Disposable Gowns Research Articles

Nosocomial Infections in a Tertiary Healthcare Center in Lebanon: Optimization of Safety Protocols

Objective: The Saint George Hospital – University Medical Center (SGH-UMC)– in Ashrafieh, Lebanon – aims at achieving excellence in medical services by empowering the Infection Control and Prevention Department (ICPD) to maintain a healthy environment and ensure the safety of patients and medical personnel equally. In association with the University of Balamand, two interventions were employed to attempt at further ameliorating the ICPD and the patient safety.
 Interventions: The first intervention constitutes of a cost-benefit analysis to evaluate the possibility of substituting the use of reusable gowns with disposable ones and the second is a questionnaire allowing the evaluation of the physician satisfaction with the ICPD at SGH-UMC.
 Results: The cost-benefit analysis suggested that the use of reusable gowns was more cost effective than the use of disposable gowns even after taking into consideration the attributable cost of nosocomial infections. The physician’s satisfaction questionnaire highlighted the physician’s various perceptions regarding the ICPD and the infection control and prevention in the hospital and recommended some corrective actions to overcome the obstacles faced.
 Conclusion: The process of quality improvement requires the employment of several quality tools, identifying the problems and attempting to solve them; therefore, development and distinction can only be attained after a process of self-evaluation, troubleshooting and corrective actions.

Practical aspects of COVID-19 autopsies

HintergrundDie COVID-19-Pandemie stellt die medizinische Fachwelt vor eine bislang ungekannte Herausforderung. Obduktionen sind für die Erforschung dieser neuen Krankheit wesentlich, ihre sichere Durchführbarkeit wurde aber anfangs infrage gestellt.FragestellungUnter welchen rechtlichen Rahmenbedingungen und unter welchen Schutzmaßnahmen können COVID-19-Obduktionen durchgeführt werden?Material und MethodenDas obduktionstechnische Vorgehen in 5 Zentren in Deutschland, Österreich und der Schweiz wird unter Berücksichtigung der jeweiligen rechtlichen Grundlagen und der ergriffenen Schutzmaßnahmen dargestellt.ErgebnisseIn allen Institutionen konnten die Obduktionen in technisch geeigneten Räumen sicher durchgeführt werden. Die persönliche Schutzausrüstung umfasste Augenschutz, Mund-Nasen-Masken (mindestens FFP2), Kopfhauben, Funktionskleidung, Mäntel, Schürzen und 2 Paar Handschuhe. In 4 Instituten wurden die Leichen nach unterschiedlichen Techniken eröffnet. In einem Institut wurde ein minimal-invasives Verfahren, die postmortale ultraschallunterstützte Gewebeentnahme im Rahmen des „postmortal imaging and biopsy programs“, durchgeführt. Letztere gibt zwar keine makroskopischen Einblicke in die inneren Organe, ermöglicht aber eine standardisierte bioptische Gewinnung von Gewebe für Diagnostik und Forschung. Aus den Obduktionen resultierten mehrere Arbeiten in hochrangigen Journalen, die profunde Einblicke in die Organveränderungen ermöglichten und wesentliche Schlüsse auf die Pathomechanismen zuließen. Virus-RNA konnte häufig in COVID-19-Verstorbenen nachgewiesen werden. Vereinzelt gelang auch die Anzüchtung der Viren. Die Frage nach der postmortalen Infektiosität bleibt aber unklar und bei Ct-Werten über 30 umstritten.FazitUnter Beachtung geeigneter Schutzmaßnahmen sind Obduktionen von COVID-19-Verstorbenen sicher durchführbar und für die medizinische Forschung hoch relevant.Zusatzmaterial onlineZusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00292-021-00925-w) enthalten.

