Disposable Gowns Research Articles

Micro-bacterial assessment of disposable gowns with a focus on green endoscopy in gastrointestinal endoscopy procedures: A Japanese pilot study for healthcare waste reduction.

This study aimed to implement green endoscopy through the microbiological assessment of gowning techniques during endoscopy to reduce carbon emissions and separate medical waste. Twenty-five patients who performed esophagogastroduodenoscopy from March to May 2024 were included in this study. Four sections of the isolation gowns (anterior, posterior, right, and left) were cut into 2 cm2 after endoscopy, and the rate of microbial contamination was examined using the stamp method. The endoscopic examination time was 8 min (6-12), and endoscopy was performed by 10 expert endoscopists, six endoscopists, and nine residents. The overall isolation gown contamination rate was 56%, with 25%, 20.8%, 20.8%, and 33.3% in the front, back, as well as right and left arms, respectively. The rates of isolation gown contamination rates in the expert endoscopists, endoscopists, and residents groups were 30%, 50%, and 77.8%, respectively, with a higher rate in the residents group. Regardless of the physician's performance, bacterial detection was consistently higher in the left arm (42.9% vs. 40% vs. 25%; p = 0.093). The detected bacteria comprised 58% Gram-positive and 42% Gram-negative organisms, including those from tap water used for endoscopy bacteria and obtained from the participant's skin or mouth. No pathogenic organisms were detected. The bacteria detected in disposable gowns after gastrointestinal endoscopy were non-pathogenic. Thus, our findings suggest that changing all personal protective equipment of respective endoscopes might not be essential. We advocate for green endoscopy to achieve sustainable development goals and reduce medical waste.

FP8.11 - Surgical Site Infection Post-operation (gowning vs not gowning): A District General Hospital Experience

Abstract Aims Increasing evidence shows that surgical site infection (SSI) does not differ significantly between main operation theatre and field sterility for many surgical procedures. This audit aimed to assess the rate of surgical site infection (comparing the operating surgeon using a disposable gown vs not using one) for emergency/elective skin procedures like uncomplicated incision and drainage of abscess, excision of lipoma, sebaceous cyst, and pilonidal sinus. Methods The electronic database was used to collect data (September-October 2023) on the type of surgery performed, number of theatre staff scrubbed in. Poster displays and informal education were used to raise awareness of theatre wastage (November 2023). All were advised to wear an apron, mask, sterile gloves, and field sterility only for uncomplicated cases. Data was recollected (December 2023-January 2024). Results 54 cases were performed in September and October 2023. All theatre staff scrubbed in and 160 gowns were used. 5/54 (9.3%) returned with wound infection and managed with antibiotics. The median of the number of days in which the patients returned post-operatively is 7 days. 24 cases were performed from December 2023-January 2024. Theatre staff in 5/24 cases did not scrub in and none of these patients returned with wound infection. Out of the other 17/24 cases, 5/17 (29.4%) returned with wound infection. Conclusions With the limitation of small sample size and multi-factorial aetiology of wound infection, surgeons who did not gown up had no increased risk of wound infection. The higher monetary and environmental costs of complete gowning without improvement of patients’ care are unjustifiable.

The carbon footprint of a laparoscopic cholecystectomy.

Lay Summary Background Gallbladder removal is one of the most common surgical procedures worldwide. The keyhole operation treats patients with symptomatic gallstones. This procedure uses many single-use tools and results in a lot of waste. Before we can make this operation more sustainable, we need to assess the amount of waste and CO2 emissions. Aim The aim of this study was to identify the types of waste and measure the CO2 emissions created by a gallbladder removal. Method We collected waste from 15 gallbladder operations at three hospitals. We noted the medications used and measured the surgery duration to estimate electricity consumption. We also asked all the staff how they travelled to the hospital that day. Findings and Conclusion The operation produces about 56.5 kg of CO2. The main sources of CO2 are single-use tools, packaging materials and disposable drapes and gowns. This study helps us understand where most CO2 is produced, so we can work on reducing it more effectively.

