1197. The Gloves Are Off: The State of Personal Protective Equipment (PPE) Use in Contact, Droplet, and Standard Precautions at a Major Teaching Hospital

Do established infection prevention and control measures prevent spread of SARS-CoV-2 to the hospital environment beyond the patient room?

ASE Statement on the Reintroduction of Echocardiographic Services during the COVID-19 Pandemic

One form in avoiding the occurrence of occupational diseases and workplace accidents is to understand the use of PPE and wear personal protective equipment. Use of the intended personal protective equipment in which the scavenger conditions in the Tamangapa TPA while working with masks, boots, gloves and protective helmets. With the aim of preventing contamination of the disease and protecting the part or whole body there is a potential danger. This study aims to determine the relationship of knowledge and social economy to the use of personal protective equipment in garbage scavengers in TPA Tamangapa Makassar City. This research was conducted in TPA Tamangapa Kota Makassar. The research was conducted in January until February 2018. The research design used was analytic observational method is a research design that aims to see the relationship of two variables or without any treatment or intervention with cross sectional approach with the number of samples was 99 respondents according to the inclusion and exclusion criteria. Data collection using questionnaire and data analysis using statistic with chi square test. The result of bivariate analysis showed that there was a correlation of knowledge with the use of self-protective device p = 0.024, and there was an economic status relationship with the use of Personal Protective Equipment (p = 0,029). Conclusion there is a relationship between knowledge, and economic status of garbage scavengers in TPA Tamangapa Makassar City. It is advisable to garbage collectors to further improve their understanding and discipline of using Personal Protective Equipment when working.
 
 One form in avoiding the occurrence of occupational diseases and workplace accidents is to understand the use of PPE and wear personal protective equipment. Use of the intended personal protective equipment in which the scavenger conditions in the Tamangapa TPA while working with masks, boots, gloves and protective helmets. With the aim of preventing contamination of the disease and protecting the part or whole body there is a potential danger. This study aims to determine the relationship of knowledge and social economy to the use of personal protective equipment in garbage scavengers in TPA Tamangapa Makassar City. This research was conducted in TPA Tamangapa Kota Makassar. The research was conducted in January until February 2018. The research design used was analytic observational method is a research design that aims to see the relationship of two variables or without any treatment or intervention with cross sectional approach with the number of samples was 99 respondents according to the inclusion and exclusion criteria. Data collection using questionnaire and data analysis using statistic with chi square test. The result of bivariate analysis showed that there was a correlation of knowledge with the use of self-protective device p = 0.024, and there was an economic status relationship with the use of Personal Protective Equipment (p = 0,029). Conclusion there is a relationship between knowledge, and economic status of garbage scavengers in TPA Tamangapa Makassar City. It is advisable to garbage collectors to further improve their understanding and discipline of using Personal Protective Equipment when working.