Awareness and knowledge of undergraduate dental students about the signs and symptoms of Corona viral infection (COVID-19), and the required infection control measures to prevent its spread

BackgroundCoronavirus disease (COVID-19) is considered a highly contagious disease with flu-like symptoms and causing relatively high level of death. It can be transmitted from a person to another through droplets and that makes the dentists at high risk of infection. Therefore, the aim of the current study was to assess the awareness and knowledge of dental students about the signs and symptoms of Coronavirus disease (COVID-19) and to evaluate their awareness about the required infection control measures during the dental treatment to control the spread of the disease. A questionnaire was formed using Google forms and distributed among dental students and interns in different universities in Cairo, Egypt. Questions were about signs and symptoms of COVID-19, attitude of the dentists toward dental treatment of suspected patients and the required personal protective equipment (PPE) and infection control measures at the dental clinic.ResultsThe majority of the participants strongly agreed/agreed that COVID-19 is a highly dangerous disease, Participants reported that the most common symptom is difficulty in breathing (89.4%) followed by fever (84.4%). Face shield was the most recommended personal protective equipment (PPE) during dental treatment (98.6%) followed by disposable gown (96.3%). The majority of participants (84.8%) recommended using 70% ethyl alcohol as the first method to disinfect surfaces in between dental visits, followed by sodium hypochlorite.ConclusionsDental students and interns in Cairo, Egypt, have good knowledge and awareness about COVID-19 and the necessary precautions required to provide adequate dental treatment for the patients during the pandemic COVID-19; however, the importance of infection control should be highlighted for both clinical and preclinical dental students, to provide safe dental treatment to the patients as well as protection of the dentists and healthcare workers.

Self-Report Assessment of Nurses' Risk for Infection After Exposure to Patients With Coronavirus Disease (COVID-19) in the United Arab Emirates.

PurposeNurses have an increased risk for acquiring COVID‐19 infection. This study assessed levels of risk for exposure to COVID‐19 among nurses, and determined those at the greatest risk.DesignA cross‐sectional design was used to assess risk for exposure to COVID‐19 in nurses from five randomly selected governmental hospitals in the United Arab Emirates. Participants completed an online survey (including the World Health Organization survey) to assess their risk for exposure to COVID‐19. Descriptive statistics were used to describe classes of risk for exposure, and logistic regression was used to identify factors associated with greater risk.FindingsOf the 552 participants, 284 nurses (51.4%) were classified at high risk for COVID‐19 exposure as they did not report adherence to infection control and prevention (ICP) guidelines at all times during healthcare interactions and when performing aerosol procedures, or had accidental exposure to biological fluid and respiratory secretions. Compared with adherence to wearing medical masks, gloves, and hand hygiene practices, adherence to wearing face shields or goggles and disposable gowns and decontaminating high‐touch surfaces was less frequent. Shifting to work in critical care units, not having adequate critical care experience, and reporting a need for training in ICP practices were factors that contributed to high‐risk exposure (p values for Ex (Bs) = 2.60, 2.16, 1.75, ≤ 0.05, consecutively).ConclusionsA considerable number of nurses were classified at high risk for COVID‐19 exposure. Critical care work experience and adequate evidence‐based training in ICP practices related to COVID‐19 must be considered to mitigate the risk for exposure to COVID‐19 in nurses.Clinical RelevanceThis study provided a strong message regarding protecting nurses at high risk for exposure to COVID‐19. Clinical leaders must stay vigilant to ensure nurses’ adherence to ICP practices in the context of COVID‐19, and to proactively address any related deficits.

Disposable Surgical Gowns

Disposable Surgical Gowns

A new therapeutic communication model “TAGEET” to help nurses engage therapeutically with patients suspected of or confirmed with COVID‐19

To design and present a new communication model "TAGEET" to help nurses engage therapeutically with patients suspected of or confirmed with COVID-19. COVID-19 is a highly contagious disease that brings with it fear and anxiety for all involved inclusive of nurses and patients. New guidelines for nurses to follow such as attention to physical distance coupled with the wearing of defined personal protective equipment, gloves, long-sleeved disposable gown, FFP2 face mask and eye protection place additional strain on nurses to engage therapeutically with patients. Evidence suggests that the wearing of face masks and personal protective equipment acts as barriers to effective therapeutic engagement with patients. We found an absence of communication models to help nurses engage therapeutically with patients. This is a position paper that draws on previous research to inform the design of a new model for nurses to engage therapeutically with patients suspected of or confirmed with COVID-19. We reviewed the literature on caring for patients in isolation, the barriers to therapeutic communication and the psychological impact of infectious diseases on nurses and patients. Remaining emotionally present to self, whilst being present to others can be challenging for nurses in a pandemic environment. We believe that the "TAGEET" model (T-Tune-in, A-Approach and introduce, G-Ground self, E-Engage and respond, E-End encounter, T-Tune-out), although devised for nurses to engage therapeutically with patients suspected of or confirmed with COVID-19 could be used by all healthcare professionals in any challenging clinical environment. This new therapeutic communication model will provide support for nurses with how to manage self in the context of caring for others in a COVID-19 environment.