Experience with Using Personal Protective Equipment among Korean Healthcare Personnel: For the Development of Better Products

Background: Although various difficulties and self-contamination concerns have been continuously reported regarding the use of personnel protective equipment (PPE) among healthcare personnel (HCP), better PPE options are unavailable in healthcare settings. This study aimed to thoroughly examine HCP’s PPE experience to develop improved PPE. Method: By sending cooperation requests to eight academic societies (e.g., Korean Society of Infectious Disease, Korean Society of Critical Care Nursing), four hospitals (e.g., National Medical Center), and Korea Disease Control and Prevention Agency, 250 HCP who had direct patient contact with emerging infectious diseases were recruited. The questionnaire with 65 main questions (211 maximum including sub-questions and 19 open-ended questions) was developed in detail (e.g., use frequency, priority check among the options) based on literature reviews and verified by an expert panel. Through an online survey link, participants completed the questionnaire between December 6-11, 2023, and received a $53 incentive. Descriptive statistics were performed for data analysis. Results: Among 250 participants, most were female (80%), in their thirties (46.4), nurses (78%,), working at general hospitals (56%), and averaged 121.1 months of clinical experience (Table 1). Among 6 PPE sets (Figure 1), 29% of participants used Set #2 (i.e., disposable water-proof gown, gloves, goggles/face shield, hair cap, and N95 mask) and 26% used Set #3 (i.e., Level D, gloves, goggles/face shield, shoe cover, N95 mask, and hair cap). 64% of HCP preferred Set #2 due to practical aspects (e.g., simple, convenient, safer than Set #1, and easy donning/doffing). Most PPE sets were largely used for 30 minutes to 1 hour (except level D, to 2 hours). Most prioritized difficulties of PPE use were: disposable mask dampness; pressure pain on the wearing area for N95 masks; powered air purifying respirator (PAPR) wear takes a long time; sweating for gloves, waterproof gowns, and level D/C coveralls; skin exposed through torn gloves; blurry visibility for goggles/face shield; hearing difficulty for hoods; and a slippery bottom for shoe covers. Moments for self-contamination concerns were: adjusting PPE that has slipped down (e.g., masks, gowns, gloves, goggles/face shield, and hoods); doffing hood procedure (e.g., PAPR); and skin contact of shoe cover surfaces during doffing. Most difficulties when using PPE combinations were unfamiliarity with donning/doffing procedures. Participants wish to develop various PPE sizes which can be easily donned/doffed intuitively (e.g., well-ventilated integral PPE). Conclusion: Collaboration with manufacturers based on our results is necessary to develop better PPE options for HCP’s safety and satisfaction.

Evaluation of Tactile and Thermophysiological Comfort in Reusable Surgical Gowns Compared to Disposable Gowns

Though the transition from disposable to reusable surgical gowns holds substantial promise, successful implementation faces challenges. This study investigated tactile and thermophysiological comfort in surgical reusable gowns, comparing them with their disposable counterparts. Parameters such as surface roughness, compression, heat flux, and material rigidity were tested using a Fabric Touch Tester. Additionally, the water vapour permeability and static charge of the gowns were assessed. Thermophysiological comfort of the gowns was evaluated by measuring the temperature and relative humidity (RH) on test subjects during wear trials where they were engaged in an activity that mimics a surgeon’s performance. Skin temperature was monitored using iButton sensors and a thermal camera, and the impact on heart rate during the task was analysed. Following each test, participants provided subjective feedback through a questionnaire. The results indicated that reusable gowns boasted a smoother texture, translating to reduced friction on the skin and better heat transfer compared to the disposable fabrics, as indicated using FTT. They also exhibited higher water vapour permeability compared to their disposable counterparts. The wear trials revealed minimal differences in comfort between disposable and reusable gowns. While performing the activity, an increase in body temperature led to decreased RH, yet this rise did not adversely affect subject comfort, as validated using heart rate and questionnaire survey data. From a comfort point of view, switching from disposable to reusable gowns would not have drawbacks, meaning hospitals should be able to switch provided logistics and costs can be managed.