BackgroundCorrect personal protective equipment (PPE) use is key to prevent infection. Observations on a single unit at the Veterans Affairs (VA) Tennessee Valley Healthcare System (TVHS) prior to COVID-19 (October 2019-February 2020) showed low rates of correct PPE use among healthcare workers (HCWs) (Figure 1). In response to the COVID-19 epidemic, the VA implemented new PPE protocols. Based on our initial observations, we were concerned that incorrect use of PPE may increase the risk of COVID-19 exposure among HCWs. Resident physicians, who work at many sites, may be at high-risk for incorrect PPE use due to rapid turnover and limited site-specific PPE training. We aimed to assess and improve COVID-19 PPE use among internal medicine residents rotating at the VA TVHS.Figure 1: Pre-COVID-19 Observations of Adherence to Contact Precaution Protocols at the Veterans Affairs Tennessee Valley Healthcare SystemMethodsWe used the plan, do, study, act (PDSA) model. Prior to starting VA rotations, residents were emailed PPE education to review. We implemented a 1-hour video conference PPE protocol review at rotation start followed by in-person PPE use evaluations for residents performed by infectious diseases fellows on day 2 and day 5-6 post-review to provide just-in-time educational intervention. Errors at each PPE don/doff step were tracked. Correct PPE use data from both observations were compared using McNemar’s test. Baseline and post-implementation resident surveys assessed PPE use knowledge and comfort.ResultsPre-implementation survey response rate was 72% (21/29); 19/21(91%) reported knowing which PPE to use and 16/21(76%) reported knowing how to safely don/doff PPE. Twenty of 29 (69%) residents completed both observations. Errors decreased by 55% (p=0.0045) from 17/20 (85%) to 6/20 (30%) between initial and follow up observations. Errors in hand hygiene, inclusion of all donning/doffing steps, and PPE reuse decreased, but PPE don/doff order errors increased (Figure 2). Post-project survey response rate was 16/29 (55%). All 16 reported knowing which PPE to use and how to safely don/doff PPE, and 11/16 (69%) residents felt both online and in-person interventions were helpful.Figure 2: COVID-19 PPE Errors and Correction Types by ObservationConclusionCorrect COVID-19 PPE use is essential to protect HCWs and patients. Just-in-time education intervention for PPE training may yield higher correct use compared to pre-recorded or online training.DisclosuresAll Authors: No reported disclosures

Background: Hospital is one of the health services demanded according to standards by the community. But hospitals also have a high risk of infection, both due to treatment and medication. Of the many health workers, nurses are one who plays a role in the quality of service. In improving quality, nurses' behavior needs to be considered as a form of hospital prevention against infection. Measures that can prevent infection by washing hands and using PPE properly. Objective: Knowing the description of hand washing behavior and the use of nurses' personal protective equipment about the risk of spreading nasocomial infections. Method: Descriptive research using quantitative descriptive methods with total sampling techniques and using univariate test analysis. The subjects of this study were 67 respondents. Data collection was carried out by observation method regarding hand washing behavior and the use of nurses' personal protective equipment in hospitals.Results: The results of the study of 59 respondents studied found that 30 nurses behaved obediently (50.8%) while nurses who did not comply with the moment of hand washing amounted to 29 people (49.2%). With respondents who had a handwashing step behavior adhering to six steps amounted to 31 people (52.5%), while nurses who did not comply with six steps of hand washing amounted to 28 people (47.5%). While respondents who had compliant behavior in the use of PPE amounted to 34 people (57.6%), while nurses who did not comply in the use of PPE amounted to 25 people (42.4%). Conclusion: Inpatient nurses in hospitals have the majority of behaviors that comply with hand washing and the use of PPE (personal protective equipment) Keyword: Personal Protective Equipment; Hand Washing; Nasocomial Infection; Behavior Abstrak Latar Belakang : Pelayanan kesehatan yang diberikan oleh rumah sakit harus mematuhi standar yang diharapkan oleh Masyarakat.. Namun fasilitas kesehatan tersebut juga memiliki resiko tinggi terhadap infeksi, baik karena perawatan maupun pengobatan. Dari banyaknya petugas kesehatan, perawat ialah salah satu yang berperan dalam mutu pelayanan. Dalam meningkatkan mutu, perilaku perawat perlu diperhatikan sebagai bentuk dari pencegahan rumah sakit terhadap infeksi. Tindakan yang dapat mencegah terjadinya infeksi dengan cuci tangan serta penggunaan APD dengan benar. Tujuan : Mengetahui Gambaran Perilaku Cuci Tangan dan Penggunaan Alat pelindung diri Perawat Tentang Risiko Penyebaran Infeksi Nasokomial. Metode : Studi deskriptif dilakukan dengan metode deskriptif kuantitatif, teknik total sampling, serta analisis uji univariat pada 67 responden. Pengambilan data dilakukan dengan metode observasi mengenai perilaku cuci tangan dan penggunaan Alat pelindung diri perawat di Rumah sakit.Hasil : Hasil penelitian dari 59 responden yang diteliti didapatkan 30 orang perawat berperilaku patuh (50.8%) sedangkan perawat yang tidak patuh terhadap momen cuci tangan berjumlah 29 orang (49.2%). Dengan responden yang memiliki perilaku langkah cuci tangan patuh terhadap enam langkah berjumlah 31 orang (52.5%), sedangkan perawat yang tidak patuh terhadap enam langkah cuci tangan berjumlah 28 orang (47.5%). Sedangkan responden yang memiliki perilaku patuh dalam penggunaan APD berjumlah 34 orang (57.6%), sedangkan perawat yang tidak patuh dalam penggunaan APD berjumlah 25 orang (42.4%). Kesimpulan : Perawat rawat inap yang ada di Rumah Sakit memiliki perilaku mayoritas patuh terhadap cuci tangan maupun penggunaan APD (alat pelindung diri) Kata kunci: Alat Pelindung Diri; Cuci Tangan;Infeksi Nasokomial;Perilaku;

