scholarly journals Evaluation of Viral Surrogate Markers for Study of Pathogen Dissemination During Simulations of Patient Care

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Heba Alhmidi ◽  
Amrita John ◽  
Thriveen C. Mana ◽  
Sreelatha Koganti ◽  
Jennifer L. Cadnum ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Patient Care ◽  
Mosaic Virus ◽  
Personal Protective Equipment ◽  
Cauliflower Mosaic Virus ◽  
Protective Equipment ◽  
Surrogate Markers ◽  
Bacteriophage Ms2

Abstract During patient care simulations, cauliflower mosaic virus DNA and bacteriophage MS2 performed similarly as surrogate markers of pathogen dissemination. These markers disseminated to the environment in a manner similar to Clostridium difficile spores but were more frequently detected on skin and clothing of personnel after personal protective equipment removal.

scholarly journals Dissemination of Methicillin-Resistant Staphylococcus aureus (MRSA) and Viral Surrogate Markers Outside Patient Rooms

2020 ◽  
Vol 41 (S1) ◽  
pp. s193-s194
Author(s):  
Daniel Li ◽  
Natalia Pinto Herrera ◽  
Heba Alhmidi ◽  
Jennifer Cadnum ◽  
Curtis Donskey
Keyword(s):  
Staphylococcus Aureus ◽  
Mosaic Virus ◽  
Dna Marker ◽  
Pathogen Transmission ◽  
Cauliflower Mosaic Virus ◽  
Surrogate Markers ◽  
Viral Dna ◽  
Term Care ◽  
Methicillin Resistant ◽  
Bacteriophage Ms2

Background: Patients with methicillin-resistant Staphylococcus aureus (MRSA) colonization often shed MRSA, resulting in contamination of surfaces in their room. It is not known whether MRSA-colonized patients also frequently contaminate surfaces during medical appointments and other activities outside their room. Methods: We conducted an observational cohort study of MRSA-colonized long-term care facility (LTCF) residents to determine the frequency and mechanisms of contamination of surfaces outside patient rooms. Nares, skin, and clothing of patients in contact precautions for MRSA were cultured for MRSA, and high-touch surfaces in the residents’ room were contaminated with the live virus bacteriophage MS2 and cauliflower mosaic virus DNA. The participants were observed during activities and medical appointments outside their rooms for 3 days, and sites that were contacted were sampled for recovery of MRSA, bacteriophage MS2, and cauliflower mosaic virus DNA. Results: As shown in Fig. 1, bacteriophage MS2 and cauliflower mosaic virus DNA was transferred to 1 or more surfaces outside the resident’s room by 5 of the 7 participants, and MRSA was recovered from surfaces touched by 6 (86%) participants. MRSA was recovered during 16 of 35 episodes (46%) where sampling was performed, and recovery was similar for medical appointments (eg, hemodialysis, physical therapy) and nonmedical activities (eg, using the dining room or activity center). Moreover, MRSA, MS2, and the viral DNA marker were recovered both from sites contacted only by participants’ hands and from sites contacted only by clothing. Bacteriophage MS2 and the viral DNA marker were also recovered from portable equipment and from the nursing station. Conclusions: MRSA-colonized LTCF residents frequently disseminated MRSA and viral surrogate markers to surfaces outside their rooms through contact with contaminated hands and clothing. Efforts to reduce contamination of hands and clothing might reduce the risk for pathogen transmission.Funding: NoneDisclosures: None

Use of simulations to evaluate the effectiveness of barrier precautions to prevent patient-to-patient transfer of healthcare-associated pathogens

2020 ◽  
pp. 1-6
Author(s):  
Heba Alhmidi ◽  
Daniel F. Li ◽  
Jennifer L. Cadnum ◽  
Muhammed F. Haq ◽  
Natalia C. Pinto-Herrera ◽  
...  
Keyword(s):  
Mosaic Virus ◽  
Pathogen Transmission ◽  
Cauliflower Mosaic Virus ◽  
Surrogate Markers ◽  
Fluorescent Tracer ◽  
Clostridioides Difficile ◽  
Bacteriophage Ms2 ◽  
Different Types ◽  
Healthcare Associated ◽  
Standardized Examinations

