scholarly journals Impact of Personal Protective Equipment on the Performance of Emergency Pediatric Procedures by Prehospital Providers

2020 ◽  
pp. 1-8
Author(s):  
Maybelle Kou ◽  
Aaron J. Donoghue ◽  
Helen Stacks ◽  
Adam Kochman ◽  
Meghan Semião ◽  
...  
Keyword(s):  
Pediatric Patient ◽  
Personal Protective Equipment ◽  
Clinical Care ◽  
Chemical Exposure ◽  
Task Completion ◽  
Protective Equipment ◽  
Signed Rank ◽  
The Difference ◽  
Simulation Center ◽  
Bag Mask Ventilation

ABSTRACT Background: Personal protective equipment (PPE) is worn by prehospital providers (PHPs) for protection from hazardous exposures. Evidence regarding the ability of PHPs to perform resuscitation procedures has been described in adult but not pediatric models. This study examined the effects of PPE on the ability of PHPs to perform resuscitation procedures on pediatric patients. Methods: This prospective study was conducted at a US simulation center. Paramedics wore normal attire at the baseline session and donned full Level B PPE for the second session. During each session, they performed timed sets of psychomotor tasks simulating clinical care of a critically ill pediatric patient. The difference in time to completion between baseline and PPE sessions per task was examined using Wilcoxon signed-rank tests. Results: A total of 50 paramedics completed both sessions. Median times for task completion at the PPE sessions increased significantly from baseline for several procedures: tracheal intubation (+4.5 s; P = 0.01), automated external defibrillator (AED) placement (+9.5 s; P = 0.01), intraosseous line insertion (+7 s; P < 0.0001), tourniquet (+8.5 s; P < 0.0001), intramuscular injection (+21-23 s, P < 0.0001), and pulse oximetry (+4 s; P < 0.0001). There was no significant increase in completion time for bag-mask ventilation or autoinjector use. Conclusions: PPE did not have a significant impact on PHPs performing critical tasks while caring for a pediatric patient with a highly infectious or chemical exposure. This information may guide PHPs faced with the situation of resuscitating children while wearing Level B PPE.

The challenge of infection control in patients' homes

2021 ◽  
Vol 26 (4) ◽  
pp. 168-174
Author(s):  
Drew Payne ◽  
Martin Peache
Keyword(s):  
Infectious Disease ◽  
Disease Management ◽  
Hand Hygiene ◽  
Infection Control ◽  
Personal Protective Equipment ◽  
Clinical Care ◽  
Cross Infection ◽  
Protective Equipment ◽  
Unique Challenge ◽  
Clinical Equipment

Infection control is the responsibility of all nurses, but, traditionally, it has been seen as a priority only in hospitals. Infection control does not stop when a patient is discharged home, but should be practiced wherever clinical care takes place. Community nurses face a unique challenge as they work in patients' homes, and they must manage infection control in that unique environment. This article looks at practical ways to maintain infection control in patients' homes. It covers hand hygiene and personal protective equipment (PPE), including the five moments of hand hygiene, appropriate hand hygiene, the use of all PPE and when gloves are required and when they are not. It also discusses managing clinical equipment, both that taken into the home and that left with a patient, including decontamination, safe storage of sharps and waste management. It touches upon what can be done in a patient's home to reduce the risk of contamination, as well as infectious disease management, including specimens and wound infection management. Lastly, it talks about cross-infection and why staff health is also important.

scholarly journals Impact of an e-learning module on personal protective equipment knowledge in student paramedics: a randomized controlled trial

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Laurent Suppan ◽  
Loric Stuby ◽  
Birgit Gartner ◽  
Robert Larribau ◽  
Anne Iten ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Controlled Trial ◽  
Ambulance Service ◽  
Protective Equipment ◽  
Post Intervention ◽  
Learning Group ◽  
Learning Module ◽  
E Learning ◽  
The Difference ◽  
The Impact

