Availability Of Personal Protective Equipment Research Articles

Practices of Midwives in the Use of Personal Protective Equipment when Aid Labor during the COVID-19 Pandemic

Background: In the era of the COVID-19 pandemic, the use of personal protective equipment (PPE) is very important to reduce the risk of transmitting infectious diseases to medical personnel because it can prevent contact with pathogens. This shows that midwives as first-line managers of pregnancy, childbirth and postpartum cases must be vigilant by wearing complete Personal Protection Equipment (PPE) so that there is no transmission of the virus from the patient to the midwife. Objective: To determine the analysis of midwives' practices in using PPE when assisting labor during the COVID-19 pandemic at the Banten Regional General Hospital 2020-2021.
 Methodology: A quantitative analytic study using a cross sectional approach. The sample in this study was 102 respondents with purposive sampling technique. Data were analyzed using SPSS with Chi Square, which previously tested the validity and reliability.
 Results: The use of PPE in midwives in Banten Hospital obtained an average value of 84.3. Based on age, the average value was 53.9. Based on the length of service, the average score was 96.1. Based on education, the average score is 55.9. The results of the chi-square test showed that all independent variables had no relationship with the use of PPE including knowledge (p = 0.323), attitude (p = 0.665), availability of PPE (p = 0.740), and supervision (p = 0.603).
 Conclusions and Suggestions: The use of PPE in midwives has no relationship with knowledge, attitudes, availability of PPE and supervision. There is a need for socialization about the importance of using PPE to midwives in order to maintain the quality of expected care services. There is a need for an K3 unit in Banten Hospital which is one of the authorities. There needs to be special attention from the Hospital Management regarding the supervision of the use of PPE in midwives.

Quo Vadis, COVID-19?

Quo Vadis, COVID-19?

Disaster response and COVID-19: was safety and health a priority among medical doctors in Serbia?

Abstract The coronavirus disease (COVID-19) pandemic has an unimaginable impact on the global health workforce. Health workers are deployed as frontline workers to rapidly respond to increasing patient needs. This study aimed to examine the preparedness of healthcare workers during the COVID-19 pandemic to protect their own safety and health. An online survey was conducted among physicians licensed by the Serbian Medical Chamber in September 2020. The Ethics Committee of the Serbian Medical Chamber approved this study (Decision No: 1462/September 15, 2020). The sample consisted of 1,553 physicians who completed the online questionnaire. Almost two thirds (64%) of the physicians worked with COVID-19 patients, and around one third (34%) were deployed to a different work position. Physicians working with COVID-19 patients were younger, less-experienced (mean work experience 14 years vs. 19.5 years) and more commonly non-specialists. Less than 39% of physicians deployed to work with COVID-19 patients had gone through the training on the use of personal protective equipment (PPE), 60% had adequate PPE available daily, and 86% reported using the PPE according to the recommendations. Having proper training regarding the use of PPE and using the PPE according to the recommendations was less common in private compared to public health institutions (31% vs 40% for training, and 89% vs 75% for adequate use, respectively). Workers engaged to work with COVID-19 patients, compared to those who were not engaged, indicated the need for professional changes to respond to the COVID-19 emergency, especially in the areas of workforce planning, education and training, workload measurement and tracking. Younger and less experienced physicians with questionable training and availability of PPE were deployed to work in COVID-19 hospitals and units, and their health and safety was a secondary priority to the primary duty of caring for patients in need. Key messages Younger and less experienced physicians with questionable training and availability of PPE were deployed to work in COVID-19 hospitals and units. Health and safety was a secondary priority to the primary duty of caring for patients in need.