Prosthodontic practice during the COVID-19 pandemic: prevention and implications.

The objective of this review is to identify preventive measures for COVID-19 to safeguard dental professionals providing prosthodontic dental care. Electronic searches were performed in PubMed, Scopus, and Cochrane databases using the following descriptors and/or words: "COVID-19," "SARS-CoV-2," "Dental practice," "Prosthodontics," and "Dental infection control." Prosthodontists are at high risk for exposure to the novel coronavirus through aerosols and possibly contaminated surfaces and indirect contact with dental laboratories and dental technicians through impressions, dental stone casts, and fixed and removable prosthetic appliances. Therefore, preventive measures should be implemented, including performing emergency treatments only, rescheduling patients with suspected disease, disinfecting surfaces and prosthodontic materials with biocidal substances, and using protective equipment such as N95 masks, disposable gowns, and face-shields.

Streamlining the dental care during COVID-19 pandemic: updated clinical recommendations and infection control management framework

Several guidelines for dental practice have been published by dental associations and regulatory boards since the beginning of the pandemic. Initially, all non-emergency dental treatment were suspended. Healthcare personnel around the world are gradually expanding back to elective procedures. International updated recommendations alert that professionals must maintain regular observation of local health department reports, ensure personal protective equipment, and screen all patients for COVID-19 signs and symptoms. Telehealth strategies, patient screening, rescheduling when presenting COVID-19 symptoms and/or history of contact with infected people and hand/environment hygiene practices are reinforced. Appropriate cleaning and surface disinfection are mandatory. The dental staff must be trained to use appropriate Personal Protective Equipment (PPE), following a risk assessment and standard precautions: gloves; fluid resistant disposable gown, eye protection (face shield or goggles) and a medical mask. A fit tested N95 or KN95 respirator (or higher) is recommended when aerosol generating procedures are performed. Only essential accompanying persons should attend to dental appointment with the patient and must wear a cloth face covering or facemask. Social distancing and mask wearing by all staff are necessary in all areas of the office. Dental health care providers should keep up to date to the current guidance of clinical practice during the pandemic.

Upper gastrointestinal stenting during the SARS-CoV-2 outbreak: impact of mitigation measures and risk of contamination for patients and staff.

Background and study aims The impact of COVID-19 mitigation measures on stent placement procedures has not yet been reported. The aim of this study was to assess the impact of COVID-19 mitigation measures on upper stenting during SARS-CoV-2 outbreak, as well as the use of personal protection equipment (PPE) and risk of contamination for patients and staff. Patients and methods This was a multicenter, retrospective study of consecutive patients who underwent stent placement for upper gastrointestinal obstruction during the second half of SARS-CoV-2 outbreak period in comparison to same period one year before. Results A total of 29 stents were placed for upper gastrointestinal obstruction during the study period, corresponding to an increase of 241 % comparing to the same period in 2019 (n = 12). No significant major differences were found between the two time periods regarding patients’ baseline characteristics, post-stenting management and number of staff involved in stent placement. Fellows’ involvement was significantly lower in 2020 compared to 2019 (21 % vs 67 %; P = 0.01). The majority of procedures were performed using FFP2 /FFP3 mask (76 %), protective eyewear (86 %), two pairs of gloves (65 %), hairnet (76 %) and full disposable gowns (90 %). One patient tested positive for SARS-CoV-2 after the procedure. None of the medical staff involved in stenting procedures developed COVID-19 14 days after procedure. Conclusion Upper gastrointestinal stenting increased during the SARS-CoV-2 outbreak period, which could be related to yearly variation on the number of procedures or reflect a change of oncologic treatment practice during COVID times.