Abstract Background Prehospital professionals such as emergency physicians or paramedics must be able to choose and adequately don and doff personal protective equipment (PPE) in order to avoid COVID-19 infection. Our aim was to evaluate the impact of a gamified e-learning module on adequacy of PPE in student paramedics. Methods This was a web-based, randomized 1:1, parallel-group, triple-blind controlled trial. Student paramedics from three Swiss schools were invited to participate. They were informed they would be presented with both an e-learning module and an abridged version of the current regional prehospital COVID-19 guidelines, albeit not in which order. After a set of 22 questions designed to assess baseline knowledge, the control group was shown the guidelines before answering a set of 14 post-intervention questions. The e-learning group was shown the gamified e-learning module right after the guidelines, and before answering post-intervention questions. The primary outcome was the difference in the percentage of adequate choices of PPE before and after the intervention. Results The participation rate was of 71% (98/138). A total of 90 answer sets was analyzed. Adequate choice of PPE increased significantly both in the control (50% [33;83] vs 25% [25;50], P = .013) and in the e-learning group (67% [50;83] vs 25% [25;50], P = .001) following the intervention. Though the median of the difference was higher in the e-learning group, there was no statistically significant superiority over the control (33% [0;58] vs 17% [− 17;42], P = .087). The e-learning module was of greatest benefit in the subgroup of student paramedics who were actively working in an ambulance company (42% [8;58] vs 25% [− 17;42], P = 0.021). There was no significant effect in student paramedics who were not actively working in an ambulance service (0% [− 25;33] vs 17% [− 8;50], P = .584). Conclusions The use of a gamified e-learning module increases the rate of adequate choice of PPE only among student paramedics actively working in an ambulance service. In this subgroup, combining this teaching modality with other interventions might help spare PPE and efficiently protect against COVID-19 infection.

scholarly journals Cost of Personal Protective Equipment During the First Wave of COVID-19

2021 ◽  
Vol 1 (S1) ◽  
pp. s49-s49
Author(s):  
Alfredo Mena Lora ◽  
Mirza Ali ◽  
Sherrie Spencer ◽  
Eden Takhsh ◽  
Candice Krill ◽  
...  
Keyword(s):  
Supply Chains ◽  
Personal Protective Equipment ◽  
Face Mask ◽  
Protective Equipment ◽  
Market Prices ◽  
Maximum Cost ◽  
Pandemic Response ◽  
The Difference ◽  
N95 Respirators ◽  
The Impact

Background: As the world prepared for and responded to the COVID-19 pandemic in early 2020, a rapid increase in demand for personal protective equipment (PPE) led to severe shortages worldwide. Acquisition of PPE in the general market was an integral part of pandemic response, along with the safeguarding of hospital supplies. We seek to quantify the difference in cost per unit (CPU) of PPE during the first wave of COVID-19 compared to prepandemic prices. Methods: We performed a retrospective review of market prices for PPE during the first surge of the pandemic in Chicago. Cost of PPE was tabulated and compared with prepandemic prices. The maximum cost per unit (CPU) of PPE was tabulated for each week, and the average cost throughout the pandemic was calculated. Disposable gowns, washable gowns, N95 respirators, face masks, and gloves were included in our analysis. Results: PPE prices were significantly higher during the pandemic compared to prepandemic prices (Figure 1). Disposable gown CPU peaked at $12 during the first week of March, 13.7 times higher than prepandemic prices, and the average gown CPU was 7.5 times higher than prepandemic prices. N95 respirators had a peak CPU of $12, and average CPU was 8 times higher than prepandemic prices. Face-mask CPU peaked at $0.55, 11 times higher, and averaged 9 times higher the regular price. Gloves averaged 2.5 times higher than the prepandemic CPU. Conclusions: Market prices for PPE were significantly elevated during the first weeks of the pandemic and remained high throughout the first wave of COVID-19. Multiple factors likely contributed to high prices, including demand shock, disrupted supply chains, and a rush to acquisition by healthcare systems and the general population alike. The impact of COVID-19 on prices highlights the importance of supply chains and national stockpiles for pandemic preparedness.Funding: NoDisclosures: None

scholarly journals Effect of Wearing Personal Protective Equipment (PPE) on CPR Quality in Times of the COVID-19 Pandemic—A Simulation, Randomised Crossover Trial

