recommendations regardless of whether they have been exposed to occupational risk for COVID-19. CONCLUSIONS: The healthcare workers' high level of adherence to infection prevention practices at this hospital helped reduce and minimize their occupational exposure to COVID-19.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control/standards , Health Personnel/statistics & numerical data , Occupational Exposure/prevention & control , Adult , COVID-19/transmission , COVID-19 Testing/statistics & numerical data , Cross-Sectional Studies , Female , Humans , Malaysia/epidemiology , Male , Occupational Exposure/statistics & numerical data , Pandemics , Personal Protective Equipment/statistics & numerical data , Risk Assessment , SARS-CoV-2
5.
Gac. méd. Méx ; 157(3): 327-331, may.-jun. 2021. tab
Article in Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-1552060

ABSTRACT

Resumen Introducción: Ante la pandemia de COVID-19, el apego a las medidas de higiene es un objetivo para disminuir la morbimortalidad. Objetivo: Evaluar el apego a la higiene de manos y medidas de protección durante la pandemia de COVID-19 en un hospital de tercer nivel. Métodos: Estudio transversal acerca del lavado de manos del personal de salud en los cinco tiempos recomendados por la Organización Mundial de la Salud, así como sobre el uso del equipo de protección personal específico. Resultados: Fueron observadas 117 oportunidades de higiene de manos en personal de salud: 40 (34 %) respecto al lavado de manos y 76 (65 %) respecto a su omisión; sobre el apego al uso de careta en cinco (4 %) y sobre la falta de apego en 112 (96 %). Se identificó apego al uso de mascarilla en 65 profesionales de enfermería (87 %), uso adecuado de mascarilla en 56 de ellos (60 %) y uso de careta en uno (1 %.) Conclusión: El personal mostró baja proporción de apego a la higiene de manos y al uso de equipo para la protección específica durante la pandemia de COVID-19.


Abstract Introduction: During the COVID-19 pandemic, adherence to hygiene measures is an objective aimed at reducing morbidity and mortality. Objective: To evaluate adherence to hand hygiene and protection measures during the COVID-19 pandemic in a tertiary care hospital. Methods: Cross-sectional study on health personnel handwashing at the five moments recommended by the World Health Organization, as well as on the use of specific personal protective equipment. Results: One hundred and seventeen hand hygiene opportunities were observed in health personnel. Hand washing was observed in 40 (34 %) and omission in 76 (65 %). Adherence to the use of face shield was observed in five (4 %), and lack of adherence in 112 (96%). Adherence to the use of face mask was observed in 65 nursing professionals (87 %), with appropriate use of the mask in 56 of them (60 %) and use of face shield in one (1 %). Conclusion: Health personnel showed low proportions of adherence to hand hygiene and use of equipment for specific protection during the COVID-19 pandemic.


Subject(s)
Humans , Male , Female , Personnel, Hospital/statistics & numerical data , Guideline Adherence/statistics & numerical data , Hand Hygiene/statistics & numerical data , Personal Protective Equipment/statistics & numerical data , COVID-19/prevention & control , Personnel, Hospital/standards , Time Factors , Cross-Sectional Studies , Prospective Studies , Tertiary Care Centers , Hand Hygiene/standards
6.
Gac Med Mex ; 157(3): 313-317, 2021.
Article in English | MEDLINE | ID: covidwho-1535087

ABSTRACT

INTRODUCTION: During the COVID-19 pandemic, adherence to hygiene measures is an objective aimed at reducing morbidity and mortality. OBJECTIVE: To evaluate adherence to hand hygiene and protection measures during the COVID-19 pandemic in a tertiary care hospital. METHODS: Cross-sectional study on health personnel handwashing at the five moments recommended by the World Health Organization, as well as on the use of specific personal protective equipment. RESULTS: One hundred and seventeen hand hygiene opportunities were observed in health personnel. Hand washing was observed in 40 (34 %) and omission in 76 (65 %). Adherence to the use of face shield was observed in five (4 %), and lack of adherence in 112 (96%). Adherence to the use of face mask was observed in 65 nursing professionals (87 %), with appropriate use of the mask in 56 of them (60 %) and use of face shield in one (1 %). CONCLUSION: Health personnel showed low proportions of adherence to hand hygiene and use of equipment for specific protection during the COVID-19 pandemic.


