Adapting electroconvulsive therapy service delivery: Insights from providers’ experiences during the COVID-19 pandemic in Australia and beyond

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.

Introduction: The increasing use of fluoroscopy-guided procedures raises concerns about occupational radiation exposure, underscoring the need for effective radiation protection (RP) practices among healthcare professionals. The primary objective was to evaluate compliance with the use of personal protective equipment (PPE) and dosimeters, and to identify factors influencing safety behaviors among exposed workers. Methods: A cross-sectional, exploratory quantitative study was conducted at a hospital centre using a self-administered questionnaire in fluoroscopy-guided operating and interventional settings. The questionnaire collected sociodemographic and professional data, information on RP training, compliance with personal and collective protective equipment, and dosimeter use, as well as perceptions of occupational risk. Results: The study included 52 workers. Compliance with PPE use varied across professions, with radiographers reporting significantly higher use of lead aprons/skirt-coats and thyroid shields than other professionals (p < 0.05). The RP training was significantly associated with compliance with PPE and dosimeter use (odds ratios: 4.2–8.9). Older age groups reported lower compliance with PPE use. Overall, risk perception of radiation-related diseases was low (46.2%), and no statistically significant association was found between risk perception and reported PPE use. Regarding protection practices, 67% reported appropriate use of the apron/skirt-coat, 65% of the thyroid shield, and 62% of the dosimeter. The main barriers to PPE use were discomfort, weight, and inadequate cleaning, while forgetfulness was the most reported reason for not using the dosimeter. Conclusions: Inconsistent use of protective equipment and dosimeters may lead to unnecessary exposure and underestimation of occupational radiation doses, whereas RP training is a key determinant of compliance and a strong safety culture.

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.&#x0D; &#x0D; 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.&#x0D;

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.

Objective: to describe personal protective equipment (PPE) use, hand hygiene and the association with biosafety training among physical therapists during the COVID-19 pandemic. Methods: this exploratory, observational, and transversal study was conducted in Brazil during the pandemic using an online self-administered questionnaire composed of the socio-demographic characteristics, PPE use, and hand hygiene. Statistical analysis was performed using Spearman’s correlation and logistic regression. Results: the most PPE used were long-sleeved lab coats (82.4%), face masks (81.4%) and closed shoes (79.1%). Most physical therapists washed hands before and after procedures (87.4%). Only 47.5% had biosafety training during the COVID-19 pandemic. Biosafety training was associated with medical apron (OR = 2.21. 95%CI = 1.08 to 4.52), isolation gown (OR = 2.71. 95%CI =1.09 to 6.75), long-sleeved lab coat (OR = 0.44. 95%CI = 0.22 to 0.87) and safety goggles (OR = 2.15. 95%CI = 1.21 to 3.84). Conclusion: although PPE use and hand hygiene are part of the Brazilian physical therapist routine, almost half of the assessed physical therapists had not performed biosafety training during the COVID-19 pandemic.

Artisanal goldminers in Ghana are exposed to various levels and forms of health, safety and environmental threats. Without the required legislation and regulations, artisanal miners are responsible for their own health and safety at work. Consequently, understanding the probabilities of self-protection at work by artisanal goldminers is crucial. A cross-sectional survey of 500 artisanal goldminers was conducted to examine the probabilities of personal protective equipment use among artisanal goldminers in Ghana. The data was subjected to both descriptive and inferential statistics. Initial findings showed that personal protective equipment use among artisanal miners was 77.4%. Overall, higher probabilities of personal protective equipment use was observed among artisanal goldminers who work in good health and safety conditions as compared to artisanal miners who work in poor health and safety conditions. Also, personal protective equipment use was more probable among the highly educated artisanal goldminers, miners who regularly go for medical screening and the most experienced miners. Additionally, personal protective equipment use was more probable among artisanal miners who work in non-production departments and miners who work in the medium scale subsector. Inversely, personal protective equipment use was less probable among female artisanal miners and miners who earn more monthly income ($174 and above). To increase self-care and safety consciousness in artisanal mining, there is the need for a national occupational health and safety legislation in Ghana. Also, interventions and health promotion campaigns for better occupational conditions in artisanal mining should target and revise the health and safety related workplace programs and conditions.