2021 ◽  
Vol 10 (8) ◽  
pp. 1728
Author(s):  
Simon Rauch ◽  
Michiel Jan van Veelen ◽  
Rosmarie Oberhammer ◽  
Tomas Dal Cappello ◽  
Giulia Roveri ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Resuscitation Guidelines ◽  
Significant Difference ◽  
Negative Effect ◽  
Cpr Quality ◽  
The Difference ◽  
Analyse Data ◽  
And Performance

Cardiopulmonary resuscitation (CPR) is considered an aerosol-generating procedure. Consequently, COVID-19 resuscitation guidelines recommend the use of personal protective equipment (PPE) during resuscitation. In this simulation of randomised crossover trials, we investigated the influence of PPE on the quality of chest compressions (CCs). Thirty-four emergency medical service BLS-providers performed two 20 min CPR sequences (five 2 min cycles alternated by 2 min of rest) on manikins, once with and once without PPE, in a randomised order. The PPE was composed of a filtering facepiece 3 FFP3 mask, safety glasses, gloves and a long-sleeved gown. The primary outcome was defined as the difference between compression depth with and without PPE; secondary outcomes were defined as differences in CC rate, release and the number of effective CCs. The participants graded fatigue and performance, while generalised estimating equations (GEE) were used to analyse data. There was no significant difference in CC quality between sequences without and with PPE regarding depth (mean depth 54 ± 5 vs. 54 ± 6 mm respectively), rate (mean rate 119 ± 9 and 118 ± 6 compressions per minute), release (mean release 2 ± 2 vs. 2 ± 2 mm) and the number of effective CCs (43 ± 18 vs. 45 ± 17). The participants appraised higher fatigue when equipped with PPE in comparison to when equipped without PPE (p < 0.001), and lower performance was appraised when equipped with PPE in comparison to when equipped without PPE (p = 0.031). There is no negative effect of wearing PPE on the quality of CCs during CPR in comparison to not wearing PPE.

scholarly journals The Impact of COVID-19 Vaccination on Anxiety Levels of Turkish Dental Professionals and Their Attitude in Clinical Care: A Cross-Sectional Study

2021 ◽  
Vol 18 (19) ◽  
pp. 10373
Author(s):  
Fatih Karayürek ◽  
Ahmet Taylan Çebi ◽  
Aydın Gülses ◽  
Mustafa Ayna
Keyword(s):  
Personal Protective Equipment ◽  
Clinical Care ◽  
Protective Equipment ◽  
Main Concern ◽  
Positive Effects ◽  
Number Of Patients ◽  
Anxiety Levels ◽  
Fear And Anxiety ◽  
The Impact ◽  
Dental Professionals

Background: The current study aimed to assess the anxiety and fear levels and the attitude towards clinical care, such as the use of personal protective equipment and number of patients examined, before and after COVID-19 vaccination among Turkish dental professionals. Methods: A questionnaire including socio-demographical characteristics and clinical data regarding the number of patients, the use of personal protective equipment, vaccine confidence interval, positive or negative COVID-19 diagnosis, and fear and anxiety levels were examined. Results: A total of 475 dentists (196 men and 279 women) participated. Overall, the vaccination had a positive effect on the decrease of fear and anxiety levels of dental professionals. It was observed that the number of interventional procedures significantly increased after vaccination. Besides that, the amount of personal protective equipment used in patients, especially after the vaccination, has decreased. Conclusion: Despite the positive effects of vaccination on the anxiety levels of dental professionals, protective measurements should further be the main concern, regardless of the vaccination status of both the dental professional and the patient.