Engineering a compostable isolation gown to reduce hospital-derived synthetic waste accumulation in landfill

The ever-increasing accumulation of synthetic waste in landfill is a growing pollution and public health concern. In 2018, hospitals in the United States landfilled 1.5 million tons of personal protective equipment (PPE). Single-use, disposable PPE gowns constitute the greatest percentage of landfilled PPE by weight and are overwhelmingly made from non-degradable synthetic materials. The most common and disposed of type of PPE gown are isolation gowns, which are used by healthcare workers attending patients under isolation precautions. One study has shown that under isolation procedures, healthcare systems will on average dispose of 33 gowns per patient per day as municipal waste, contributing a substantial amount of solid waste to landfills. Therefore, to alleviate the strain on landfills, a need exists for isolation gowns that do not contribute to the accumulation of synthetic waste. The approach taken in the present work to address this need was through the creation of a degradable textile from which to make isolation gowns. The prototype textile is a paper-based substrate with an ASTM D6400 certified compostable functional coating to grant the barrier properties necessary to prevent liquid penetration. The compostable, lightweight, coated paper product was tested in accordance with the ASTM F3352 Standard Specification for Isolation Gowns Intended for Use in Healthcare Facilities. The prototype exceeded the AATCC 42 and 127, and ASTM D5034, D5733, and D1683 standardized test requirements to be classified as a high-protection Level 3 isolation gown. As such, the prototype textile has been identified as a suitable material from which to create compostable isolation gowns.

Tackling Disposable Gown Use with Sustainability in Quality Improvement Approach

Tackling Disposable Gown Use with Sustainability in Quality Improvement Approach

Handling 'carbon footprint' in orthopaedics.

The National Health Service contributes 4%-5% of England and Wales' greenhouse gases and a quarter of all public sector waste. Between 20% and 33% of healthcare waste originates from a hospital's operating room, and up to 90% of waste is sent for costly and unneeded hazardous waste processing. The goal of this study was to quantify the amount and type of waste produced during a selection of common trauma and elective orthopaedic operations, and to calculate the carbon footprint of processing the waste. Waste generated for both elective and trauma procedures was separated primarily into clean and contaminated, paper or plastic, and then weighed. The annual carbon footprint for each operation at each site was subsequently calculated. Elective procedures can generate up to 16.5kg of plastic waste per procedure. Practices such as double-draping the patient contribute to increasing the quantity of waste. Over the procedures analysed, the mean total plastic waste at the hospital sites varied from 6 to 12kg. One hospital site undertook a pilot of switching disposable gowns for reusable ones with a subsequent reduction of 66% in the carbon footprint and a cost saving of £13,483.89. This study sheds new light on the environmental impact of waste produced during trauma and elective orthopaedic procedures. Mitigating the environmental impact of the operating room requires a collective drive for a culture change to sustainability and social responsibility. Each clinician can have an impact upon the carbon footprint of their operating theatre.

Awareness of the Protective Measures Against Covid-19 among Turkish Dentists: A Questionnaire Survey

Objective: The COVID-19 pandemic has deeply affected the entire world. This study aims to evaluate Turkish dentists’ awareness of and protective measures against COVID-19 infection.
 Methods: A web-based questionnaire consisting of 35 closed-ended and multiple-choice questions was prepared according to Turkish Dental Association guidelines. The questionnaire was divided into three domains: demographic data, precautionary measures, and attitude. Ethical clearance was obtained from the Istanbul University institutional review board. questionnaire was sent to the dentists registered with the Turkish Dental Association. The minimum sample size was calculated as 756 individuals. The Chi-Square test was used to evaluate the difference for categorical variables. Statistical significance was accepted as p< .05.
 Results: A total of nine hundred and ninety-seven questionnaires was analyzed. Five hundred and sixty-three respondents (56.5%) were general dentists, and 434 (43.5%) were specialists. Seven hundred and thirty-five (73.7%) dentists were found to wear disposable gowns, N95/FFP2 masks, and face shields. About half (48.1%) were confident of avoiding infection. Twenty-one (2.1%) subjects were SARS-Cov-2 positive. A majority of both dentists who had COVID-19 (71.4%) and dentists who did not have it (92.7%) agreed that COVID-19 is an occupational risk (p< .001).
 Conclusion: Although nearly two-thirds of the respondents reported using personal protective equipment, greater precautionary measures should be taken by dental staff to protect the patients from COVID-19 and other contagious diseases.