Abstract Background: There is controversy regarding whether the addition of cover gowns offers a substantial benefit over gloves alone in reducing personnel contamination and preventing pathogen transmission. Design: Simulated patient care interactions. Objective: To evaluate the efficacy of different types of barrier precautions and to identify routes of transmission. Methods: In randomly ordered sequence, 30 personnel each performed 3 standardized examinations of mannequins contaminated with pathogen surrogate markers (cauliflower mosaic virus DNA, bacteriophage MS2, nontoxigenic Clostridioides difficile spores, and fluorescent tracer) while wearing no barriers, gloves, or gloves plus gowns followed by examination of a noncontaminated mannequin. We compared the frequency and routes of transfer of the surrogate markers to the second mannequin or the environment. Results: For a composite of all surrogate markers, transfer by hands occurred at significantly lower rates in the gloves-alone group (OR, 0.02; P < .001) and the gloves-plus-gown group (OR, 0.06; P = .002). Transfer by stethoscope diaphragms was common in all groups and was reduced by wiping the stethoscope between simulations (OR, 0.06; P < .001). Compared to the no-barriers group, wearing a cover gown and gloves resulted in reduced contamination of clothing (OR, 0.15; P < .001), but wearing gloves alone did not. Conclusions: Wearing gloves alone or gloves plus gowns reduces hand transfer of pathogens but may not address transfer by devices such as stethoscopes. Cover gowns reduce the risk of contaminating the clothing of personnel.

scholarly journals Rapid implementation of Inpatient eConsult Programme addresses new challenges for patient care during COVID-19 pandemic

2021 ◽  
pp. bmjinnov-2020-000557
Author(s):  
Sharon Rikin ◽  
Eric J Epstein ◽  
Inessa Gendlina
Keyword(s):  
Palliative Care ◽  
Infectious Diseases ◽  
Patient Care ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Qualitative Feedback ◽  
The Usa ◽  
New Challenges ◽  
Science Framework ◽  
Context Specific

IntroductionAt the early epicentre of the COVID-19 crisis in the USA, our institution saw a surge in the demand for inpatient consultations for areas impacted by COVID-19 (eg, infectious diseases, nephrology, palliative care) and shortages in personal protective equipment (PPE). We aimed to provide timely specialist input for consult requests during the COVID-19 pandemic by implementing an Inpatient eConsult Programme.MethodsWe used the reach, effectiveness, adoption, implementation and maintenance implementation science framework and run chart analysis to evaluate the reach, adoption and maintenance of the Inpatient eConsult Programme compared with traditional in-person consults. We solicited qualitative feedback from frontline physicians and specialists for programme improvements.ResultsDuring the study period, there were 46 available in-person consult orders and 21 new eConsult orders. At the peak of utilisation, 42% of all consult requests were eConsults, and by the end of the study period, utilisation fell to 20%. Qualitative feedback revealed subspecialties best suited for eConsults (infectious diseases, nephrology, haematology, endocrinology) and influenced improvements to the ordering workflow, documentation, billing and education regarding use.DiscussionWhen offered inpatient eConsult requests as an alternative to in-person consults in the context of a surge in patients with COVID-19, frontline physicians used eConsult requests and decreased use of in-person consults. As the demand for consults decreased and PPE shortages were no longer a major concern, eConsult utilisation decreased, revealing a preference for in-person consultations when possible.ConclusionsLessons learnt can be used to develop and implement inpatient eConsults to meet context-specific challenges at other institutions.