scholarly journals Effect of an E-Learning Module on Personal Protective Equipment Proficiency Among Prehospital Personnel: Web-Based Randomized Controlled Trial

10.2196/21265 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e21265 ◽  
Author(s):  
Laurent Suppan ◽  
Mohamed Abbas ◽  
Loric Stuby ◽  
Philippe Cottet ◽  
Robert Larribau ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Control Group ◽  
Protective Equipment ◽  
Web Based ◽  
Learning Group ◽  
Randomized Controlled ◽  
Learning Module ◽  
E Learning ◽  
Baseline Knowledge ◽  
The Difference

Background To avoid misuse of personal protective equipment (PPE), ensure health care workers’ safety, and avoid shortages, effective communication of up-to-date infection control guidelines is essential. As prehospital teams are particularly at risk of contamination given their challenging work environment, a specific gamified electronic learning (e-learning) module targeting this audience might provide significant advantages as it requires neither the presence of learners nor the repetitive use of equipment for demonstration. Objective The aim of this study was to evaluate whether a gamified e-learning module could improve the rate of adequate PPE choice by prehospital personnel in the context of the coronavirus disease (COVID-19) pandemic. Methods This was an individual-level randomized, controlled, quadruple-blind (investigators, participants, outcome assessors, and data analysts) closed web-based trial. All emergency prehospital personnel working in Geneva, Switzerland, were eligible for inclusion, and were invited to participate by email in April 2020. Participants were informed that the study aim was to assess their knowledge regarding PPE, and that they would be presented with both the guidelines and the e-learning module, though they were unaware that there were two different study paths. All participants first answered a preintervention quiz designed to establish their profile and baseline knowledge. The control group then accessed the guidelines before answering a second set of questions, and were then granted access to the e-learning module. The e-learning group was shown the e-learning module right after the guidelines and before answering the second set of questions. Results Of the 291 randomized participants, 176 (60.5%) completed the trial. There was no significant difference in baseline knowledge between groups. Though the baseline proportion of adequate PPE choice was high (75%, IQR 50%-75%), participants’ description of the donning sequence was in most cases incorrect. After either intervention, adequate choice of PPE increased significantly in both groups (P<.001). Though the median of the difference in the proportion of correct answers was slightly higher in the e-learning group (17%, IQR 8%-33% versus 8%, IQR 8%-33%), the difference was not statistically significant (P=.27). Confidence in the ability to use PPE was maintained in the e-learning group (P=.27) but significantly decreased in the control group (P=.04). Conclusions Among prehospital personnel with an already relatively high knowledge of and experience with PPE use, both web-based study paths increased the rate of adequate choice of PPE. There was no major added value of the gamified e-learning module apart from preserving participants' confidence in their ability to correctly use PPE.

scholarly journals Study on the Effectiveness Evaluation of Personal Protective Equipment for Health Care Staff Trained with Graphical Interpretation and Operation

2019 ◽  
Vol 34 (s1) ◽  
pp. s168-s169
Author(s):  
Yang Sha ◽  
You Jian-Ping ◽  
Zhang Hui-Lan ◽  
Luo Hong-Xia
Keyword(s):  
Personal Protective Equipment ◽  
Medical Staff ◽  
Emerging Infectious Diseases ◽  
Error Rates ◽  
Care Staff ◽  
Whole Body ◽  
Health Care Staff ◽  
Protective Equipment ◽  
Training Methods ◽  
The Difference