Utilization of Waste Natural Fibers Mixed with Polylactic Acid (PLA) Bicomponent Fiber: Incorporating Kapok and Cattail Fibers for Nonwoven Medical Textile Applications.

Disposable surgical gowns are usually made from petroleum-based synthetic fibers that do not naturally decompose, impacting the environment. A promising approach to diminish the environmental impact of disposable gowns involves utilizing natural fibers and/or bio-based synthetic fibers. In this study, composite webs from polylactic acid (PLA) bicomponent fiber and natural fibers, cattail and kapok fibers, were prepared using the hot press method. Only the sheath region of the PLA bicomponent fiber melted, acting as an adhesive that enhanced the strength and reduced the thickness of the composite web compared with its state before hot pressing. The mechanical and physical properties of these composite webs were evaluated. Composite webs created from kapok fibers displayed a creamy yellowish-white color, while those made from cattail fibers showed a light yellowish-brown color. Additionally, the addition of natural fibers endowed the composite webs with hydrophobic properties. The maximum natural fiber content, at a ratio of 30:70 (natural fiber to PLA fiber), can be incorporated while maintaining proper water vapor permeability and mechanical properties. This nonwoven material presents an alternative with the potential to replace petroleum-based surgical gowns.

Healthcare workers safety in the COVID-19 era: the impact of pre-pandemic personal protective equipment (PPE) training in Pakistan

BackgroundThe COVID-19 pandemic has revealed vulnerabilities in healthcare systems worldwide, emphasizing the importance of healthcare worker safety through adequate utilization of personal protective equipment (PPE). This study aims to assess the impact of pre-pandemic PPE training on the practices and other associated factors among frontline healthcare workers during the COVID-19 pandemic in Pakistan and provide insights into the implications of such training programs for future initiatives.MethodsA cross-sectional study from May 9th to June 5th, 2020 was conducted among the frontline healthcare workers against COVID-19 in Pakistan, utilizing an online structured questionnaire shared via WhatsApp and Facebook by using purposive sampling. Statistical analyses, including chi-square tests for proportion and logistic regression for the association while multi-logistic regression for potential confounders, were performed using SPSS version 22.ResultsA total of 453 healthcare staff participated, with 68.9% (n = 312) reporting no prior PPE training and 31.1% (n = 141) having received training. Significant associations were found between prior training and healthcare group distribution (p = 0.006), with doctors exhibiting the highest proportion of training 82 (37.61%), followed by nurses 50 (27.32%) and paramedics 9 (17.31%). Those who didn’t receive any prior training in PPEs showed a higher perceived professional risk of 216 (69.23%) compared to those who received prior PPE training 96 (30.77%, p-value 0.005). Similarly, a higher frequency 137 (63.72%) of Perceived Personal risk was observed in those who didn’t receive training, labeled as “high risk” compared to those who were trained 78 (36.28%, P value 0.02). Multi-logistic regression analysis identified paramedics as 0.26 times less likely to have received prior PPE training (Adjusted OR 0.26, 95% CI 0.10–0.65, p = 0.01) compared to medical doctors. Healthcare workers in tertiary care hospitals were 0.46 times less likely to undergo PPE training (Adjusted OR 0.46, 95% CI 0.25–0.87,p = 0.01) compared to those working at COVID-19 facilities/hospitals/quarantine centers. Likewise, individuals who doffed disposable gowns [Adjusted OR 3.86, (95% CI, 1.23–12.08, p = 0.02] were 3.86 times more interested in getting prior training in PPE compared to those who don’t have skills to wear them.ConclusionOur findings highlight that healthcare levels, type of healthcare, and doffing skills are important predictors of whether healthcare workers have taken prior training in PPE. These findings imply developing effective training programs for healthcare workers to ensure safety while providing care during pandemics like COVID-19.

User experience of wearing comfort of reusable versus disposable surgical gowns and environmental perspectives: A cross-sectional survey.