Introduction:Coronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV2). COVID-19 is highly contagious, potentially fatal, and a global public health concern. Combining optimized personal protective equipment (PPE) use and hand hygiene is the best strategy for preventing COVID-19 in health care workers (HCWs).Methods:We conducted a national cross-sectional web-based survey of HCWs in the infection control program (IPC) in Thailand between May 5, 2020 and May 15, 2020. The primary objective was the prevalence of optimized PPE use amongst HCWs. The secondary objective was identification of the independent predictors of optimized PPE use.Results:We received a response from 46% of HCWs (756/1650), and all those who responded were nurse or HCWs who were registered in the IPC network. Five HCWs were excluded because of missing data, and 751 were included in the final analysis. The prevalences of PPE use were 22% (168/751) for optimized PPE use, 78% (583/751) for non-optimized PPE use, 35% (263/751) for PPE overuse, and 43% (320/751) for PPE underused. In univariate analysis, optimized PPE use was significantly associated with age, education level, knowledge of appropriate negative pressure room selection, and knowledge of apparently milder symptom severity in children than adults. In multivariate analysis, independent predictors of optimized PPE use were knowledge of appropriate negative pressure room selection (aOR = 1.95, 95% CI = 1.18-3.22), the difference in symptom severity between children and adults (aOR = 0.55, 95% CI = 0.37-0.81), and education level (aOR = 1.54, 95% CI = 1.04-2.27).Conclusion:The prevalence of optimized PPE use amongst HCWs was 22%. Independent predictors of optimized PPE use were COVID-19 knowledge-based factors and education level. Therefore, the continued education training program should be implemented to ensure maintenance of appropriate practices during the COVID-19 pandemic.

Controversies in airway management of COVID-19 patients: updated information and international expert consensus recommendations

Determine the frequency of personal protective equipment (PPE) use in adolescent inline skaters, skateboarders, and snowboarders; explore factors influencing PPE use; identify factors that would influence use; and examine the association of high-risk behaviors and PPE use. Cross-sectional survey. Central/southeast Wisconsin. Participants 13-18 years-old. None. Independent variables = age, gender, sport. None. Dependent variables = PPE use, factors influencing use, and frequency of other high-risk behaviors. The mean age of 333 participiants was 14.9 years. Adolescents wore considerably less PPE than recommended. Inline skaters wore the most; snowboarders the least. The most common reasons adolescents wore PPE were parents, peers, and rule/requirement. Younger adolescents cited parents more often than older adolescents as a factor for PPE use. Discomfort and lack of perceived need were the most common reasons for nonuse. Sustaining/witnessing an accident was the most common reason that would convince adolescents to wear PPE. Almost half of adolescents reported nothing would convince them to wear PPE. Younger adolescents wore more PPE than older adolescents. An association was seen between PPE use in all sports and bicycle helmets. An inverse relationship was found for tobacco and helmet use among skaters, as well as alcohol and helmet use in skateboarders. Adolescents underuse PPE. PPE reinforcement by parents/peers, encouraging bike helmets, manufacturing more comfortable gear, educating adolescents, and instituting PPE requirements in public areas may increase compliance. This could lead to decreased injuries. Physicians should discuss PPE with their patients/families. There may be an association between PPE use in extreme sports and decreased high-risk health behaviors.