INTRODUCCIÓN: Ante la pandemia de COVID-19, el apego a las medidas de higiene es un objetivo para disminuir la morbimortalidad. OBJETIVO: Evaluar el apego a la higiene de manos y medidas de protección durante la pandemia de COVID-19 en un hospital de tercer nivel. MÉTODOS: Estudio transversal acerca del lavado de manos del personal de salud en los cinco tiempos recomendados por la Organización Mundial de la Salud, así como sobre el uso del equipo de protección personal específico. RESULTADOS: Fueron observadas 117 oportunidades de higiene de manos en personal de salud: 40 (34 %) respecto al lavado de manos y 76 (65 %) respecto a su omisión; sobre el apego al uso de careta en cinco (4 %) y sobre la falta de apego en 112 (96 %). Se identificó apego al uso de mascarilla en 65 profesionales de enfermería (87 %), uso adecuado de mascarilla en 56 de ellos (60 %) y uso de careta en uno (1 %). CONCLUSIÓN: El personal mostró baja proporción de apego a la higiene de manos y al uso de equipo para la protección específica durante la pandemia de COVID-19.


Subject(s)
COVID-19/prevention & control , Guideline Adherence/statistics & numerical data , Hand Hygiene/statistics & numerical data , Personal Protective Equipment/statistics & numerical data , Personnel, Hospital/statistics & numerical data , Cross-Sectional Studies , Female , Hand Hygiene/standards , Humans , Male , Personnel, Hospital/standards , Prospective Studies , Tertiary Care Centers , Time Factors
7.
PLoS One ; 16(11): e0259981, 2021.
Article in English | MEDLINE | ID: covidwho-1528721

ABSTRACT

BACKGROUND: Somalia is considered severely underprepared to contain an outbreak of COVID-19, with critical shortages in healthcare personnel and treatment resources. In limited-resource settings such as Somalia, providing healthcare workers with adequate information on COVID-19 is crucial to improve patient outcomes and mitigate the spread of the SARS-CoV-2 virus. This study assessed the knowledge of, preparedness for, and perceptions toward COVID-19 prevention and treatment among Somali healthcare workers. METHODS: A descriptive, cross-sectional survey was completed by 364 Somali healthcare workers in summer of 2020 utilizing a convenience sampling method. RESULTS: Participants' most accessed sources of COVID-19 information were from social media (64.8%), official government and international health organization websites (51.1%,), and traditional media sources such as radio, TV, and newspapers (48.1%). A majority of participants demonstrated strong knowledge of treatment of COVID-19, the severity of COVID-19, and the possible outcomes of COVID-19, but only 5 out of 10 symptoms listed were correctly identified by more than 75% of participants. Although participants indicated seeing a median number of 10 patients per week with COVID-19 related symptoms, access to essential medical resources, such as N95 masks (30.2%), facial protective shields (24.5%), and disposable gowns (21.4%), were limited. Moreover, 31.3% agreed that Somalia was in a good position to contain an emerging outbreak of COVID-19. In addition, 40.4% of participants agreed that the Somali government's response to the pandemic was sufficient to protect Somali healthcare professionals. CONCLUSION: This study provides evidence for the need to equip Somali healthcare providers with more information, personal protective equipment, and treatment resources such that they can safely and adequately care for COVID-19 patients and contain the spread of the virus. Social media and traditional news outlets may be effective outlets to communicate information regarding COVID-19 and the Somali government's response to frontline healthcare workers.