How are countries supporting health workers? Data from the COVID-19 Health System Response Monitor

BackgroundHealth workers have been at the forefront of treating and caring for patients with COVID-19. They were often under immense pressure to care for severely ill patients with a new disease, under strict hygiene conditions and with lockdown measures creating practical barriers to working. This study aims to explore the range of mental health, financial and other practical support measures that 36 countries in Europe and Canada have put in place to support health workers and enable them to do their job.MethodsWe use data extracted from the COVID-19 Health Systems Response Monitor (HSRM). We only consider initiatives implemented outside of clinical settings where COVID-19 patients are treated, and therefore exclude workplace provisions such as availability of personal protective equipment, working time limits or mandatory rest periods.ResultsWe show that countries have implemented a range of measures, ranging from mental health and well-being support initiatives, to providing bonuses and temporary salary increases. Practical measures such as childcare provision and free transport and accommodation have also been implemented to ensure health workers can get to their workplace and have their children looked after. Other initiatives such as offering continuing professional development credits for knowledge learnt during the crisis were also offered in some countries, albeit less frequently.ConclusionsWhile a large number of initiatives have been introduced, often as ad-hoc measures, their effectiveness in helping staff is unknown in most countries. The effectiveness of these initiatives should be evaluated to inform future crisis responses and strategies for health workforce development.

70 Availability of Personal Protective Equipment in NHS Hospitals During COVID-19: A National Survey

Abstract Introduction The continuous supply of personal protective equipment (PPE) in the National Health Service (NHS) is paramount in order to sustain a safe level of staffing and to reduce transmission of COVID-19 to patients, public and staff. Method A 16-question survey was created to assess the availability and personal thoughts of healthcare professionals regarding PPE supply in England. The survey was distributed via social media (Facebook © and Twitter ©) to all UK COVID-19 healthcare professional groups, with responses collected over 3 weeks in March 2020 during the beginning of the pandemic. Results A total of 121 responses from physicians in 35 different hospitals were collected (105 inpatient wards, 16 from intensive care units). In inpatient wards, eye and face protection were unavailable to 19.1% of respondents. Masks were available to 97.7% of respondents and gloves in all respondents (100%). Body protection was available primarily as a plastic apron (83.8%). All of respondents working in intensive care had access to full-body PPE, except FFP3 respirator masks (available in 87.5%). PPE is ‘Always’ available for 29.8% of all respondents, and ‘Never’ or ‘Almost Never’ in 11.6%. There was a statistically significant difference between London and non-London responders that ‘Always’ had PPE available (43.9% versus 19.0%, p = 0.003). Conclusions This is the first survey to evaluate PPE supply in England during the COVID-19 pandemic. Our survey demonstrated an overall lack of PPE volume supply in the UK, with preferential distribution in London. Eye and full body protection are in most lack of supply.

Shortage of Personal Protective Equipment and Nurse Safety in the Coronavirus Disease-19 Pandemic: A Cross-sectional Study in Indonesia

BACKGROUND: There has been a substantial scarcity of personal protective equipment (PPE) in several countries during the ongoing pandemic of Coronavirus disease-19 (COVID-19). Nurses in Indonesia also experience a shortage of PPE as the number of COVID-19 patients in Indonesia continues to increase. There is no accurate data yet regarding the exact number of PPE scarcity for nurses. AIM: This study aimed to describe the availability of PPE and adverse consequences long-term used off the PPE and examine the relationship between shortage PPE and nurse behavior response in Indonesia. METHODS: An online-based survey was used to collect data on the nurse, regardless of their discipline, training background, or degree of experience, who are directly involved in managing COVID-19 patients. In this study, a total of 211 questionnaires were gathered. The survey was conducted using the Google form. This study employs univariate and bivariate analysis. RESULTS: Most of the mask N95 provision reaches up to 80%. The second is the hazmat (71%) and the lowest in the gloves (30%). Around 71% of respondents generally resist removing their PPE until the shift is complete. Then, 62% of the respondents are ready to propose to the leaders of the PPE, and 51% show that they are modifying the PPE. Nasal blisters are the most prevalent type of injury sustained by nurses while wearing PPE (86%), followed by headaches and dehydration. This study found that most respondents (60.7%) with insufficient PPE had a positive behavior reaction, whereas just 18% had a poor behavior reaction. CONCLUSION: Most nurses have difficulties accessing N95 and experience some adverse effects of prolonging PPE use. Policymakers should take urgent action to tackle these concerns.