Background: This study was done to describe the pattern of personal protective equipment (PPE) use, associated factors, and adverse events among obstetricians and obstetric nurses in obstetrics & gynecology departments. Methods: A cross sectional study was conducted in Obstetrics & Gynecology departments in three hospitals (physician & nurses n=252) using an online Google form including demographic and occupational health data, type of available personal protective equipment during usual care, CS and emergency labor, infection control measures and hazards of full PPE use. Results Full PPE use was 37.7% during CS and 34.9% during emergency labor. The significant predictors of wearing full PPE during CS were daily work hours > 8 hours and receiving formal training about PPE use. During CS & emergency labor most of HCws used sterile gloves and sterile fluid resistant gowns and surgical mask.to less extent used face shields or tight fitting googles and one tenth (11.8%) only used N95. The most common health effects of full PPE use was sense of heat (79.5%) .Conclusion: During the COVID-19 pandemic more vigorous respiratory (N95 mask) and eye protection is required during aerosol-generating procedures. Formal training is an evident predictor for full PPE use.

Background: This study was done to describe the pattern of personal protective equipment (PPE) use, associated factors, and adverse events among obstetricians and obstetric nurses in obstetrics & gynecology departments. Methods: A cross sectional study was conducted in Obstetrics & Gynecology departments in three hospitals (physician & nurses n=252) using an online Google form including demographic and occupational health data, type of available personal protective equipment during usual care, CS and emergency labor, infection control measures and hazards of full PPE use. Results Full PPE use was 37.7% during CS and 34.9% during emergency labor. The significant predictors of wearing full PPE during CS were daily work hours > 8 hours and receiving formal training about PPE use. During CS & emergency labor most of HCws used sterile gloves and sterile fluid resistant gowns and surgical mask.to less extent used face shields or tight fitting googles and one tenth (11.8%) only used N95. The most common health effects of full PPE use was sense of heat (79.5%) . Conclusion: During the COVID-19 pandemic more vigorous respiratory (N95 mask) and eye protection is required during aerosol-generating procedures. Formal training is an evident predictor for full PPE use.

Background: This study was done to describe the pattern of personal protective equipment (PPE) use, associated factors, and adverse events among obstetricians and obstetric nurses in obstetrics & gynecology departments. Methods: A cross sectional study was conducted in Obstetrics & Gynecology departments in three hospitals (physician & nurses n=252) using an online Google form including demographic and occupational health data, type of available personal protective equipment during usual care, CS and emergency labor, infection control measures and hazards of full PPE use. Results Full PPE use was 37.7% during CS and 34.9% during emergency labor. The significant predictors of wearing full PPE during CS were daily work hours > 8 hours and receiving formal training about PPE use. During CS & emergency labor most of HCws used sterile gloves and sterile fluid resistant gowns and surgical mask.to less extent used face shields or tight fitting googles and one tenth (11.8%) only used N95. The most common health effects of full PPE use was sense of heat (79.5%) .Conclusion: During the COVID-19 pandemic more vigorous respiratory (N95 mask) and eye protection is required during aerosol-generating procedures. Formal training is an evident predictor for full PPE use.