To determine the user experience of wearing comfort of reusable sterile surgical gowns and compare these gowns with conventional disposable surgical gowns. Cross-sectional survey. An academic hospital in the Netherlands. Gynaecologists, surgeons, residents and operating room assistants (n=80). Quantitative and qualitative data were obtained via a written questionnaire. Participants provided subjective comments and scored the reusable gown on each individual topic with a score from 1 to 5 (1 = unsatisfactory, 2 = moderate, 3 = good, 4 = very good, 5 = excellent) and compared the reusable gown with the conventional disposable alternative (better, equal or worse). Wearing comfort: ventilation and temperature regulation, fit and length, functionality, barrier function and ease of use. The results of the overall scores of the reusable gown are scored as 'very good' (mean 4.3, SD ± 0.5) by its users. Regarding comparison of the gowns, more than 79% (lowest score 79%, highest score 95%) of the participants scored the reusable gown equal or higher on six of seven topics. The topic 'ease of use' was scored equal or higher by 59% of the participants. Subjective comments provided information on possible improvements. The findings of this study demonstrate that there is professional acceptance regarding the utilisation of reusable surgical gowns. To facilitate broader adoption, it is imperative to foster collaboration among suppliers and healthcare institutions. The reusable surgical gown is an environmentally sustainable, safe and comfortable alternative in the operating room.

Investigation of the barrier performance of disposable isolation gowns

Recent epidemics and pandemics highlighted the need for effective personal protective equipment, including isolation gowns. The most critical property of an isolation gown is its ability to keep liquids and viruses from passing through the gown. Liquid and viral barrier penetration can be measured using laboratory test methods. Association for the Advancement of Medical Instrumentation (AAMI) PB70 standard defines isolation gown barrier performance levels and requirements. In this study, 22 disposable isolation gown models from6manufacturers were tested for liquid and viral penetration resistance. Standard test methods were used to evaluate water and viral penetration. Test results were evaluated using AAMI PB70 barrier performance criteria for 4 protection levels. Seven of the 22 tested gown models did not pass liquid and viral penetration testing based on AAMI PB70 at the level claimed by the manufacturer. The majority of these failures occurred at the seam and/or tie attachment areas. The study findings underscore the need for improved processes surrounding activities such as premarket testing and postmarket evaluation of gowns according to standardized test methods by third-party laboratories. This study also supports the recent Food and Drug Administration guidance document that clarified the characteristics of isolation gowns considered to be class II and subject to Food and Drug Administration premarket review. Infection preventionists, hospital purchasers, and safety professionals should seek isolation gowns demonstrating conformance to industry standards from manufacturers.

748 Views of Theatre Staff Regarding Reusable Gowns and Sustainability

Abstract Aim The three Colleges of Surgeons declared a climate emergency. Reusable gowns are suggested to improve sustainability in theatres. Method Reusable gowns were made available to explore the interest of staff in using them. Staff were encouraged to answer a questionnaire about their attitude towards sustainability, their view on the impact of using reusable gowns, and whether they would be prepared to approach a colleague wearing a single use gown for a non-clinical reason (feeling cold). Results 30 staff members agreed with global warming being important to them, with 4 staff members being indifferent. The same proportion agreed with theatres being an important area of net zero opportunities. 10 staff members consider changes in theatres to only play a minor role in relation to the magnitude of global warming. 26 of 34 colleagues would voluntarily wear reusable gowns, 8 would prefer single-use gowns given a choice. Replying to the scenario of a staff member not being scrubbed up wearing a single-use gown feeling cold 7 would do the same, 9 would disapprove and raise this to the staff member, 8 would disapprove but not raise this, 3 would disapprove and raise this if there was a hospital policy in place to challenge 'it is ok to ask'. Conclusions Most staff (30/34) recognise opportunities in theatre to become carbon neutral. A considerable proportion (26/34) would use reusable gowns if available. We have started work on a logo for a code of conduct of respectful conversations regarding wasteful behaviour (e.g. wearing disposable gowns for non-clinical reasons).

