Personal Protective Equipment Removal Research Articles

Enhancing workplace safety: A flexible approach for personal protective equipment monitoring

Workplace safety is a prominent concern, motivating researchers across diverse disciplines to investigate valuable ways to address its challenges. However, creating an efficient system to address this issue remains a significant challenge. Since many accidents happen due to improper usage or complete removal of Personal Protective Equipment (PPE), one straightforward method for enhancing workplace security involves monitoring their usage This paper introduces an Operator Area Network (OAN) system which improves the existing solutions by increasing portability across different users and environments, non-intrusiveness and privacy. To enhance robustness in detecting the situations in which PPEs are not used correctly, we take advantage of Machine Learning to analyse the received signal strength indicator (RSSI) between PPEs in the same OAN The novelty of this work is that it does not exploit RSSI as a proxy of the distance but instead recognizes a signature of the correct wearing of the PPE By employing this system, employers can effectively ensure the proper usage of PPE devices at their worksites while also minimizing any adverse effects on workers’ comfort and reducing the setup burden for employers. The system runs a Support Vector Machine (SVM) model several times per second and employs a post-processing algorithm to enhance its initial accuracy further As a result, the system effectively reduces false positives by about 80% and swiftly detects instances of improper usage of the worker’s PPE, raising the alarm in less than seven seconds. Moreover, the post-processing algorithm can be customized to meet the specific needs of different use cases, allowing for a flexible trade-off between the detection time interval and the overall accuracy of the detection system.

Assessment of risk factors for COVID-19 spread by staff in intensive care units of a multidisciplinary hospital

Objective. To evaluate the risk factors for COVID-19 spreading by personnel of resuscitation units of a multifield hospital.
 Materials and Methods. The study included epidemiological, statistical, and mathematical research methods with retrospective analysis of COVID-19 morbidity and COVID-19 preventive measures in resuscitation units of a multifield hospital.
 Results. The results of the study indicated the highest incidence of COVID-19 among medical personnel in the cardiac surgery and neuroresuscitation units with the highest rates among physicians (66.6 and 45.5 %). The determining risk factors for infection with COVID-19 and other pathogens of acute respiratory diseases among medical personnel were the following: admission of patients in urgent condition to the department without examination results; high load for doctors working with patients, determining the excessive use of personal protective equipment (PPE) by two, four times; violation of rules for PPE removal and utilization conditions, improper storage and contamination of clean PPE, low proportion of PPE use in the interepidemic period; procedures associated with formation of aerosol, airtightness failure during mask ventilation in 24 % of patients that led to leakage of aerosol into the environment, insufficient coverage of medical personnel with preventive vaccination against COVID-19 in some units.
 Conclusions. The high incidence of COVID-19 among medical personnel and workload, violations of PPE usage, and procedures with aerosol formation specific for resuscitation units all these things determine the increased risk of COVID-19 spread by medical staff in resuscitation units.

Removal of Contaminated Personal Protective Equipment With and Without Supervision. A Randomized Crossover Simulation-Based Study.

Personal protective equipment (PPE) reduces the risk of pathogens reaching the skin and clothing of health care personnel. We hypothesize that doffing PPE following verbal instructions by a supervisor is more effective in reducing contamination compared with doffing without verbal instructions. Our primary aim was to determine contamination rates with and without supervised doffing. The secondary aim was to determine the number and localization of contaminated body sites and PPE removal times in both groups. Staff members of Bnai Zion Medical Center participated in this single-center, randomized simulation study (NCT05008627). Using a crossover design, all participants donned and doffed the PPE twice, once under guidance from a trained supervisor and then independently without supervision (group A), or vice versa (group B). Participants were randomized to either group A or B using a computer-generated random allocation sequence. The PPE was "contaminated" with Glo Germ on the thorax, shoulders, arms, hands, legs, and face shield. After doffing the PPE, the participant was examined under ultraviolet light to detect traces of contamination. The following variables were collected: contamination rates, the number and localization of contaminated body sites, and PPE doffing time. Forty-nine staff members were included. In group A, the contamination rate was significantly lower (8% vs. 47%; χ2 = 17.19; p < 0.001). The sites most frequently contaminated were the neck and hands. Mean PPE doffing time under verbal instructions was significantly longer [mean (SD): 183.98 (3.63) vs. 68.43 (12.75) seconds, P < 0.001] compared with unsupervised doffing. In a simulated setting, PPE doffing following step-by-step verbal instructions from a trained supervisor reduces the rate of contamination but prolongs doffing time. These findings could have important implications for clinical practice and could further protect health care workers against contamination from emerging and high-consequence pathogens.