Introduction:Proper use of personal protective equipment (PPE) is essential when facing emerging infectious diseases. Proper training methods can promote the use of the PPE correctly.Aim:To explore the effect of the training method of sequential operation training on medical staff to master PPE penetration and removal skills, and to study the memory attenuation after training.Methods:Fifteen medical staff with no experience of PPE operation in a hospital were trained to wear PPE in accordance with WHO standards by illustration and sequential operation method. The training included 30 minutes of theoretical teaching and 60 minutes of practical exercises. At the end of the training and 1 week after the training, the training objects were evaluated for PPE operation. A 2.5 x 2.5 cm fluorescent agent was applied on 6 parts, such as hands, chest, abdomen, and knees, to simulate contamination. After taking the PPE off, the parts of the whole body and the inner layer of clothing that were fluorescently contaminated were recorded. The whole operation process was recorded by video to evaluate whether the operation was correct. The error rates of two operations and the contamination position and frequency were compared.Results:The error rate of the operating PPE after training was 18.6%, rising to 31.9% after 1 week (Z=16.0, P<0.05). After the training, the average number of contaminated PPE removal was 1.96±1.56, which rose to 2.96±2.03 one month later. The difference was statistically significant (Z=8.92, P<0.05). The main vulnerable sites are the wrist, chest, abdomen, and left calf.Discussion:Illustrative sequential operation training is an important means to improve the way for medical staff to wear PPE, but it must be completed more than once to ensure that medical staff can firmly master the skills of wearing and removing PPE.

scholarly journals Effect of an E-Learning Module on Personal Protective Equipment Proficiency Among Prehospital Personnel: Web-Based Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Laurent Suppan ◽  
Mohamed Abbas ◽  
Loric Stuby ◽  
Philippe Cottet ◽  
Robert Larribau ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Control Group ◽  
Protective Equipment ◽  
Web Based ◽  
Learning Group ◽  
Randomized Controlled ◽  
Learning Module ◽  
E Learning ◽  
Baseline Knowledge ◽  
The Difference

BACKGROUND To avoid misuse of personal protective equipment (PPE), ensure health care workers’ safety, and avoid shortages, effective communication of up-to-date infection control guidelines is essential. As prehospital teams are particularly at risk of contamination given their challenging work environment, a specific gamified electronic learning (e-learning) module targeting this audience might provide significant advantages as it requires neither the presence of learners nor the repetitive use of equipment for demonstration. OBJECTIVE The aim of this study was to evaluate whether a gamified e-learning module could improve the rate of adequate PPE choice by prehospital personnel in the context of the coronavirus disease (COVID-19) pandemic. METHODS This was an individual-level randomized, controlled, quadruple-blind (investigators, participants, outcome assessors, and data analysts) closed web-based trial. All emergency prehospital personnel working in Geneva, Switzerland, were eligible for inclusion, and were invited to participate by email in April 2020. Participants were informed that the study aim was to assess their knowledge regarding PPE, and that they would be presented with both the guidelines and the e-learning module, though they were unaware that there were two different study paths. All participants first answered a preintervention quiz designed to establish their profile and baseline knowledge. The control group then accessed the guidelines before answering a second set of questions, and were then granted access to the e-learning module. The e-learning group was shown the e-learning module right after the guidelines and before answering the second set of questions. RESULTS Of the 291 randomized participants, 176 (60.5%) completed the trial. There was no significant difference in baseline knowledge between groups. Though the baseline proportion of adequate PPE choice was high (75%, IQR 50%-75%), participants’ description of the donning sequence was in most cases incorrect. After either intervention, adequate choice of PPE increased significantly in both groups (<i>P</i>&lt;.001). Though the median of the difference in the proportion of correct answers was slightly higher in the e-learning group (17%, IQR 8%-33% versus 8%, IQR 8%-33%), the difference was not statistically significant (<i>P</i>=.27). Confidence in the ability to use PPE was maintained in the e-learning group (<i>P</i>=.27) but significantly decreased in the control group (<i>P</i>=.04). CONCLUSIONS Among prehospital personnel with an already relatively high knowledge of and experience with PPE use, both web-based study paths increased the rate of adequate choice of PPE. There was no major added value of the gamified e-learning module apart from preserving participants' confidence in their ability to correctly use PPE.

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