Personal Protective Equipment for Frontline Health-Care Workers During COVID-19 Pandemic

The coronavirus disease-2019 (COVID-19) pandemic has thrown health systems indiscriminately across the globe into turmoil. The important route for the spread of COVID-19 is through aerosolized droplets that are expelled at the time of coughing, sneezing, or breathing, but there are also concerns for possible airborne transmission. COVID-19 pandemic has placed an unprecedented stress on the health-care system. Sudden increase in demand and limited availability of personal protective equipment (PPE) is making risks on health-care workers, which hamper their ability for effective management of the patients. Several health-care workers are dying in this global outbreak because of the improper protective measures during performing the high-risk procedures. Limited availability of the vaccine to health-care workers in all parts of the world and inadequate supply of proper therapeutic agents, such as personal protective measures, among health-care workers for restricting the COVID-19 spread are an important requirement. Regardless of the debate among the medical community for the use of PPE, a greater number of countries in the world are moving ahead with recommendations or mandates for using PPE in clinical interventions or caring for the COVID-19 patients. Some have attributed the death of health-care workers to inadequate supply of the PPE. However, there are some concerns about the improper use of PPE by the health-care workers. Policy makers, government, and health experts have increased the importance of manufacturing more PPE for the safety of the health-care professionals particularly frontline workers for COVID-19 patients. This review article provides an overview of PPE for frontline health-care workers in the COVID-19 pandemic.

Perceived Risks and Ramifications of the COVID-19 Pandemic by Community and Healthcare Providers in Nepal

Background: The COVID-19 pandemic has inflicted real suffering in many parts of the world and is expected to impact different sectors. Lockdown is considered to be an effective measure in slowing the spread of coronavirus. The study expects to understand community and healthcare providers’ perspectives on COVID-19 and pandemic responses during and after the lockdown in Nepal.
 Methods and Materials: Data were collected through telephone interviews with six representatives of community-based organizations and nine healthcare providers, and the collation of information about COVID-19 from social media, news outlets and government announcements. Data were thematically coded and analyzed according to the themes.
 Results: Although rapid dissemination of educational information through various social media was found, people reported an information overload on COVID-19 while questioning the authenticity of their sources. Several misbeliefs on the COVID-19 virus are rooted in the Nepalese community. Lockdown for a longer period was deemed an unsustainable preventive measure that directly impacted the income source of daily-wage workers. The fear of contracting coronavirus among healthcare providers at their workplaces was further triggered by the poor working conditions and non-availability of personal protective equipment (PPE). In fighting the pandemic, screening and management of other health issues were ignored.
 Conclusion: The prevention measures against COVID-19 are important for the local context, however, the communities need access of basic commodities and access to reliable information to enable them to follow these measures. Availability of appropriate PPE for the healthcare providers is required to reduce the fear of contracting the virus from the patients and workplace. Essential health-care services must also be continued to help reduce excess mortality and morbidity.

Community pharmacists’ needs, education, and readiness in facing COVID‐19: Actions & recommendations in Egypt

IntroductionCoronavirus disease 2019 (COVID‐19) outbreak is considered one of the most important public health crises all over the world and in Egypt. Community pharmacists represent the third largest health care professional group after physicians and nurses. Community pharmacists are expected to be fully prepared at the frontline of defending their community needs by limiting the spread of COVID‐19 via different pharmaceutical care services.AimThis study aimed to evaluate the sources of knowledge and readiness of community pharmacists in facing COVID‐19 early outbreak in Egypt.MethodsA descriptive cross‐sectional study was performed via a self‐administered online google form questionnaire during the early period from 14 April to 3 June 2020. The questionnaire focused on; evaluating education level, sources of information, and readiness of Egyptian community pharmacists in the COVID‐19 pandemic crisis.ResultsA total of 318 community pharmacists from Egypt participated in this questionnaire. About half of the surveyed pharmacists reported that they were frequently consulted and that their patients were seeking consultation regarding COVID‐19 management more than 10 times per day. More than half of the pharmacists reported using social media as a source of information and knew the right social distancing recommendations. Regarding protective measures, only a quarter of pharmacists disclosed the availability of personal protective equipment (PPE). Nevertheless, the majority of pharmacists significantly reported some initial lack of support either inform of recommendations or PPE supply.ConclusionThe study revealed the dependence of community pharmacists on social media as the main source of information and the lack of early awareness of evidence‐based practice resources. Community pharmacists were in need of more initial support to achieve better satisfaction, patient counselling and infection control. Corrective measures were promptly undertaken to support and satisfy the Egyptian community pharmacists’ initial awareness and readiness facing COVID‐19.