Subject(s)
COVID-19/prevention & control , Health Knowledge, Attitudes, Practice , Health Personnel/psychology , Personal Protective Equipment/statistics & numerical data , Practice Guidelines as Topic/standards , Protective Clothing/statistics & numerical data , SARS-CoV-2/physiology , Adolescent , Adult , Aged , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Somalia/epidemiology , Young Adult
8.
Adv Skin Wound Care ; 34(12): 651-655, 2021 Dec 01.
Article in English | MEDLINE | ID: covidwho-1528177

ABSTRACT

OBJECTIVE: To determine the frequency of hand dermatitis among nurses during the COVID-19 pandemic and factors affecting its prevalence. METHODS: The research sample consisted of 175 nurses working in state hospitals. Research data were collected via Google survey between September and October 2020. The data were collected using a sociodemographic data collection form, and a self-assessment form was used to determine dermatologic symptoms. RESULTS: The frequency of hand dermatitis among nurses was 70.9%. A statistically significant difference was found between sex, allergy history, and increased frequency of handwashing and the frequency of hand dermatitis. No significant difference in terms of the frequency of hand dermatitis was found between nurses who provided care to patients who were COVID-19 positive versus nurses who provided care to patients who were COVID-19 negative. However, the frequency of washing hands and using hand disinfectants and hand creams was found to have increased significantly during the COVID-19 pandemic compared to the prepandemic period. CONCLUSIONS: The frequency of hand dermatitis increased among nurses during the pandemic. The increased frequency of handwashing during the pandemic poses a risk for hand dermatitis among nurses, although this should not discourage nurses from appropriate hygiene.


Subject(s)
Dermatitis/diagnosis , Hand/physiopathology , Nurses/statistics & numerical data , Adult , COVID-19/prevention & control , COVID-19/transmission , Dermatitis/epidemiology , Female , Hand Disinfection , Humans , Infection Control/instrumentation , Infection Control/methods , Male , Middle Aged , Personal Protective Equipment/adverse effects , Personal Protective Equipment/statistics & numerical data , Prevalence , Turkey/epidemiology
10.
Antimicrob Resist Infect Control ; 10(1): 159, 2021 11 08.
Article in English | MEDLINE | ID: covidwho-1505725

ABSTRACT

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.


Subject(s)
COVID-19/prevention & control , Eye Protective Devices/supply & distribution , Health Personnel/psychology , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Masks/supply & distribution , Personal Protective Equipment/supply & distribution , Protective Clothing/supply & distribution , Safety Management , COVID-19/epidemiology , Humans , Infection Control , Pandemics , Personal Protective Equipment/statistics & numerical data , Protective Clothing/statistics & numerical data , Quality Improvement , SARS-CoV-2
11.
Turk J Ophthalmol ; 51(5): 269-281, 2021 10 26.
Article in English | MEDLINE | ID: covidwho-1497595

ABSTRACT

Objectives: To investigate the effect of the novel coronavirus disease 2019 (COVID-19) pandemic on the clinical practice of ophthalmologists in our country. Materials and Methods: A questionnaire consisting of 22 questions was delivered to 250 ophthalmologists via e-mail and a smartphone messaging application. A total of 113 ophthalmologists completed the survey. The questions included the participants' demographic data (age, years in practice, institution, and city), changes in their working conditions and institutional preventive measures implemented during the pandemic, their personal COVID-19 experiences, the prevalence of telemedicine applications, and their attitudes toward these practices. Results: Nearly half (47.8%) of the 113 ophthalmologists were 36 to 45 years old. In terms of years in practice, the largest proportion of respondents (28.3%) had 6-10 years of experience. Most of the participants worked in private/foundation universities (37.2%), while 22.1% worked in education and research clinics. Participants working at public universities most often reported that they or a close contact had to work in COVID wards (89.5%). Triage was performed in 51.5% of ophthalmology outpatient clinics, with 88.0% of these participants reporting that patients with fever, cough, or dyspnea were directed to the pandemic clinic without ophthalmological examination. All participants working in public hospitals, education and research clinics, and public university hospitals had postponed elective surgeries, whereas 12.5% of those working in private practice and 20.5% of those working in private/foundation universities reported that they continued elective surgeries. While 80.8% of the participants did not conduct online interviews or examinations, 40.4% stated that they considered telemedicine applications beneficial. Seventy-seven percent of participants expressed concern about a decrease in their income during the pandemic, with this being especially common among participants working in private practice (87.5%) and private/foundation university hospitals (85.7%). Conclusion: Ophthalmologists across our country have been affected by this pandemic at a level that will change their clinical approach. We think that ophthalmologists impacted by the difficulty of providing personal protective equipment and economic concerns should be supported more during the pandemic.


