Postpandemic Evaluation of the Eco-Efficiency of Personal Protective Equipment Against COVID-19 in Emergency Departments: Proposal for a Mixed Methods Study.

BACKGROUND: The COVID-19 pandemic has had a profound impact on emergency department (ED) care in Canada and around the world. To prevent transmission of COVID-19, personal protective equipment (PPE) was required for all ED care providers in contact with suspected cases. With mass vaccination and improvements in several infection prevention components, our hypothesis is that the risks of transmission of COVID-19 will be significantly reduced and that current PPE use will have economic and ecological consequences that exceed its anticipated benefits. Evidence is needed to evaluate PPE use so that recommendations can ensure the clinical, economic, and environmental efficiency (ie, eco-efficiency) of its use. OBJECTIVE: To support the development of recommendations for the eco-efficient use of PPE, our research objectives are to (1) estimate the clinical effectiveness (reduced transmission, hospitalizations, mortality, and work absenteeism) of PPE against COVID-19 for health care workers; (2) estimate the financial cost of using PPE in the ED for the management of suspected or confirmed COVID-19 patients; and (3) estimate the ecological footprint of PPE use against COVID-19 in the ED. METHODS: We will conduct a mixed method study to evaluate the eco-efficiency of PPE use in the 5 EDs of the CHU de Québec-Université Laval (Québec, Canada). To achieve our goals, the project will include four phases: systematic review of the literature to assess the clinical effectiveness of PPE (objective 1; phase 1); cost estimation of PPE use in the ED using a time-driven activity-based costing method (objective 2; phase 2); ecological footprint estimation of PPE use using a life cycle assessment approach (objective 3; phase 3); and cost-consequence analysis and focus groups (integration of objectives 1 to 3; phase 4). RESULTS: The first 3 phases have started. The results of these phases will be available in 2023. Phase 4 will begin in 2023 and results will be available in 2024. CONCLUSIONS: While the benefits of PPE use are likely to diminish as health care workers' immunity increases, it is important to assess its economic and ecological impacts to develop recommendations to guide its eco-efficient use. TRIAL REGISTRATION: PROSPERO CRD42022302598; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=302598. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/50682.

Factors associated with noncompliance of sodium restriction in hypertensive and heart failure patients at the National Hospital of Cotonou, Benin.

INTRODUCTION: Nutritional therapy in the treatment of high blood pressure and heart failure is a real challenge in terms of compliance of sodium restriction for success of the treatment. The study aims to assess the level of patient compliance with the sodium restriction by salt consumption, prescribed by care providers and the associated factors. MATERIALS AND METHODS: Total daily salt intake was estimated in a cross-sectional study of 166 hypertensive and heart failure subjects monitored in the cardiology department of the "Centre Hospitalier Universitaire - Hubert Koutoukou Maga" (CNHU-HKM), using two 24-hour recalls combined with a food frequency questionnaire for salt-providing foods. RESULTS: Out of the study, 83.7% of patients had a daily intake above recommendations. Factors associated with the non-compliance of salt restriction were the lack of knowledge of palliative spices and herbs of salty taste (p=0.009) and the consumption of salty snack foods and salty peanuts (p=0.032). CONCLUSION: Nutritional education and support activities should be carried out to improve the salt reduction compliance for these patients.