Personal protective equipment (PPE) is a device that people use to protect against people who have received a disease that can be spread through contact or by other people. PPE is needed for medical personnel in order to reduce the risk of transmission of the Covid-19 virus because during the Covid-19 pandemic, the risk of increasing cases in health workers is very high because they are in direct contact with patients who have contracted Covid-19 for treatment or who are quarantined. The use of non-standard personal protective equipment is one of the reasons why health workers get Covid-19 infections. This is intended for people who work in the distribution and management of PPE, public and individual health, public health management, and providing PPE information. Before making direct contact with patients infected with the Covid-19 virus, health workers must be required to wear PPE, but the availability of PPE is very limited because it is also used by patients and the community. This condition forces health workers to reduce the use of PPE by providing health services without removing PPE for a long time or by using homemade PPE. This is what motivates academics to conduct a literature review that evaluates the factors that influence the habit of using PPE for health workers. In this study, the method used is Observational Retrospective, specifically with a qualitative approach in Systematic Review to synthesize descriptive qualitative research results using the PRISMA (Preffered Reporting Items for Systematic Review and Meta-Analysis) method, which is carried out systematically by following the steps outlined below. good and right. To get reliable and accurate results from articles that are used as references, the authors search and select scientific publications from database sources (Literature review) using Google Scholar and the search term "Analysis of Compliance Behavior in the Use of Personal Protective Equipment (PPE) in Health Workers During the Covid Pandemic. -19." The data analysis used papers related to research issues, namely the examination of compliance behavior in the use of PPE in health workers during the Covid-19 pandemic, which was then systematically researched by selecting 10 articles to be reviewed and included in the review process. After a literature search was carried out by entering keywords in Google Schoolar with keyword analysis of compliance behavior in the use of PPE in health workers during the Covid-19 pandemic from the 2019-2022 range, at least 1040 articles were obtained, but only 10 articles met the inclusion criteria after articles that were not suitable to be removed.

Personal protective equipment (PPE) use is associated with reduced risk of SARS-CoV-2 infection among healthcare personnel (HCP). There are limited data on the impact of the novel coronavirus disease 2019 (COVID-19) pandemic on the PPE use of HCP. We describe the changes in PPE use from just before the widespread of community outbreaks ('pre-pandemic') to intra-pandemic time points, and examine factors associated with not changing in PPE use behavior among HCP in four Thai hospitals. We performed a retrospective cohort evaluation using two-time points: (i) February-March 2020 (pre-pandemic period); and (ii) January-March 2021 (intra-pandemic period). Self-reported frequency of appropriate PPE use was measured by a Likert scale. We used multivariable logistic regression to identify factors associated with no increase in self-reported PPE use. Of 343 HCP, the proportion of participants reporting 'always' using PPE rose from 66% during the pre-pandemic period to 80% during the pandemic. Factors associated with HCP who did not increase in PPE use included having high baseline reported PPE, being a non-registered HCP (e.g. nurse assistants, dental assistants, porters), being male, and having a low perceived risk of becoming infected with any respiratory virus while working in the hospital. PPE education, training, and risk communication content should target all cadres of HCP, regardless of registered/non-registered status, with a focus on behavior change for improved prevention and control of SARS-CoV-2 and other respiratory viruses in healthcare settings.