PANDEMIC SCENARIO OF TAMLUK IN PURBA MEDINIPUR DISTRICT

At the end of the last year, 2019 a pneumonia/ SARS like respiratory disease broke out Wuhan, the largest metropolitan area in Chinas Hubei province. It started in the month of December.On Feb 11, 2020, the WHO Director General announced that the disease is caused by a new variety of corona virus.The disease was called COVID-19 or Corona virus disease 2019. Corona virus is large, roughly spherical particles with tuberous surface projections. The objective of this paper is to increase awareness regarding COVID-19 among the people at Tamluk sub-division of purba Medinipur district of West Bengal in India. This paper highlights about different problems such as economical, social, educational and mental during pandemic period in Tamluk sub-division. Preventive strategies are (a) to wash hands frequently with a soap (b) to use personal protective equipment (PPE) such as FFP3 or N95 mask, disposable gown and gloves, (c) to maintain social distancing or avoid close contact with others (d) to avoid touching eyes, nose and mouth, (e) medical care for breathing problem (f) to admit local hospital for fever, coughs or sneezes (g) to avoid public gatherings (h) to stay home etc. The COVID-19 pandemic is spreading day after day all over the world. An immediate discovery of approved Vaccine is required to protect people against this disease.

Adapting trauma workflows for severely injured trauma patients during the COVID-19 pandemic: experience in a regional trauma centre in Singapore.

Adapting trauma workflows for severely injured trauma patients during the COVID-19 pandemic: experience in a regional trauma centre in Singapore.

Влияние неравновесной низкотемпературной плазмы на потребительские характеристики спанмелт-материала

Nonwovens (nonwovens) are widely used in medicine, for the manufacture of medical linen, sanitary and hygienic items, medical clothing, surgical materials (including dressings). The rapid development of the clothing market requires domestic manufacturers to be competitive not only through new products and technologies, but also new sensations for the consumer, provided that the price is competitive. According to medical workers, disposable surgical gowns based on spunmelt materials give a feeling of discomfort during use. One and relatively new method for modifying nanomaterials is treatment with nonequilibrium low-temperature plasma (NLTP). The main advantage of this type of material modification is the environmental friendliness of the method, as in the process of processing aqueous solutions of chemicals are not used, as in the case of using special impregnations. Modern research of medical services. As a result of the work, it was revealed that the modification of NM NNTP allows you to change the NM for changes in surface, physical and mechanical, as well as consumer properties, while maintaining the strength characteristics. It is shown that after plasma treatment spunmelt materials increase such consumer characteristics as air permeability, hygroscopicity, while maintaining the strength during elongation; reduction of material stiffness during bending. It was also found that after the processing of NTPP, the electrification rate increases within the normal range, in GOST 12.1.045-84. Manufacturers are recommended to process spunmelt material with non-equilibrium low-temperature plasma on a high-frequency capacitive plasma installation with a power of Wp = 1.5 kW, processing time τ = 180 s and pressure P = 21.5 Pa. Use argon gas with a gas flow of 1500 cm3/min as a plasma-forming gas.

Comparison of the conventional reusable cotton and disposable nonwoven fabric patient gowns in digital chest radiography

The purpose of this study was to analyze artifacts caused by conventional cotton material gowns in chest X-ray images obtained with digital radiography (DR) and to evaluate whether image artifacts were reduced when nonwoven fabric gowns were used. We assessed DR chest X-ray images of patients in our hospital database for artifacts. We also obtained images of reusable woven gowns made of two thicknesses of cotton and of disposable gowns made of unwoven polypropylene material. We then measured signal and noise obtained in the same test regions of these different types of gowns, three times under the same conditions and calculated the mean of each signal. The regions of interest (ROI) selected were based on three representative regions of the chest images; signal and noise were measured using a window width of 950 and a window level of 3340 after setting an ROI measuring 334 mm2. In the patient images, linear artifacts caused by cotton gowns appeared in the left and right upper lung areas, while no artifacts were caused by gowns made of nonwoven material. In the comparison of gowns made of different materials, the mean value of the ROI signal of the cotton material was significantly higher than that of the nonwoven material (p = 0.01); the noise value of the cotton material was also higher, but without statistical significance. Linear artifacts were found in images obtained in DR chest radiography when patients wore cotton fabric gowns, but no artifacts were observed when these were replaced with nonwoven fabric gowns.