The use of personal protective equipment can cause various skin problems in the facial area. The aim of the systematic review study is to determine the skin problems and related factors due to the use of personal protective equipment. Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Joanna Briggs Institute Systematic Reviews Tools were used in the methodological approach of this systematic review. The publications were searched using MEDLINE(R), CINAHL, Web of Science, PubMed and Scopus databases without year limitation. Data were screened, extracted and appraised for quality by two authors. In total 1670 records were identified, of which 15 studies were included in the review. These studies were mostly conducted during the COVID-19 pandemic. Studies have shown that the incidence of skin problems in the face area is high due to the use of personal protective equipment. The most common skin problems were pressure injury, rash, irritation, sweating and moisture accumulation and acne. Anatomical regions with skin problems were nose bridge, cheeks, ears, chin and forehead. The duration of use and type of personal protective equipment and sweating and moisture were the most prominent risk factors for the development of skin problems. This study has shown that though the studies included in the review have methodological differences, there is a high rate of skin problems related to personal protective equipment used in the facial region. Well-structured, prospective observational and randomised controlled trials are needed. It is important to understand the types and causes of skin problems in the face area due to the use of personal protective equipment to protect the facial skin health of healthcare workers. In the inclusion criteria of this systematic review, the patients or public were not included in the study. The systematic review study has been registered in PROSPERO International Prospective Register of Systematic Reviews System (CRD4202127650).

Availability and appropriate use of personal protective equipment (PPE) is of particular importance in Low and Middle-Income countries (LMICs) where disease outbreaks other than COVID-19 are frequent and health workers are scarce. This study assesses the availability of necessary PPE items during the COVID-19 pandemic at health facilities in seven LMICs. Data were collected using a rapid-cycle survey among 1554 health facilities in seven LMICs via phone-based surveys between August 2020 and December 2021. We gathered data on the availability of World Health Organization (WHO)-recommended PPE items and the use of items when examining patients suspected to be infected with COVID-19. We further investigated the implementation of service adaptation measures in a severe shortage of PPE. There were major deficiencies in PPE availability at health facilities. Almost 3 out of 10 health facilities reported a stock-out of medical masks on the survey day. Forty-six percent of facilities did not have respirator masks, and 16% did not have any gloves. We show that only 43% of health facilities had sufficient PPE to comply with WHO guidelines. Even when all items were available, healthcare workers treating COVID-19 suspected patients were reported to wear all the recommended equipment in only 61% of health facilities. We did not find a statistically significant difference in implementing service adaptation measures between facilities experiencing a severe shortage or not. After more than a year into the COVID-19 pandemic, the overall availability of PPE remained low in our sample of low and middle-income countries. Although essential, the availability of PPE did not guarantee the proper use of the equipment. The lack of PPE availability and improper use of available PPE enable preventable COVID-19 transmission in health facilities, leading to greater morbidity and mortality and risking the continuity of service delivery by healthcare workers.

BackgroundAvailability and appropriate use of personal protective equipment (PPE) is of particular importance in Low and Middle-Income countries (LMICs) where disease outbreaks other than COVID-19 are frequent and health workers are scarce. This study assesses the availability of necessary PPE items during the COVID-19 pandemic at health facilities in seven LMICs.MethodsData were collected using a rapid-cycle survey among 1554 health facilities in seven LMICs via phone-based surveys between August 2020 and December 2021. We gathered data on the availability of World Health Organization (WHO)-recommended PPE items and the use of items when examining patients suspected to be infected with COVID-19. We further investigated the implementation of service adaptation measures in a severe shortage of PPE.ResultsThere were major deficiencies in PPE availability at health facilities. Almost 3 out of 10 health facilities reported a stock-out of medical masks on the survey day. Forty-six percent of facilities did not have respirator masks, and 16% did not have any gloves. We show that only 43% of health facilities had sufficient PPE to comply with WHO guidelines. Even when all items were available, healthcare workers treating COVID-19 suspected patients were reported to wear all the recommended equipment in only 61% of health facilities. We did not find a statistically significant difference in implementing service adaptation measures between facilities experiencing a severe shortage or not.ConclusionAfter more than a year into the COVID-19 pandemic, the overall availability of PPE remained low in our sample of low and middle-income countries. Although essential, the availability of PPE did not guarantee the proper use of the equipment. The lack of PPE availability and improper use of available PPE enable preventable COVID-19 transmission in health facilities, leading to greater morbidity and mortality and risking the continuity of service delivery by healthcare workers.