Background: Disease control personnel have an important role in preventing spreading of COVID-19, such as case screening, outbreak investigation, and contact tracing. This study aims to find out their protective behaviors and other associated factors with inappropriate PPE use, as well as the percentage of seropositivity by natural SARS-CoV2 infection in September 2020 during the period without any COVID-19 vaccine. Methods: This is a cross-sectional study of 172 Thai Department of Disease Control personnel, which all had done questionnaires regarding demographic data and protective behavior. The blood test was performed to find out Neutralizing antibody titer (Nab) and Enzyme-Linked Immunosorbent Assay (ELISA). Data were analyzed using descriptive statistics and binary logistic regression was conducted for identifying factors associated with inappropriate Personal Protective Equipment (PPE) use. Results: Of all 172 participants, 38 (22.1%) were Health Care Workers (HCW), 79 (45.9%) were Public Health Personnel (PHP), and 55 (32%) were Non-Health Workers (NHW). Most were female (130; 75.6%). Hand hygiene was the behavior with the highest proportion of being done every time among all participants during work (90.5%), while cleaning high-touch surface and using cashless system were done only a few or sometimes by most participants (55.9% and 56.1%, respectively). Middle age, less experience, and working as Public Health Officers, were associated with appropriate PPE use during work. Participants who had trained for PPE use at least once in the recent year practice inappropriate PPE use less than those who had not been trained, even though there were no significant differences.

BackgroundDoctors and healthcare workers (HCW) are at frontline in control of the pandemic caused by the novel coronavirus infection (COVID‐19). The virus is transmitted by contact, droplet, and airborne transmission; hence, hand hygiene, social distancing, environmental disinfection, and use of appropriate personal protective equipment (PPE) form important components to protect HCWs from cross‐infection. Appropriate use of PPE is of paramount importance not only to reduce the risk of transmission but also to maintain adequate stock for those who are dealing directly with COVID‐19 patients.AimsIn this article, we aim to provide the rationale for appropriate use of PPE in the dermatology setting in the current scenario. We have also discussed the scientific evidence for use of each component of protection and the practical problems faced in our COVID referral tertiary hospital.MethodsOur review was based on articles that have studied or analyzed the efficacy of various protective measures being utilized by health workers against spread of COVID‐19. This was done by carrying out a PUBMED search with terms “coronavirus, COVID‐19, personal protective equipment (PPE), transmission, mask, face shields, goggles, gloves.” We also scrutinized the various pragmatic issues being faced by doctors in our setup while using PPE.ResultsIn order to maximize the appropriate use of PPE, the rationale for use needs to be understood and problems encountered in daily practice need to be addressed.ConclusionAdherence to protective measures and use of PPE is of utmost importance for HCWs to prevent cross‐infection in this pandemic. The use of PPE can limit transmission to a great extent, but appropriate use and avoiding misuse is equally important in the dermatology setting in order to avoid depletion of stock. It is also essential to consider various practical issues with use of PPE and device measures to avoid them so that breach in protocols can be prevented and spread of infection minimized.

IntroductionTo treat and properly care for COVID-19 patients it is vital to have healthy healthcare workers to ensure the continued function of the healthcare system and to prevent transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to patients, co-workers, and the community. Personal protective equipment (PPE) can prevent healthcare workers from being infected with and transmitting SARS-CoV-2. Experience and training are pivotal to ensure optimal protection. This study aims to examine the use and failure of PPE and compliance with PPE guidelines during the first and the second wave of the COVID-19 pandemic among Danish healthcare workers.MethodsHealthcare workers from the Central Denmark Region and the Capital Region of Denmark were invited to participate April–June 2020 during the first wave and November 2020–April 2021 during the second wave. Day-by-day, participants reported work procedures, use and failure of PPE, and compliance with PPE guidelines. Register-based information on sex, age, department, and profession was available for all participants.ResultsIn total, 21 684 and 10 097 healthcare workers participated during the first and the second wave, respectively. During the first wave, 1.7% used filtering face piece-2 or -3 (FFP2 or FFP3) respirators and 8.2% used face masks [fluid resistant (type IIR) masks, masks with visor (typically type IIR), and other unspecified face masks] during physical contact with patients. During the second wave, the corresponding figures increased to 17.8% and 80.7%. During respiratory procedures, the use of FFP2 or FFP3 respirators increased from 5.6 to 24.3%, and the use of face masks from 14.7 to 77.8%. The no PPE use decreased from 21.3% during the first wave to 0.4% in the second wave, during respiratory procedures. Total PPE failures decreased from 0.7 to 0.4% from the first to second wave. The proportion not complying with PPE guidelines declined from 3.6 to 2.2% during physical contact with patients and from 6.5 to 4.6% during respiratory procedures. PPE failure and non-compliance varied by age, sex and type of department. Frequent reasons for non-compliance were forgetfulness and lack of time, and during the first but not during the second wave, limited availability of PPE.ConclusionWe found a substantial increase in the use of PPE and a substantial decrease in PPE failures from the first to the second wave of COVID-19 in Denmark. However, there is still a need for continuous focus on compliance in use of PPE among healthcare workers.