Subject(s)
COVID-19/epidemiology , Ophthalmologists/statistics & numerical data , Ophthalmology/trends , Practice Patterns, Physicians'/statistics & numerical data , SARS-CoV-2 , Adult , Aged , Delivery of Health Care , Elective Surgical Procedures/statistics & numerical data , Female , Health Surveys , Hospitals, Private , Hospitals, Public , Humans , Male , Middle Aged , Ophthalmologists/psychology , Patient Care , Personal Protective Equipment/statistics & numerical data , Surveys and Questionnaires , Telemedicine , Turkey/epidemiology
12.
Pan Afr Med J ; 39: 265, 2021.
Article in English | MEDLINE | ID: covidwho-1472498

ABSTRACT

INTRODUCTION: dental procedures produce bio-aerosols that can carry the highly contagious COVID-19 virus. Hence, the entire dental care team has to follow the current COVID-19 related infection control protocols. The study aims to assess the knowledge, attitude, and practices associated with infection control methods during dental procedures among dental practitioners during the COVID-19 pandemic in India. METHODS: the online questionnaire consisted of four sections namely, demographic details, eight questions on knowledge, four questions on attitude and eight questions on the practice of dentists during COVID-19 pandemic. One point was attributed for a correct response and zero point for an incorrect response. The study used descriptive statistics and binary logistic regression models in Jamovi 1.8.1 to establish relationships between knowledge, attitude, and practices among dental professionals and their demographic characteristics. RESULTS: among 384 dentists, 294 (76.6%) were aware of the hand hygiene methods, 372 dentists (96.9%) were aware of the Personal Protective Equipment (PPE), 343 dentists (89.3%) recorded the body temperature of the patients. One hundred and thirty eight (138) dentists (35.9%) did not use rubber dam and 158 dentists (41.1%) were not aware of the four-handed dentistry. Among the study participants, 57.8% displayed adequate knowledge, 63.8% possessed good attitude and 93.5% followed good practices on COVID-19 appropriate infection control measures during dental procedures. The mean knowledge, attitude, and practice scores were found to be 6.61, 2.04, and 3.38 respectively. Based on multivariable binary logistic regression analysis, it is observed that males (aOR: 0.55, 95% CI 0.35-0.87; p=0.011) have a lower likelihood of having a good knowledge when compared with females after adjusting for the other independent variables in the model. Also, individuals with higher qualifications (aOR: 0.57, 95% CI 0.36-0.92; p=0.022) appear to have lower likelihood of having good knowledge on COVID-19 infection control methods during dental procedure. CONCLUSION: the study concludes that participants possess sound knowledge, attitude and practice on hand hygiene, PPE, patient triage and waiting area modifications at the workplace. However, poor response was noted on the use of rubber dam, remote telephonic screening and four-handed dentistry practice.