Examining the cost-effectiveness of personal protective equipment for formal healthcare workers in Kenya during the COVID-19 pandemic

BackgroundHealthcare workers are at a higher risk of COVID-19 infection during care encounters compared to the general population. Personal Protective Equipment (PPE) have been shown to protect COVID-19 among healthcare workers, however, Kenya has faced PPE shortages that can adequately protect all healthcare workers. We, therefore, examined the health and economic consequences of investing in PPE for healthcare workers in Kenya.MethodsWe conducted a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model following the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. We examined two outcomes: 1) the incremental cost per healthcare worker death averted, and 2) the incremental cost per healthcare worker COVID-19 case averted. We performed a multivariate sensitivity analysis using 10,000 Monte Carlo simulations.ResultsKenya would need to invest $3.12 million (95% CI: 2.65–3.59) to adequately protect healthcare workers against COVID-19. This investment would avert 416 (IQR: 330–517) and 30,041 (IQR: 7243 – 102,480) healthcare worker deaths and COVID-19 cases respectively. Additionally, such an investment would result in a healthcare system ROI of $170.64 million (IQR: 138–209) – equivalent to an 11.04 times return.ConclusionDespite other nationwide COVID-19 prevention measures such as social distancing, over 70% of healthcare workers will still be infected if the availability of PPE remains scarce. As part of the COVID-19 response strategy, the government should consider adequate investment in PPE for all healthcare workers in the country as it provides a large return on investment and it is value for money.

Willingness to Work amongst Australian Frontline Healthcare Workers during Australia's First Wave of Covid-19 Community Transmission: Results of an Online Survey.

The majority of research investigating healthcare workers' (HCWs) willingness to work during public health emergencies, asks participants to forecast their perceptions based on hypothetical emergencies, rather than in response to the actual public health emergencies they have experienced. This research explored frontline HCWs willingness to work during Australia's first wave of the COVID-19 pandemic among frontline HCWs. Participants (n = 580) completed an online questionnaire regarding their willingness to work during the pandemic. A total of 42% of participants reported being less willing to work during the pandemic compared to before. Availability of personal protective equipment (PPE), concern expressed by family members, and viral exposure were significant barriers. A third of participants disagreed that some level of occupational risk for exposure to infectious disease was acceptable while a quarter of participants had received communications from their workplace concerning obligations to work during COVID-19. The COVID-19 pandemic has impacted Australian frontline HCWs' willingness to work. Scarcity of PPE and exposure to the virus were the most cited reasons impacting on willingness to work. Appropriate policies and practices should be implemented and communicated efficiently to frontline HCW's. This research provides insight into the lived experiences of Australian healthcare professionals' willingness to work during a pandemic.