IntroductionAccurate and appropriate use of personal protective equipment (PPE) is an integral component in infection prevention and control policy to ensure healthcare workers’ safety. Poor compliance with personal protective behaviours and inconsistent use of PPE has been identified as the main cause of transmission of nosocomial infections in healthcare settings and this reduced compliance is linked to many individual, environmental, and organizational factors. Therefore, the current study was carried out to identify various factors influencing PPE use among healthcare workers. Materials and methodsA descriptive cross-sectional survey has been carried out among healthcare workers selected from two selected tertiary care hospitals in central India. Data on compliance with PPE and factors influencing compliance were collected using a three-point rating scale and structured questionnaire. Quantile regression was performed to identify the factors associated with adherence to PPE use among healthcare workers.ResultsThe median score for compliance with PPE use among healthcare workers was found to be 22 with an interquartile range (IQR) of 16-24. The multiple quantile regression found that variables such as occupation (p<0.001), institutional policy (p=0.003), quality of PPE (p=0.002), availability of PPE (p<0.001), and improper size (p=0.042) were significantly associated with PPE compliance by healthcare workers.ConclusionThe current study highlights the importance of taking adequate measures by the government and healthcare organizations to eliminate various factors hindering PPE compliance levels among healthcare workers to ensure consistent use of PPE by healthcare workers to safeguard themselves and patients.

Background Farmers in the U.S. and in Europe are at a high risk for injury and illness. Farmers have an increased risk of respiratory disease, noise-induced hearing loss, skin disorders, and eye injuries. Many of these health risks can be prevented or reduced through proper use of personal protective equipment (PPE). However, studies show low compliance of PPE use among farmers. The purpose of this study was to identify barriers to wearing PPE, and current health and safety training as potential targets for future intervention, in farmers in Nebraska, Lithuania, Latvia, and Slovenia. The European Cooperation in Science and Technology and the Central States Center for Agricultural Safety and Health collaborated on this study. Methods We administered a 7-item questionnaire to 57 farmers in Nebraska (n = 10), Lithuania (n = 22), Latvia (n = 10) and Slovenia (n = 15). The farmers primarily grew crops (corn, soy) and some raised livestock. Results We found that gloves, respirators, and safety glasses were the PPE most commonly worn; use of face shields were only reported in Nebraska and Lithuania. Only 45% reported wearing PPE always when they needed them. In Nebraska and Latvia, most farmers reported not wearing PPE because they are not readily available although they have them on the farm; in Lithuania and Slovenia, farmers cited time to don PPE and discomfort as primary reasons. The percentage of farmers who reported receiving training on the selection, use, and maintenance of PPE varied widely-13% in Nebraska, 14% in Lithuania, 40% in Latvia, and 67% in Slovenia. Farmers purchased PPE over the internet, supermarkets, and agricultural cooperatives. Conclusions This study provided an opportunity to understand current perceptions of PPE use and challenges, among a cross section of farmers in the U.S. and Europe. We recommend enhancing training through creative modules to address the needs of farmers. Key messages By identifying why farmers do not always wear PPE, we can design effective interventions to overcome this barrier; by knowing where they purchase them, we can provide education at these venues. This study is a joint collaboration between U.S. and European researchers. This global cooperation has highlighted some similarities but also differences within European countries.