Subject(s)
COVID-19/prevention & control , Dental Health Services/standards , Dentists/psychology , Health Knowledge, Attitudes, Practice , Infection Control/methods , Pandemics/prevention & control , Personal Protective Equipment/statistics & numerical data , Practice Guidelines as Topic , Adult , Attitude of Health Personnel , COVID-19/epidemiology , Dentists/statistics & numerical data , Female , Humans , Male , Middle Aged , Professional Role
15.
Medicine (Baltimore) ; 100(37): e27240, 2021 Sep 17.
Article in English | MEDLINE | ID: covidwho-1434546

ABSTRACT

ABSTRACT: During the coronavirus disease 2019 (COVID-19) pandemic, the mandatory use of personal protective equipment (PPE) has resulted in a significant reduction in the infection rate among health care workers (HCWs). However, there are some ongoing concerns about the negative impact of using PPE for prolonged periods.This study examined the impact of wearing PPE on surgeons' performance and decision making during the COVID-19 pandemic.In this cross-sectional study, an anonymous online questionnaire was created and disseminated to surgeons all over the Eastern Province of Saudi Arabia. The questionnaire included the demographic data, the local hospital policies, the non-technical skills (e.g., communication, vision, and comfort) and the technical skills, and the process of decision making.From June 2020 to August 2020, 162 surgeons participated in this questionnaire. Of them, 80.2% were aged from 26 to 45 years, 70.4% have received a special training for PPE, and 59.3% of participants have operated on COVID-19 confirmed cases. A negative impact of wearing PPE was reported on their overall comfort, vision, and communication skills (92.6%, 95.1%, and 82.8%, respectively). The technical skills and decision making were not significantly affected (60.5% and 72.8%, respectively). More preference for conservative approach, damage control procedures, and/or open approach was reported.Despite its benefits, PPE is associated with a significant negative impact on the non-technical skills (including vision, communication, and comfort) as well as a non-significant negative impact on technical skills and decision making of surgeons. Extra efforts should be directed to improve PPE, especially during lengthy pandemics.


Subject(s)
COVID-19/prevention & control , Decision Making , Personal Protective Equipment/standards , Surgeons/psychology , Adult , COVID-19/psychology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Personal Protective Equipment/statistics & numerical data , Saudi Arabia , Surgeons/statistics & numerical data , Surveys and Questionnaires
16.
West J Emerg Med ; 22(5): 1045-1050, 2021 Aug 17.
Article in English | MEDLINE | ID: covidwho-1405508

ABSTRACT

INTRODUCTION: The coronavirus 2019 (COVID-19) pandemic has reinforced the importance of facial protection against droplet transmission of diseases. Healthcare workers wear personal protection equipment (PPE), including face shields and masks. Plastic face shields may have advantages over regular medical masks. Although many designs of face shields exist, there is a paucity of evidence regarding the efficacy of shield designs against droplet transmissions. There is even less published evidence comparing various face shields. Due to the urgency of the pandemic and the health and safety of healthcare workers, we aimed to study the efficacy of various face shields against droplet transmission. METHODS: We simulated droplet transmission via coughing using a heavy-duty chemical spray bottle filled with fluorescein. A standard-adult sized mannequin head was used. The mannequin head wore various face shields and was positioned to face the spray bottle at either a 0°, 45°, or 90° angle. The spray bottle was positioned at and sprayed from 30 centimeters (cm), 60 cm, or 90 cm away from the head. These steps were repeated for all face shields used. Control was a mannequin that wore no PPE. A basic mask was also tested. We collected data for particle count, total area of particle distribution, average particle size, and percentage area covered by particles. We analyzed percent covered by particles using a repeated measures mixed-model regression with Tukey-Kramer pairwise comparison. RESULTS: We used least square means to estimate the percentage area covered by particles. Wearing PPE regardless of the design reduced particle transmission to the mannequin compared to the control. The LCG mask had the lowest square means of 0.06 of all face-shield designs analyzed. Tukey-Kramer pairwise comparison showed that all PPEs had a decrease in particle contamination compared to the control. LCG shield was found to have the least contamination compared to all other masks (P < 0.05). CONCLUSION: Results suggest the importance of wearing a protective covering against droplet transmission. The LCG shield was found to decrease facial contamination by droplets the most of any tested protective equipment.