The Psychosocial Impact of COVID‐19 on Registered Nurses

Research ObjectiveCentral the COVID‐19 pandemic response are registered nurses (nurses), making life and death decisions amidst personal protective equipment (PPE) shortages and scarcity in other resources (e.g., ventilators, medications, staff). Emerging international evidence suggests nurses are at higher risk for detrimental psychosocial outcomes related to the pandemic, such as anxiety, depression, and sleep problems, compared to other clinician groups. The objective of this research is to describe the psychosocial impact of the COVID‐19 pandemic on nurses currently practicing in the U.S.Study DesignWe conducted a concurrent mixed methods study from May‐August 2020. Participants were recruited through email listservs from regional professional nursing organizations, NIOSH‐funded Education and Research Centers nationwide, and through social media. Through REDCap, participants completed researcher‐developed sociodemographic and work characteristic questions (e.g., unit type, staffing levels, availability of PPE), and several validated instruments to measure depressive symptoms (Patient Health Questionnaire; PHQ‐9), anxiety (Generalized Anxiety Disorder; GAD‐7), insomnia (Insomnia Severity Index; ISI), and resilience (Connor Davidson Resilience Scale; CD‐RISC‐10). A subset of participants was purposefully selected for semi‐structured individual phone interviews to achieve maximum variation. Following data collection, we randomly drew 10 participants to receive a $50 Amazon giftcard.Population StudiedWe recruited a sample of nurses from 36 states and the District of Columbia. The analytic sample included N=629 for the survey and N=34 for the interviews. We report only survey findings herein.Principal FindingsParticipants were on average 43 years old (SD 13), 92% female, and 80% White; 92% were non‐Hispanic. Three‐quarters (76%) worked in inpatient hospital settings; 20% worked in intensive care or step‐down units. Approximately 70% of the sample worked day shifts and 59% worked 12‐hour shifts. Out of a list of 13 common PPE items, 91% of the sample reported at least one PPE shortage since the pandemic began, and 24% reported bringing or making their own PPE for use at work. Over one in four (28%) nurses reported being unsure or planned to leave their employer in the next year. About 18% of the sample scored ≥ 15 on the ISI, suggesting insomnia symptoms significant enough to warrant evaluation and treatment. A third of participants (34%) had scores reflecting mild anxiety, a quarter (24%) had scores reflecting moderate anxiety, and 9% scored in the range reflecting severe anxiety on the GAD‐7. Reports on the PHQ‐9 showed 9% of the sample with scores consistent with major depressive disorder while another 7% scored in the range consistent with other depressive disorder. Finally, the average CD‐RISC score was 29, with lower scores indicating lower resilience (range 0‐40).ConclusionsAs with other countries, U.S. nurses are facing highly stressful working conditions, with warning signals indicated in the psychosocial domains of anxiety, depression, and insomnia. Overall, resilience levels are worse than pre‐pandemic levels from previously published literature.Implications for Policy or PracticeAs healthcare organizations adapt and respond to the pandemic, priority should be given to assessing and treating the psychosocial harm to nurses. Evidence‐based treatments and development of novel interventions to support this vital healthcare sector are warranted.Primary Funding Sourceintramural university funds

Challenges to the orthopedic resident workforce during the first wave of COVID-19 pandemic: Lessons learnt from a global cross-sectional survey

BackgroundThe COVID-19 pandemic has caused unprecedented concerns on the safety, well-being, quality of life(QOL), and training of the orthopedic resident physician workforce worldwide. Although orthopedic residency programs across the globe have attempted to redefine resident roles, educational priorities, and teaching methods, the global orthopedic residents’ perspective with regards to their safety, well-being, QOL, and training, taking into account regional variances remains unknown. MethodsA 56-item-questionnaire-based cross-sectional survey was conducted online during the COVID-19 pandemic involving 1193 orthopedic residents from 29 countries across six geographical regions to investigate the impact of the COVID-19 pandemic on the well-being, safety, and training of orthopedic residents at a global level, as well as to analyze the challenges confronted by orthopedic residency programs around the world to safeguard and train their resident workforce during this period. ResultsThe total response rate was 90.3%(1077/1193). Time spent on residency-training activities decreased by 24.7 h/week (95% CI, −26.5 to −22.9,p < 0.001), with 50.2% (n = 541) residents performing duties outside their residency curriculum. 80.5% (n = 869) residents had no prior experience working in infectious outbreaks. A greater percentage of residents from Middle East, Asia and Europe were redeployed to the COVID-19 frontlines, p < 0.001. Only 46.5% (n = 491) and 58.4% (n = 600) of residents underwent training in critical care or PPE (Personal Protective equipment) usage, respectively; 28.5% (n = 302) residents (majority from Africa, Middle East, South America) reported lack of institutional guidelines to handle infectious outbreaks; 15.4% (n = 160) residents (majority from Africa, Asia, Europe) had concerns regarding availability of PPE and risk of infection. An increase in technology-based virtual teaching modalities was observed. The most significant stressor for residents was the concern for their family's health. Residents' QOL significantly decreased from 80/100 (IQR 70–90) to 65/100 (IQR 50–80) before and during the pandemic, p < 0.001. ConclusionsThe COVID-19 pandemic has significantly impacted the safety, well-being, QOL, and training of the global orthopedic resident physician workforce to different extents across geographical regions. The findings of this study will aid educators, program leaderships, and policy makers globally in formulating flexible, generalizable, and sustainable strategies to ensure resident safety, well-being, and training, while maintaining patient care.