COVID-19 Guidelines to Protect Healthcare Workers at Hospitals and Dental Professionals at Dental Office.

Coronavirus disease 2019 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. This study aimed to address the preventive procedures to protect healthcare workers at hospital to avoid COVID-19, and infection control procedures to protect dental professionals in dental office. We conducted a search of published articles from PubMed, google scholar databases using key words such as COVID-19, healthcare worker, infection control, and dental practice. Relevant articles were identified and reviewed. Most published papers were clinical reports and case studies. We have selected some of the current published papers written in English in 2020. Infection control procedures to protect health workers at hospitals, and dental professionals at dental office were summurised and presented. Infection control procedures for healthcare workers at hospitals include Personal protective equipment, Korea filter (KF)94 respirator, goggles, face protector, disposable waterproof long-arm gown, and gloves, and others. Extra-protection procedures should be taken with old and vulnerable healthcare workers. Dental professionals should evaluate patients in advance before starting dental treatment. Aerosols generating procedures should be avoided and personal protective equipment should be used. Dental treatment should be restricted to emergency cases only. Old medical staff should be in safer distance to avoid infection, but young physicians and nurses should work at frontline as their immunity is better than their colleagues at old age. Screening patients and measurement of the body temperature are essential measures before dental treatment.

Risk assessment for rationalizing the use of personal protective equipment for SARS-CoV2 in healthcare settings with special focus on low- and middle-income settings

Risk assessment for rationalizing the use of personal protective equipment for SARS-CoV2 in healthcare settings with special focus on low- and middle-income settings

Disposable versus reusable medical gowns: A performance comparison

BackgroundMedical gowns are essential personal protective equipment (PPE) that prevents the spread of microorganisms and bodily fluids. During surge capacity situations, such as the COVID-19 pandemic, reusable PPE is often recommended due to shortages. MethodsThis research evaluated the performance of disposable versus reusable medical gowns by assessing their ability to provide adequate protection across their expected service lifespan. Level I, II, and III gowns were tested for water resistance and hydrostatic pressure, along with other durability assessments (breaking, tear, and seam strength, pilling resistance, dimensional stability, and air permeability, colorfastness, and fabric hand) per standard test methods. Data were collected at new for the disposable gowns and after 1, 25, 50, and 75 industrial launderings for the reusable gowns. Results were compared to the Association of the Advancement Instrumentation® (AAMI) PB70 performance specifications. ResultsLevel I and II disposable gowns did not meet AAMI performance specifications for impact penetration water resistance. All 3 levels of disposable gowns also failed to meet the American Society for Testing and Materials performance requirements for breaking strength in the crosswise direction. ConclusionsThe adoption of reusable gowns may result in increased protection and significant cost savings due to their superior durability and sustainability when compared to disposable gowns.

Locally produced personal protective equipment can offer hospital staff protection against Covid‐19 if combined with surgical masks and rigorous personal protective equipment cleaning routine

Locally made, washable and reusable personal protective equipment (PPE), used in combination with N95 masks that were reused safely, has proven to be a viable alternative to disposable gowns and caps for hospital staff in low‐ and middle‐income countries. Muhimbili University Hospital's children's cancer ward in Dar es Salaam, Tanzania, developed locally made PPE and created rigorous cleaning and disinfecting protocols, when the daily use of imported, disposable materials were not an option. These items continue to protect staff, children and parents. The novel PPE approach was able to prevent staff from becoming infected during the pandemic despite the fact that several parents, and subsequently their children, became infected with Covid‐19 during cancer treatment at the facility.