Transmission of monkeypox virus through the saliva and air that need careful management.

Transmission of monkeypox virus through the saliva and air that need careful management.

Evaluation of the relative potential for contact and doffing transmission of SARS-CoV-2 by a range of personal protective equipment materials

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)—the causative agent of coronavirus disease 2019 (COVID-19)—has caused a global public health emergency. Personal protective equipment (PPE) is the primary defence against viral exposure in healthcare and community settings. However, the surfaces of PPE materials may trap virus for contact transmission or through laden aerosols generated during removal of PPE, through cleaning or during movement. In this study, the relative efficacy of current PPE materials in terms of virion adsorption to materials and their antiviral potency, has been evaluated on a wide range of PPE for the first time, including four polymer glove types, two types of scrubs, apron material, a mask, visor and a selection of other commercial polymers and products. Although differences in virion adsorption to the test materials were observed, none of the existing polymer-based PPE resulted in more than tenfold reduction in the SARS-CoV-2 titre within either 10 min or 30 min contact period. The wettability and surface chemistry of the test materials were analysed to investigate any correlations with their surface physicochemical properties. While no correlation was found between wettability and viral retention under air flow challenge, one secondary ion of m/z 101.03 (+) and three secondary ions of m/z 31.98 (−), 196.93 (−) and 394.33 (+) in ToF–SIMS data of the test materials showed positive and negative correlations with the viral retention, respectively, which was identified by PLS regression model, suggesting that the surface chemistry plays a role in determining the extent of virion adsorption. Our findings outline the material aspects that influence the efficacy of current PPE against SARS-CoV-2 transmission and give suggestions on the development of novel simple polymer-based PPE for better infection protection.

Evaluation of a Web-based learning system for skills in removing personal protective equipment for highly infectious diseases-A randomized controlled trial.

Which educational method is best for 3-month retention of proper skills in removing personal protective equipment (PPE) in the setting of highly infectious diseases is unclear. We evaluated the effectiveness of a Web-based learning system after 3 months of use. One general hospital in Japan. We conducted a randomized, nonblinded, parallel-group trial with 35 nurses using the substitution block method. At baseline, both groups received face-to-face training in putting on and removing PPE. The intervention group was given access to the Web-based learning system we developed using Modular Object-Oriented Dynamic Learning Environment (Moodle). After 3 months, we assessed both groups regarding knowledge and skills in removing PPE using a 34-point test, fluorescent markers, and video recordings. Overall, 34 participants completed the trial: 16 in the intervention group and 18 in the control group. Postintervention knowledge test scores (1.3 vs -0.8; P = .013; effect size r = .42) and deviations from the required procedure (-5.4 vs 1.9; P = .001; effect size r = .55) were significantly better in the intervention group than in the control group. The number of contaminated sites (-0.5 vs 0.4; P = .128; effect size r = .26) and contaminated participants (-18.7% vs 11.1% decreased in the intervention group, and increased in the control group, although this was not significant (P = .242; effect size ϕ = .47). This learning system was an effective educational method in maintaining and improving knowledge of proper PPE removal skills. The number of deviations from the required procedure decreased, and this reduction continued after 3 months. Evaluation of the Web materials for learning PPE removal skills in the setting of highly infectious diseases. University Hospital Medical Information Network, UMIN000042725: https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000048767.

Assessing patterns of body contamination after personal protective equipment removal among health care workers: A scoping review

It is now widely recognized that health care personnel (HCP) are at risk of contamination with pathogens during personal protective equipment (PPE) doffing. Studies of this phenonemona, have utilized a variety of PPE ensembles, doffing methods, and experimental methods. A scoping review was performed, consistent with PRISMA guidance. The PubMed and sciVerse Scopus databases were searched using an a priori search strategy. Data were extracted for analysis using the matrix method, and then a narrative analysis was performed. Articles were classified based on PPE ensemble. Only 19 of 151 articles were included in the final analysis. All included studies reported some post-doffing contamination, and this contamination was most frequently observed on the hands, wrist, face, and neck. Reviewed studies used a variety of tracer contaminants, PPE ensembles, doffing protocols, tracer assessment locations, and methods, making it difficult to identify patterns across studies. Additional research is needed to improve the study methodology related to the selection and placement of tracers to ensure sensitive detection of post-doffing contamination, compare how specific doffing procedures or pieces of PPE influence post-doffing contamination, and to understand what post-doffing contamination means for patient and HCP infection risk.