A Statewide Voluntary Movement Addressing the Shortage of Medical Supplies During the COVID-19 Pandemic

2021 ◽  
Vol 111 (9) ◽  
pp. 1595-1599
Author(s):  
Martin Krause ◽  
Andrew Henderson ◽  
Daniel Griner ◽  
Olivia S. Rissland ◽  
Jeremy Beard ◽  
...  
Keyword(s):  
Health Care ◽  
Additive Manufacturing ◽  
Patient Care ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Laser Cutting ◽  
Voluntary Movement ◽  
Protective Equipment ◽  
Medical Supplies ◽  
Care Workers

During the COVID-19 pandemic, a shortage of personal protective equipment compromised efficient patient care and provider safety. Volunteers from many different backgrounds worked to meet these demands. Additive manufacturing, laser cutting, and alternative supply chains were used to produce, test, and deliver essential equipment for health care workers and first responders. Distributed equipment included ear guards, face shields, and masks. Contingent designs were created for powered air-purifying respirator hoods, filtered air pumps, intubation shields, and N95 masks.

scholarly journals Compounding sterile products during a personal protective equipment shortage

2021 ◽  
Author(s):  
Amanda Danielle Wollitz ◽  
Christine Hong ◽  
Fernando Blanco
Keyword(s):  
Patient Care ◽  
Personal Protective Equipment ◽  
Patient Population ◽  
Conservation Strategies ◽  
Protective Equipment ◽  
Pandemic Response

Abstract Purpose To describe our pharmacy department’s plan for conservation of personal protective equipment (PPE) during the coronavirus disease 2019 (COVID-19) pandemic to ensure continued availability of sterile compounded products. Summary PPE shortages impacted hospitals throughout the nation in the early months of the COVID-19 pandemic response. The PPE requirement for sterile compounding and need to maintain supplies within the pharmacy cleanroom is often overlooked. A sustained supply of PPE is critical to ensure an uninterrupted supply of compounded medications to our patient population. Multiple conservation strategies, including staffing changes, communication, adjustments to training, and even reuse of select PPE, can assist with conservation. Conclusion PPE in pharmacy cleanrooms is critical for the continued provision of sterile compounds with appropriate beyond-use dates and effective patient care. Pharmacy departments must employ multiple conservation strategies to ensure PPE is available for continued compounding of sterile products, and early planning and implementation of conservation strategies are key.

The Ebola Disinfection Booth: Evaluation of an Enclosed Ultraviolet Light Booth for Disinfection of Contaminated Personal Protective Equipment Prior to Removal

2015 ◽  
Vol 36 (10) ◽  
pp. 1226-1228 ◽  
Author(s):  
Myreen E. Tomas ◽  
Jennifer L. Cadnum ◽  
Annette Jencson ◽  
Curtis J. Donskey
Keyword(s):  
Staphylococcus Aureus ◽  
Ultraviolet Light ◽  
Personal Protective Equipment ◽  
Infect Control Hosp ◽  
Protective Equipment ◽  
Methicillin Resistant ◽  
Bacteriophage Ms2 ◽  
Ultraviolet C ◽  
Full Body

A portable booth designed to disinfect full-body coverage protective equipment before removal using ultraviolet-C radiation resulted in at least 3 log reductions in bacteriophage MS2 and methicillin-resistant Staphylococcus aureus within 3 minutes. The booth could be useful for disinfection of contaminated protective equipment before removal during care of Ebola patients.Infect Control Hosp Epidemiol 2015;36(10):1226–1228

scholarly journals Effects of personal protective equipment on the physiological parameters of health care workers

2020 ◽  
Vol 18 (7) ◽  
pp. 37-39
Author(s):  
Varun Mahajan, MD ◽  
Karan Singla, MD ◽  
Kamal Kajal, MD ◽  
Shiv Soni, MD ◽  
Amarjyoti Hazarika, MD ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Management ◽  
Patient Care ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Physiological Parameters ◽  
Protective Equipment ◽  
Physiological Effects ◽  
Care Workers

We would like to add to the study, Understanding the physiological effects of wearing enhanced personal protective equipment while providing patient care by Bulson and Shawl from the November/December 2019 issue of Journal of Emergency Management.

scholarly journals Percepção do enfermeiro acerca do uso de equipamentos de proteção individual em hospital paraibano