Subject(s)
Aerosols/analysis , COVID-19/prevention & control , Infection Control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Inhalation Exposure/prevention & control , Masks/statistics & numerical data , Personal Protective Equipment/statistics & numerical data , COVID-19/epidemiology , Cough , Delivery of Health Care , Humans , Manikins , Masks/standards , Particle Size , Personal Protective Equipment/standards , SARS-CoV-2
17.
MMWR Morb Mortal Wkly Rep ; 69(43): 1605-1610, 2020 Oct 30.
Article in English | MEDLINE | ID: covidwho-1389857

ABSTRACT

Health care personnel (HCP) are at increased risk for infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), as a result of their exposure to patients or community contacts with COVID-19 (1,2). Since the first confirmed case of COVID-19 in Minnesota was reported on March 6, 2020, the Minnesota Department of Health (MDH) has required health care facilities* to report HCP† exposures to persons with confirmed COVID-19 for exposure risk assessment and to enroll HCP with higher-risk exposures into quarantine and symptom monitoring. During March 6-July 11, MDH and 1,217 partnering health care facilities assessed 21,406 HCP exposures; among these, 5,374 (25%) were classified as higher-risk§ (3). Higher-risk exposures involved direct patient care (66%) and nonpatient care interactions (e.g., with coworkers and social and household contacts) (34%). Within 14 days following a higher-risk exposure, nearly one third (31%) of HCP who were enrolled in monitoring reported COVID-19-like symptoms,¶ and more than one half (52%) of enrolled HCP with symptoms received positive SARS-CoV-2 test results. Among all HCP with higher-risk exposures, irrespective of monitoring enrollment, 7% received positive SARS-CoV-2 test results. Compared with HCP with higher-risk exposures working in acute care settings, those working in congregate living or long-term care settings more often returned to work (57%), worked while symptomatic (5%), and received a positive test result (10%) during 14-day postexposure monitoring than did HCP working outside of such settings. These data highlight the need for awareness of nonpatient care SARS-CoV-2 exposure risks and for targeted interventions to protect HCP, in addition to residents, in congregate living and long-term care settings. To minimize exposure risk among HCP, health care facilities need improved infection prevention and control, consistent personal protective equipment (PPE) availability and use, flexible sick leave, and SARS-CoV-2 testing access. All health care organizations and HCP should be aware of potential exposure risk from coworkers, household members, and social contacts.


Subject(s)
Coronavirus Infections/transmission , Health Personnel/statistics & numerical data , Infectious Disease Transmission, Patient-to-Professional , Occupational Exposure/adverse effects , Pneumonia, Viral/transmission , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Humans , Middle Aged , Minnesota/epidemiology , Occupational Exposure/statistics & numerical data , Pandemics/prevention & control , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , Risk Assessment , Young Adult
18.
MMWR Morb Mortal Wkly Rep ; 69(35): 1221-1226, 2020 Sep 04.
Article in English | MEDLINE | ID: covidwho-1389852