Attitudes, stressors and work outcomes related to the COVID-19 pandemic among dental assistants in Germany: a cross-sectional study

ObjectivesThe COVID-19 pandemic has posed great challenges to medical professionals worldwide. Dental assistants (DAs) are at exceptionally high risk of infection with SARS-CoV-2 due to frequent and close patient contact...

A Phenomenological Study of COVID-19’s Impact on U.S. Nursing Personnel

The COVID-19 pandemic overwhelmed the New York City area upon its arrival in the United States. Hospitals were unprepared to handle the influx of patients. This study explored nurse/nurse practitioner experiences when caring for COVID-19 patients in New York metropolitan hospitals, concentrating on physical well-being. Data collection involved in-depth interviews with eight participants. (A) physical safety of self, family members, colleagues, and patients greatly concerned participants; (B) caring for COVID-19 patients led to participants' physical exhaustion; and (C) most participants' sleep was impacted when caring for COVID-19 patients. This study identified issues involving U.S. health care workplace safety during the COVID-19 pandemic, namely availability of personal protective equipment, lack of centralized knowledge-sharing capabilities, sleep problems, anxiety regarding physical safety of self and others, and insufficient/undertrained staffing. It serves as a foundation for future research and calls for changes in U.S. hospital policies and procedures during crises.

Intensive care unit professionals during the COVID-19 pandemic in Spain: social and work-related variables, COVID-19 symptoms, worries, and generalized anxiety levels.

Background The severe acute respiratory syndrome coronavirus 2 outbreak has been identified as a pandemic and global health emergency. It presents as a severe acute respiratory disease. The rapid dissemination of the disease created challenges for healthcare systems and forced healthcare workers (HCWs) to deal with many clinical and nonclinical stresses. The aim of our research is to describe work conditions, symptoms experienced by HCWs, worries about contagion, and generalized anxiety symptoms and compare those findings across regions in Spain. Methods This cross-sectional study was conducted using an online survey. Critical care units throughout Spain were included. The sample comprised HCWs working in intensive care units from March to May 2020. We assessed work variables, physical symptoms, worries about contagion, and anxiety (generalized anxiety disorder-7 questionnaire). Results The final sample comprised 448 surveys. Among the respondents, 86.9% (n=389) were nursing professionals, and 84.8% (n=380) were women. All participants cared for coronavirus disease 2019 (COVID-19) patients during the study period. Workload during the pandemic in Madrid was judged to be higher than in other regions (P<0.01). The availability of personal protective equipment was found to be higher in Cataluña. The most frequently experienced symptom was headaches (78.1%). Worries about self-infection and the possibility of infecting others received mean scores of 3.11 and 3.75, respectively. Mean scores for generalized anxiety levels were 11.02, with 58.7% of the professionals presenting with generalized anxiety syndrome during the assessment. Conclusions In this study, we found high levels of anxiety among HCWs caring directly for COVID-19 patients, which could produce long-term psychological alterations that still need to be assessed.

Prospective SARS-CoV-2 cohort study among primary health care providers during the second COVID-19 wave in Flanders, Belgium.

