S576 Gastroenterologists’ Utilization of Negative Pressure Rooms During the COVID-19 Pandemic: Results From a US National Survey

Abstract

Introduction: Since gastrointestinal endoscopy can increase risk of COVID-19 transmission through aerosolization, safety practice guidelines were published. These guidelines recommended performing endoscopic procedures on COVID-19 positive patients in a negative pressure room. In the absence of such room, other enhanced infection control measures were recommended. This study seeks to describe the utilization of negative pressure rooms for endoscopic procedures during the COVID-19 pandemic. Methods: In this IRB-approved multi-center cross-sectional study, we used a snowball sampling approach to disseminate a 42-question survey, pilot-tested for reliability and validity, to gastroenterologists across different geographic locations in the USA. Information on utilization of negative pressure rooms during endoscopies was collected. Fear during endoscopies was assessed using a 1-10 Likert scale. Data was analyzed using Pearson’s chi-squared, Mann-Whitney U, and Wilcoxon rank tests. Results: 69 responses from gastroenterologists at 30 sites (61 academic, 6 community, 1 private practice, and 1 military) were analyzed. Of the 69 responses, 46 (66.7%) reported having a negative pressure room for endoscopic procedures. Gastroenterologists reported performing upper endoscopic procedures on COVID-19 confirmed or suspected patients in a negative pressure environment at the following frequencies: 31 (44.9%) all the time, 5 (7.2%) most of the time, 9 (13%) sometimes, and 1 (1.4%) reported no use of the room. Similar results were found for lower endoscopies: 30 (43.5%) all the time, 5 (7.2%) most of the time, 9 (13%) sometimes, and 2 (2.9%) reported no use of the room. Although 52.2% of respondents reported risk of contracting COVID-19 as their main concern when performing endoscopic procedures on COVID-19 patients, having a negative pressure room did not significantly reduce providers’ fear compared to those without a room (P = 0.661-0.824, compared for first and subsequent procedures, before and after the COVID vaccine). Conclusion: This study shows that only 43.5%-44.9% of the institutions surveyed utilize their negative pressure room all the time for endoscopic procedures concerning COVID-19 patients. Understanding and implementing infection control measures can decrease transmission risk and may decrease gastroenterologists’ fear of infection. Future directions should investigate the standardization of infection control measures in the absence of negative pressure rooms.