A tool for the management of personal protective equipment during COVID-19 pandemic: Abderrahmen Mami Hospital case study.

INTRODUCTION: The COVID-19 pandemic is causing management difficulties in the Tunisian healthcare system inventory management and the supply of Personal Protective Equipment (PPE). AIM: Calculate the number of PPE needed for MAMI Hospital Ariana (dedicated hospital to COVID patients) to avoid stock-outs. METHODS: This study proposed a calculation method of the PPE needs for the intensive care and pneumology departments. We developed a mathematical formulation of the number of PPE needed according to the number of visits per medical and other teams, their types, the number of patients, and the validity of each type of PPE. RESULTS: Considering as input data: the number of visits for the different intervening teams (medical, paramedical, worker or other), the capacity of the different services (number of beds), the average length of stay of patients, the validity duration of an equipment and urgent visits, the developed model generates the required number of PPE (especially surgical masks, FFP2 masks, disposables gowns and coveralls). This allows to calculate the number of personal protective equipment (PPE) needed by the Mami hospital's pharmacy in this period of COVID-19 crisis. CONCLUSION: Our configurable application allowed us to calculate PPE requirements for the intensive care and pneumology departments and estimate their use duration.

Prevalence and risk factors of pressure ulcers in a Tunisian hospital.

BACKGROUND: the aim of thisstudywas to investigate the prevalence of pressure ulcers in hospitalized patients at the Charles Nicolle Hospital in Tunis, measure the risk of their occurrence, analyzepreventive and curative measuresundertaken and evaluatefactorspredisposing to pressure ulcers. METHODS: A one-day survey was performed in all hospitalized patients. Emergency services, neonatology and pediatrics were excluded. The Braden scale was used to measure the patient's risk for the development of pressure ulcers. Analysis of risk factors was performed using SPSS version 19 software. RESULTS: A total of 473 patients was included. The mean age was 52.26 years. Nearly 10% of patients had a moderate or a high risk of developing pressure ulcers with a Braden score less than 18. The prevalence of patients with pressure ulcers was 5.3% with a prevalence of 4.7% of nosocomial pressure ulcer. There was no significant difference in prevalence between medical and surgical services. The prevalence was relatively more important in intensive care and general surgery. The most frequent sites were sacrum and heels. Stages 3 (46.4%) and 2 (37.5%) were the mainly stages descriped. Evaluation of management of bedsores formed revealed that half was treated with modern wound dressings. Statistical analysis revealed that a Braden score <18 is correlated with pressure ulcers ( 96% of patients with bedsores. Patients transferred from other services, patients recently operated or those with probably inadequate diet seem to be more at risk of developing pressure ulcers. In contrast, age and sex were not identified as significant risk factors. CONCLUSION: pressure ulcer remains a significant problem in hospital.  This problem is preventable when applying adequate prevention but its management requires a multidisciplinary approach.