Ultrafast inactivation of SARS-CoV-2 by 254-nm UV-C irradiation on porous and non-porous media of medical interest using an omnidirectional chamber

Covid-19 has spurred a renewed interest in decontamination techniques for air, objects and surfaces. Beginning in 2020, urgent effort was done to permit the reuse of UV-C for inactivating SARS-CoV-2. However, those studies diverged widely on the dose necessary to reach this goal; until today, the real value of the sensitivity of the virus to a 254-nm illumination is not known precisely. In this study, decontamination was performed in an original UV-C large decontamination chamber (UVCab, ON-LIGHT, France) delivering an omnidirectional irradiation with an average dose of 50 mJ/cm2 in 60 s. Viral inactivation was checked by both cell culture and PCR test. SARS-CoV-2 was inactivated by UV-C light within 3 s on both porous (disposable gown) and non-porous (stainless steel and apron) surfaces. For the porous surface, an irradiation of 5 min was needed to achieve a completely negative PCR signal. The Z value estimating the sensitivity of SARS-CoV-2 to UV-C in the experimental conditions of our cabinet was shown to be > 0.5820 m2/J. These results illustrate the ability of this apparatus to inactivate rapidly and definitively high loads of SARS-CoV-2 deposited on porous or non-porous supports and opens new perspectives on material decontamination using UV-C.

Development of breathable and liquid/wet bacterial penetration barrier composite laminated fabrics for surgical gown applications

Disposable surgical gowns are used to protect health care workers from microorganisms and body fluids to meet the needs of surgical applications. In addition to protection, it has a significant impact on the surgical team members’ comfort and thus, the success of the operations. In this study, a dual layer surgical gown-an outer layer of film and an inner layer of nonwoven fabric-was developed. Produced composite laminated fabrics are SMS (spunbond/meltblown/spunbond) nonwoven fabric laminated microporous polyethylene film and SMS (spunbond/meltblown/spunbond) nonwoven fabric laminated thermoplastic polyurethane films. These fabrics were compared with nonporous polyethylene film-coated SS (spunbond/spunbond) nonwoven fabric available in the local market. The study aims to investigate the effect of some structural factors of composite nonwoven laminated fabrics, including lamination process, manufacturing process, and film type; microporous or monolithic, nonwoven fabric manufacturing process, and helium atmospheric-pressure glow discharge plasma treatment, on their functional performance properties, including air permeability, water vapour permeability, hydrostatic pressure resistance, and wet bacterial penetration resistance. The results showed that the produced composite fabrics offer outstanding breathability and, thus, the surgical team members' comfort. Produced composite fabrics had no wet bacterial penetration of Staphylococcus aureus and thus contributed to the prevention of the transfer of bacterial pathogens to prevent surgical site infection or post-operative infection. Produced composite fabrics offer superior liquid barriers according to the barrier protection classification of the Association for the Advancement of Medical Instrumentation (ANSI/AAMI PB 70:12) and thus contribute to the prevention of the transfer of body fluids during surgical operations.

Evaluation of the physical performance of disposable isolation gowns

The threat of emerging infectious diseases has highlighted the need for effective gowns to protect health care workers and patients. Although studies identified end user issues with the physical performance of gowns, the literature that evaluates the performance is scarce. This paper represents 1 of the first efforts to investigate the physical performance of a substantial set of isolation gown models in the marketplace. Physical performance of 20 commercial and 2 experimental disposable isolation gowns was evaluated in this study. Standard test methods were used to investigate a range of properties, including thickness, weight, tensile strength, tearing strength, and seam strength. In general, due to the differences in the fibers and methods used for the construction, large variations in the tensile, tear, and seam strength results were found. When the gowns were compared to their respective Association for the Advancement of Medical Instrumentation PB70 protection levels, no clear trend was found between protection levels and tear strength or between protection levels and seam strength, while there was a linear relationship between gowns' Association for the Advancement of Medical Instrumentation PB70 levels and their tensile strength. It was found that fabric construction significantly affects the physical performance of gowns. Based on this work, a new standard, American Society of Testing and Materials International F3352, was published and has been recognized by the Food and Drug Administration. American Society of Testing and Materials International F3352 is expected to help end users in selecting the appropriate protective clothing.