BackgroundHealthcare professionals (HCPs) are at the frontline in the fight against COVID-19 and are at an increased risk of becoming infected with coronavirus. Risk of infection can be minimized by use of proper personal protective equipment (PPE). The aim of this study was to assess the availability and use of PPE, and satisfaction of HCPs with PPE in six public hospitals in Addis Ababa, Ethiopia.MethodsA cross-sectional study was conducted among 1134 HCPs in June 2020. A systematic random sampling and consecutive sampling techniques were used to select the study participants. Data were collected using a self-administered questionnaire. Descriptive statistics were used to describe the data and Chi-square test was used to assess the association between the groups. Bivariate and multivariable logistic regression models were used to assess factors associated with satisfaction of healthcare workers.ResultsThe mean (±SD) age of the participants was 30.26 ± 6.43 year and 52.6% were females. Nurses constituted about 40% of the overall sample, followed by physicians (22.2%), interns (10.8%), midwives (10.3%) and others (16.7%). The majority (77%) of the HCPs reported that their hospital did not have adequate PPE. A critical shortage of N95 respirators was particularly reported, it only increased from 13 to 24% before and during COVID-19, respectively. The use of N95 increased from 9 to 21% before and during COVID-19, respectively. Almost 72% of the respondents were dissatisfied with the availability and use of PPE in their hospital. The independent predictors of the respondents’ satisfaction level about PPE were healthcare workers who reported that PPE was adequately available in the hospital (adjusted OR = 7.65, 95% CI:5.09–11.51), and preparedness to provide care to COVID-19 cases (adjusted OR = 2.07, 95% CI:1.42–3.03).ConclusionsA critical shortage of appropriate PPE and high level of dissatisfaction with the availability and use of PPE were identified. Therefore, urgent efforts are needed to adequately supply the healthcare facilities with appropriate PPE to alleviate the challenges.

Trends in personal protective equipment use by clinicians performing airway procedures for patients with coronavirus disease 2019 in the USA from the intubateCOVID registry

Background: Anesthesiologists, with their skills and expertise at performing various aerosol-generating procedures such as tracheal intubation and extubation, tracheostomies, and bronchoscopy-guided procedures, serve as frontline workers during the COVID-19 pandemic. They are exposed to the risk of infection as well as highly stressful environments in the operating theaters and intensive care units. Appropriate knowledge, attitudes, and practices (KAPs) with regard to the use of personal protective equipment (PPE) will help mitigate some of this stress. Materials and Methods: Owing to the nation's lockdown situation, an online questionnaire-based survey was conducted through WhatsApp, Facebook, and E-mail among anesthetists working at different health-care sectors in India. The KAP with regard to the use of PPE during the COVID-19 and its psychological impact were assessed by using a prevalidated questionnaire. All analyses were performed using SPSS version 25. Results: Among 301 study participants, 189 (62.8%) had good knowledge and 90% had favorable attitudes. Despite 66.4% of the study participants having received formal training regarding the use of PPE during the COVID-19 pandemic, good practices were seen only in 44.4%. Irrespective of the demographic variable assessed, 90% of the anesthesiologists felt that working was more stressful in the operating room during this pandemic, due to challenges with respect to effective communication, restrictions in movement and visibility attributed to PPE as well as an alteration in the usual routine. Conclusions: Despite adequate knowledge and attitudes regarding the use of appropriate PPE, the translation into practice was deficient. Emphasis on the checklist, protocol-based approaches, and regular updates on practice recommendations will help to improve adherence to quality practices. Donning of appropriate PPE contributes to significant physical and emotional stress among anesthesiologists during the COVID-19 pandemic. A platform to provide psychological support is the need of the hour.