Primary health care providers (PHCPs) are assumed to be at high risk of a COVID-19 infection, as they are exposed to patients with usually less personal protective equipment (PPE) than other frontline health care workers (HCWs). Nevertheless, current research efforts focussed on the assessment of COVID-19 seroprevalence rates in the general population or hospital HCWs. We aimed to determine the seroprevalence in PHCPs during the second SARS-CoV-2 wave in Flanders (Belgium) and compared it to the seroprevalence in the general population. We also assessed risk factors, availability of PPE and attitudes towards the government guidelines over time. A prospective cohort of PHCPs (n = 698), mainly general practitioners, was asked to complete a questionnaire and self-sample capillary blood by finger-pricking at five distinct points in time (June-December 2020). We analysed the dried blood spots for IgG antibodies using a Luminex multiplex immunoassay. The seroprevalence of PHCPs remained stable between June and September (4.6-5.0%), increased significantly from October to December (8.1-13.4%) and was significantly higher than the seroprevalence of the general population. The majority of PHCPs were concerned about becoming infected, had adequate PPE and showed increasing confidence in government guidelines. The marked increase in seroprevalence during the second COVID-19 wave shows that PHCPs were more at risk during the second wave compared to the first wave in Flanders. This increase was only slightly higher in PHCPs than in the general population suggesting that the occupational health measures implemented provided sufficient protection when managing patients.

EXPOSURES AND RISK FACTORS OF CORONA VIRUS AMONG HEALTH CARE WORKERS AND NEED FOR PREVENTIVE MEASURES IN COMBINED MILITARY HOSPITAL RAWALPINDI

Objective: Prospective To determine the various risk factors and exposures for spread of Corona Virus Disease 2019 (COVID19) among health care workers working at Combined Military Hospital Rawalpindi.&#x0D; Study Design: Cross sectional study.&#x0D; Place and Duration of Study: Combined Military Hospital, Rawalpindi, from Apr to Jul 2020.&#x0D; Methodology: A total of 134 health care workers who were infected with COVID-19, were included in study. A structured questionnaire was attained after informed consent and approval from hospital ethical committee. Data was analyzed using SPSS-19 statistical software.&#x0D; Results: Overall, 134 of 2591 Health care workers (Health care workers) in Combined Military Hospital Rawalpindi tested positive for COVID-19 during the study period. The infection rate was 5.17%. Among them 25 (18.7%) were women and 109 (81.3%) were men. There was not statistical difference in infection rate between male and female health care workers p=0.156). The infection rate in clinical category was significantly higher than non-clinical category (p&lt;0.001. The infection rate in nursing assistants was significantly higher than the doctors (p=0.021). Personal protective equipment was optimally provided to health care workers except for goggles and face shields whose provision and use were both lacking.&#x0D; Conclusion: Health care workers are at high risk of developing COVID-19. There is need for extensive training, easy availability of personal protective equipment and strict compliance to infection control policies.

How clinicians manage routinely low supplies of personal protective equipment

Recommended personal protective equipment (PPE) is routinely limited or unavailable in low-income countries, but there is limited research as to how clinicians adapt to that scarcity, despite the implications for patients and workers. This is a qualitative secondary analysis of case study data collected in Liberia in 2019. Data from the parent study were included in this analysis if it addressed availability and use of PPE in the clinical setting. Conventional content analysis was used on data including: field notes documenting nurse practice, semi-structured interview transcripts, and photographs. Data from the majority of participants (32/37) and all facilities (12/12) in the parent studies were included. Eighty-three percent of facilities reported limited PPE. Five management strategies for coping with limited PPE supplies were observed, reported, or both: rationing PPE, self-purchasing PPE, asking patients to purchase PPE, substituting PPE, and working without PPE. Approaches to rationing PPE included using PPE only for symptomatic patients or not performing physical exams. Substitutions for PPE were based on supply availability. Strategies developed by clinicians to manage low PPE likely have negative consequences for both workers and patients; further research into the topic is important, as is better PPE provision in low-income countries.

Availability and use of personal protective equipment and satisfaction of healthcare professionals during COVID-19 pandemic in Addis Ababa, Ethiopia

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.