Safety Precaution and Infection Control Practices among Dental Practitioners in Nigeria during the COVID-19 Pandemic

Background: COVID-19 remains a major public health threat globally and dental practitioners are particularly at risk due to the proximity of care givers to the patient and the generation of aerosols during many dental treatment procedures. Dental practitioners are therefore required to strictly observe standard universal precautions in their clinical practice. Objectives: To determine the safety precaution and infection control practices among dental practitioners in Nigeria during the COVID-19 Pandemic. Methods: A cross-sectional self-administered pre-tested questionnaire based survey of consenting dental practitioners from different geopolitical zones in Nigeria was employed for the study. Study participants were recruited by non-random convenience sampling. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 105 out of 142 respondents completed and returned the survey questionnaire giving a response rate of 74%. About 24-55% of study respondents performed aerosol/splatter/droplet generating procedures. Hand hygiene and donning of face mask were the most common safety practices while the use of face shield and N95 facemask were common infection control practices. Over 60% of respondents practiced triaging of patients, pre-procedural mouth rinse and donning of disposable surgical gowns. Almost half of the respondents practiced decontamination of the clinic work environment and over 70% of respondents used N95 masks. Conclusion: Aerosol generating procedures were not uncommon dental practices in Nigeria during COVID-19 pandemic. However, use of N95 mask was relatively high and there was a reasonable level of practice of basic standard COVID-19 safety measures and infection prevention and control guidelines.

A cross-sectional study on knowledge, attitude, and practices of donning and doffing of personal protective equipment: an institutional survey on interns during the COVID-19 pandemic

Background: Personal protective equipment (PPE) is a physical barrier that healthcare workers (HCW) wear to stop the transmission of a pathogen from a pathologic specimen or a confirmed or suspected case. It prevents the spread of disease from patient to HCWs as well as the other way around. Eyewear, face shield, surgical mask, particulate respirators, glove, disposable gowns and boots, and head coverings are some examples of these physical barriers. The primary objective of the study is to assess the knowledge, attitude and practices (KAP) of interns towards appropriate use of PPE and secondary objective is to find the role of training on donning and doffing of PPE of interns towards appropriate use of PPE.Methods: This is an institutional based, analytical cross-sectional study. Data was collected from interns (n=130) posted in COVID-19 ward using a universal sampling method. A predesigned questionnaire was used for study. The data was analyzed using SPSS 26 trial versionResults: Interns were aware of the importance and criticality of donning and doffing procedure, overall level of KAP of donning and doffing of PPE were 96.90%, 73.10% and 86.20% respectively. We found that there was statistically significant mean difference between the KAP scores with respect to training of PPE.Conclusions: There were some gaps in KAP at institutional level among the interns with regards to donning and doffing of PPE during the beginning of this pandemic.

Personal protective equipment: Analysis of supply among midwives during the COVID-19 pandemic in Peru

ObjectiveTo report the details of provision of personal protective equipment to midwives during the COVID-19 pandemic in Peru MethodsThis is a non-experimental, descriptive, cross-sectional study. An online survey of 679 midwives working at public healthcare centres was conducted via questionnaires. The following aspects were outlined: method of supply and frequency of delivery of personal protective equipment, type of personal protective equipment provided by the institution, and self-purchase. Furthermore, features of the midwives’ workplace were described. For statistical analysis, absolute frequencies and relative proportions were used for categorical variables, and mean and standard deviation were used for numerical variables. Measurements and findingsThe most important finding of this study is that a large proportion of midwives (66.6%) did not receive new personal protective equipment for each shift; 41.9% of midwives who received personal protective equipment during each shift exclusively provided services in the COVID-19 ward, whereas 27.6% did not. The least received supplies were of N95 respirator masks (41.7%) and disposable isolation suit gown (50.5%). Only a certain proportion of midwives (38.6%) were trained by their own institutions on the use of personal protective equipment. Key conclusionsThe provision of personal protective equipment to midwives and training on personal protective equipment were insufficient at all workplaces. Therefore, measures must be taken to increase the supply of this material to midwives who are essential workers in reproductive health.