2017 ◽  
Vol 7 (1) ◽  
pp. 01
Author(s):  
Allan Dillammary Araújo Barbosa ◽  
Allan Martins Ferreira ◽  
Edmara da Nóbrega Xavier Martins ◽  
Anne Milane Formiga Bezerra ◽  
Juliana de Almeida Leandro Bezerra
Keyword(s):  
Emergency Department ◽  
Patient Care ◽  
Work Environment ◽  
Personal Protective Equipment ◽  
Regional Hospital ◽  
Protective Equipment ◽  
Personal Protection ◽  
Work Activities

<p>Biossegurança ou segurança biológica é um conjunto de ações voltadas à prevenção e proteção do trabalhador. Uma estratégia utilizada como forma de evitar contaminação no ambiente de trabalho se dar a partir do uso de Equipamentos de Proteção Individual (EPIs). Objetivou-se analisar a percepção do enfermeiro sobre o uso e importância do EPI diante da assistência aos pacientes. O trabalho trata-se de um estudo do tipo exploratório-descritivo, com abordagem quantiqualitativa, foi realizado com enfermeiros plantonistas do setor de urgência e emergência de um Hospital Regional paraibano. Conforme os dados observa-se que a maioria dos enfermeiros é do gênero feminino, com faixa etária entre 20 e 30 anos de idade, são especialistas e atuam há dois anos no serviço de emergência. Todos os enfermeiros mostraram conhecimento sobre a importância do uso do EPI, relatando as principais doenças que podem acometê-los caso ocorram episódios de contaminação durante a execução das suas atividades laborais. Alguns dos profissionais afirmaram já se contaminar, sendo o material perfurocortante o que mais causou acidentes. Afirmaram que a instituição oferece a maioria dos EPIs necessários para proteção individual, porém só em algumas circunstâncias fazem uso desses equipamentos. Portanto, pôde-se concluir que tais contaminações poderiam ser evitadas se todos os profissionais fizerem uso dos EPIs em todas as situações que envolvam riscos, pondo em prática o conhecimento relatado, conferindo proteção não só ao profissional como a clientela que procura o serviço.</p><p><strong><em>Nurses perception about the use of personal protective equipment in a hospital in parabian</em></strong></p><p>Abstract: Biosafety or security biological is a set of actions aimed at the prevention and protection of the worker. One strategy used in order to avoid contamination in the work environment it's given from the use of Personal Protective Equipment (PPE). The work it is a study of exploratory-descriptive, with a quantiqualitative approach, was conducted with nurses in the sector of urgency and emergency in a Regional Hospital Paraiba, aiming analysis on the use and importance of PPE when providing patient care.  According to data was realized that most nurses are female, aged between 20 and 30 years old, are experts and acting for two years in the emergency department. All nurses showed knowledge about the importance of using PPE, reporting major diseases that can affect them in case occur contamination episodes during the execution of their work activities. Some professionals said they already been contaminated, being the material pierce cutter which caused more accidents. They stated that the institution offers the majority of PPEs required for personal protection, but only in some circumstances they make use of such equipment. Therefore, it was concluded that such contamination could be avoided if all professionals make use of PPE in all situations involving risk, putting into practice the knowledge reported, providing protection not only to the professional as customers seeking service.</p>

Utility of a Novel Reflective Marker Visualized by Flash Photography for Assessment of Personnel Contamination During Removal of Personal Protective Equipment

2016 ◽  
Vol 37 (6) ◽  
pp. 711-713 ◽  
Author(s):  
Myreen E. Tomas ◽  
Jennifer L. Cadnum ◽  
Thriveen S.C. Mana ◽  
Annette L. Jencson ◽  
Sreelatha Koganti ◽  
...  
Keyword(s):  
Experimental Study ◽  
Personal Protective Equipment ◽  
Infect Control Hosp ◽  
Healthcare Personnel ◽  
Protective Equipment ◽  
Bacteriophage Ms2

In an experimental study, the frequency of contamination of healthcare personnel during removal of contaminated personal protective equipment (PPE) was similar for bacteriophage MS2 and a novel reflective marker visualized using flash photography. The reflective marker could be a useful tool to visualize and document personnel contamination during PPE removal.Infect Control Hosp Epidemiol 2016;37:711–713

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