ABSTRACT

Health care personnel (HCP) caring for patients with coronavirus disease 2019 (COVID-19) might be at high risk for contracting SARS-CoV-2, the virus that causes COVID-19. Understanding the prevalence of and factors associated with SARS-CoV-2 infection among frontline HCP who care for COVID-19 patients are important for protecting both HCP and their patients. During April 3-June 19, 2020, serum specimens were collected from a convenience sample of frontline HCP who worked with COVID-19 patients at 13 geographically diverse academic medical centers in the United States, and specimens were tested for antibodies to SARS-CoV-2. Participants were asked about potential symptoms of COVID-19 experienced since February 1, 2020, previous testing for acute SARS-CoV-2 infection, and their use of personal protective equipment (PPE) in the past week. Among 3,248 participants, 194 (6.0%) had positive test results for SARS-CoV-2 antibodies. Seroprevalence by hospital ranged from 0.8% to 31.2% (median = 3.6%). Among the 194 seropositive participants, 56 (29%) reported no symptoms since February 1, 2020, 86 (44%) did not believe that they previously had COVID-19, and 133 (69%) did not report a previous COVID-19 diagnosis. Seroprevalence was lower among personnel who reported always wearing a face covering (defined in this study as a surgical mask, N95 respirator, or powered air purifying respirator [PAPR]) while caring for patients (5.6%), compared with that among those who did not (9.0%) (p = 0.012). Consistent with persons in the general population with SARS-CoV-2 infection, many frontline HCP with SARS-CoV-2 infection might be asymptomatic or minimally symptomatic during infection, and infection might be unrecognized. Enhanced screening, including frequent testing of frontline HCP, and universal use of face coverings in hospitals are two strategies that could reduce SARS-CoV-2 transmission.


Subject(s)
Antibodies, Viral/blood , Betacoronavirus/immunology , Coronavirus Infections/epidemiology , Personnel, Hospital/statistics & numerical data , Pneumonia, Viral/epidemiology , Academic Medical Centers , Adult , Asymptomatic Diseases , COVID-19 , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Cross Infection/prevention & control , Female , Humans , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Male , Middle Aged , Pandemics/prevention & control , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , SARS-CoV-2 , Seroepidemiologic Studies , United States/epidemiology
20.
Health Qual Life Outcomes ; 19(1): 207, 2021 Aug 28.
Article in English | MEDLINE | ID: covidwho-1376587

ABSTRACT

BACKGROUND: The effect of COVID-19 on Health-Care Professionals' mental health has received increased attention in the last year's literature. However, previous studies essentially evaluated psychopathological symptoms and not the presence of positive mental health. Therefore, the first objective of the present research is to evaluate health-care professionals' mental illness (i.e., anxiety and traumatic intensity) and positive mental health (i.e., well-being) using the Complete State Model of Health. Our second objective is to study the effect of Personal Protection Equipment availability on professionals' mental health. METHODS: Two-hundred and thirty-two health-care professionals working in Spain in the first line of COVID-19 patient care participated in the study. To measure anxiety, traumatic intensity and well-being participants completed the State Trait Anxiety Inventory, the Davidson Trauma Scale, and the Mental Health Continuum-Short Form. Pearson correlations were used to examine the relationships between all scales. In order to test the two continua model of mental health, we used parallel analysis and exploratory factor analysis. To analyze anxiety, traumatic intensity, and well-being differences between health-care professionals with and without Personal Protection Equipment availability we conducted different ANOVAS. To test our hypothesis regarding the moderating role of Personal Protection Equipment availability in the effect of mental illness on positive mental health, data were subjected to a hierarchical regression analysis. RESULTS: As in previous studies, health-care professionals showed high levels of anxiety and traumatic intensity. They also presented low levels of well-being indicators. According to our hypothesis, results of parallel analysis and exploratory factorial analysis indicated that the measures of mental illness and positive mental health loaded on separate but correlated factors. Finally, Personal Protection Equipment availability moderated the effects of state anxiety and traumatic intensity on professionals' well-being. CONCLUSIONS: Health-care professionals' mental illness and positive mental health reflect distinct continua, rather than the extreme ends of a single spectrum. Therefore, it is essential to measure both psychopathology and the presence of positive health to comprehensively evaluate professionals' mental health. Finally, our results indicated that Personal Protection Equipment availability is essential not only for professionals' physical health, but also for their mental health.


Subject(s)
Anxiety/psychology , COVID-19/psychology , Health Personnel/psychology , Personal Protective Equipment/supply & distribution , Quality of Life/psychology , Adult , Aged , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Personal Protective Equipment/statistics & numerical data , SARS-CoV-2 , Spain/epidemiology
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