Unintended consequences of long-sleeved gowns in a critical care setting during the COVID-19 pandemic.

At the peak of the coronavirus disease 2019 (COVID-19) pandemic, hand hygiene audits indicated decreased compliance in a 12-bed critical care (CC) area with ventilated COVID-19 patients, where staff used personal protective equipment (PPE), including sessional use of long-sleeved gowns in accordance with the recommendations of Public Health England. There was also a cluster of three central venous catheter (CVC) infections along with increases in the number of patients from whom enteric Gram-negative bacteria (GNB) were isolated from sterile sites. Environmental sampling of near-patient surfaces and frequently touched sites demonstrated that 11.5% of areas were contaminated with enteric GNB in the COVID-19 CC area, compared with 2.6% and 2.7% in COVID-19 and non-COVID-19 general wards, respectively. Following a risk assessment, hospital policy was changed to replace long-sleeved gowns with short-sleeved gowns. The CC unit underwent enhanced cleaning with hypochlorite-based disinfectant and was resampled 8 days later. On resampling, no GNB were isolated from the CC unit. Following this change in PPE, hand hygiene compliance returned to baseline standards and no further CVC infections were identified. Staff reported a preference for short-sleeved gowns. No evidence currently exists that PPE beyond that recommended for pandemic influenza (respiratory protection plus standard PPE) adds to the protection of healthcare workers (HCWs) from severe acute respiratory syndrome coronavirus-2. Long-sleeved gowns prevent HCWs performing hand hygiene effectively. While it is imperative that HCWs are adequately protected, protection of patients from infection hazards is equally important. Further studies are necessary to establish risks from PPE to inform a review of current guidance.

Developing antiviral surgical gown using nonwoven fabrics for health care sector.

BACKGROUND: Healthcare workers' uniforms including surgical gowns are used as barriers to eliminate the risk of infection for both doctor and patient. The prevalence of human immunodeficiency virus, hepatitis B and C viruses in the patient population is very common. OBJECTIVES: To develop antiviral surgical gown comprising of Polypropylene nonwoven as outer layer, Polytetrafluroethylene (PTFE) film as middle layer and polyester nonwoven as inner layer and the surgical gown with a basic weight of 70 g/m(2). METHODS: The titanium dioxide (TiO2) nano dispersion was prepared with methylene blue and urea as a reacting medium. These nano particles have an average size of 9 nm which was revealed by High resolution transmission electron microscope. The nonwoven fabric pore size was characterised by using digital image analyzer. The polypropylene nonwoven fabrics were treated with nano dispersion by pad-dry-cure method and trilaminate fabric was formed using fusing machine. The presence of nano particle on the surface of the non woven fabric was confirmed by Scanning Electron microscope. RESULTS: The trilaminate surgical gown has passed ASTM 1671 viral penetration test which is mandatory for healthcare facilities. The average pore size of inner, middle and outer layer were found as 0.187, 0.4 and 0.147 micron respectively. The tensile strength of the trilaminate fabric in both machine and cross direction was 145 N and 94 N respectively. The tearing strength of the trilaminate fabric in direction I and II was 10 N and 4 N respectively. The hydrostatic and index puncture resistance of the trilaminate fabric was 2930 mmwc and 58.8 N respectively. The moisture vapour permeability of the fabric was exhibited as 585.7 g/m(2)/day. CONCLUSIONS: The surgical gown exhibits antiviral property which can protect the health care people from human immunodeficiency virus.