Mastoid surgery: a high-risk aerosol generating surgical procedure in COVID-19 pandemic

<p class="abstract">Corona virus disease 2019 (COVID-19) is highly contagious disease occurred by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) which spreads human to human through respiratory secretions. It was declared as public health emergency all over the world. There is lack of data in relation to the otologic or mastoid surgery during COVID-19 pandemic. Aerosolization of the novel corona virus SARS-CoV-2 is associated with middle ear and mastoid surgery. So, the safety precautions are important parts in this present pandemic time for preventing transmission of the infections to the surgeon and team members of the surgery. Preoperative screening for COVID-19 is must for safety of the surgeon and team members. The mastoid surgery on the positive, suspected or unknown status for COVID-19 patients need protection with adequate Personal protection equipment (PPE) such as disposable cap, N95 respirator and sealed eye protection or Powered air-purifying respirator (PAPR), disposable gown and gloves. In the mastoid surgery, there is scarcity of the medical literature related to the transmission of the novel corona virus SARS-CoV-2and its prevention during present COVID-19 pandemic. So, the aim of this review article is to increase awareness among the otolaryngologists for preventing the viral exposure during the mastoid surgery.</p>

Infertility Treatment in COVID-19 Pandemic

AbstractThe Coronavirus pandemic has had a great impact on various health sectors including pregnancy and infertility treatments like in vitro fertilization (IVF), in utero insemination (IUI), ovulation-induction, laparoscopy, hysteroscopy, and assisted reproductive techniques (ART). Due to the current situation in the COVID-19 pandemic and the relaxation permitted by the government, allowing nonessential services in a gradual manner, infertility services are being resumed according to the guidelines set by the ministry of health and family welfare. To meet the demands of current situation, the patient and the staff should be triaged. Only those patients should be undertaken who are tested or screened negative. Diagnostic evaluation is done using RT-PCR and the testing should be done at the commencement of treatment, that is, on day 2 of IVF/intracytoplasmic sperm injection (ICSI) cycle. Repeat test is done before the hCG trigger. The husband also needs testing at least once during the cycle, preferably at the start of the cycle. If the donor tests positive for COVID-19, the cycle should be cancelled. Universal good practices should be followed in laboratory also by each staff, which includes use of proper personal protective equipment (PPE) like eye protectors, FFP-2 or N-95 face masks, double gloves, shoe covers, disposable impermeable gowns, and face shields. The sanitization of the laboratory environment, equipment and devices should be done with appropriate nonembryotoxic disinfectants at the end of each procedure. COVID-19 has actually changed the way infertility treatment is being provided, keeping in view the safety of both the doctors and the patient.

COVID-19 Salgınında Sağlık Çalışanlarının Kişisel Koruyucu Ekipman Kullanımları ile Depresyon, Anksiyete, Stres Düzeyleri Arasındaki İlişkinin Belirlenmesi

Aim: In our study, it was aimed to determine the relationship between the use of personal protective equipment by healthcare workers in the COVID-19 epidemic and their depression, anxiety and stress levels. Material and Methods: 384 healthcare professionals working in a pandemic hospital participated in our descriptive study conducted in May 2020. The data collection tools; A form consisting of descriptive features, personal protective equipment use cases and Depression-Anxiety-Stress Scale (DASS-21) was used. The forms were delivered to healthcare professionals online and the responses were collected and analyzed in this way. Results: In our study, the Anxiety and Stress scores of female healthcare workers and the “DASS-21 anxiety score” of single healthcare workers were found to be statistically significantly higher (p=0.008; p=0.001; p=0.019; p 0.05). During COVID-19 pandemic, statistically significant differences were found between Depression Anxiety and Stress scores of healthcare workers according to their visor or goggles / protective glasses use(p<0.01; p<0.05; p<0.01). Similarly, the use of disposable gowns / overalls and similar equipment during the epidemic caused a statistically significant difference in “DASS-21 depression and stress scores” in healthcare workers (p=0.002; p<0.01; p=0.029; p<0.05). Conclusion: It was observed that depression, anxiety and stress conditions of healthcare workersworking intensively during the COVID-19 outbreak were affected. Suitable working environments and necessary protective equipment should be provided for healthcare professionals. With the planning for the development of mental health protection programs, it can be ensured that they overcome the intensive process with the least damage.