Risk factors for development of personal protective equipment induced headache: e-survey of medical staff in Baltic states

BackgroundThe COVID-19 pandemic led to an unprecedented increase in the use of personal protective equipment (PPE) among medical personnel. The goal of this study was to determine the risk factors and frequency of PPE-induced headache during the COVID-19 pandemic.MethodsFrom January 25 to March 1, 2021, an anonymous online survey was undertaken in the Baltic states.ResultsIn total, 2132 individuals participated. 52.3% experienced a PPE-induced headache. Usual onset time was between 2–3 h, lasting up to 1 h after PPE removal. The most common localization was in temporal and frontal regions. Headache usually occurred 2 to 3 days per week with an average pain score of 5.04 ± 1.80 points. Higher risk was associated with discomfort/pressure OR = 11.55, heat stress OR = 2.228, skin conditions OR = 1.784, long PPE use (duration 10-12 h) OR = 2,18, headache history prior PPE use OR = 1.207. Out of 52.3% respondents with PPE-induced headache, 45.5% developed de novo headache, whereas 54.5% had headache history. Statistically significant differences of PPE-induced headache between respective groups included severity (4.73 vs 5.29), duration (≥ 6 h 6.7% vs 8.2%), accompanying symptoms (nausea (19.3% vs 25.7%), photophobia (19.1% vs 25.7%), phonophobia (15.8% vs 23.5%), osmophobia (5.3% vs 12.0%)) and painkiller use (43.0% vs 61.7%).ConclusionsOver half of the medical personnel reported headache while using PPE. The risk was higher in individuals with headache history, increased duration of PPE use and discomfort while using PPE. Predisposed individuals reported PPE-induced headache which persisted longer, was more intense and debilitating than in the respondents with de novo headache.

Thermal discomfort caused by personal protective equipment in healthcare workers during the delta COVID-19 pandemic in Guangzhou, China: A case study

BackgroundIn contrast to the previous COVID-19 pandemic, most frontline healthcare workers (HCWs) worked on residents’ nucleic acid tests in outdoor environments, instead of taking care of COVID-19 patients in hospitals during the hot summer of 2021. Therefore, it is necessary to investigate the prevalence and characteristics of thermal discomfort caused by personal protective equipment (PPE).MethodsA cross-sectional survey was conducted online at hospitals from 11 administrative regions of Guangzhou for the assessment of thermal discomfort among HCWs from June 12–16, 2021. Univariate and logistic regression analyses were used to explore the risk factors associated with thermal discomfort.ResultsA total of 3658 valid responses were collected. The thermal discomfort and humid discomfort levels increased from 2.91 ± 1.19 to 3.61 ± 0.72 and from 0.98 ± 1.36 to 3.06 ± 1.1 after wearing PPE, respectively (p < 0.01). Feelings of being “very hot” and “uncomfortably humid” were the most influenced by wearing PPE, increasing from 31% to 69.1% and from 9.1% to 45.7%, respectively. There were significant increases in the thermal discomfort level (3.75 ± 0.57 vs. 3.33 ± 0.89, p < 0.01) and the humid discomfort level (3.33 ± 0.95 vs. 2.54 ± 1.19, p < 0.01) between the comfortable group and uncomfortable group, accompanied by similar patterns in the feelings of being “very hot” and “uncomfortably humid.” For general thermal-related symptoms, the most common new-onset symptom was profuse sweating (80%) followed by labored breathing (55.2%) and excessive dehydration (46.8%), while facial swelling (74%) was associated with local thermal-related symptoms, followed by hand maceration erosion (56.7%) and visual impairment (49.3%). In the multivariate analysis, the apparent temperature of the environment (≥35 °C), working in negative-pressure ambulances and outdoors, continuing to wear PPE for 1–3 days during this period, being aged >40 years, and previous experiences fighting the pandemic were independently associated with thermal discomfort (p < 0.01). Immediately after PPE removal, 32.3% of respondents considered drinking ice water/another drink, followed by 25% shortening the duration of wearing PPE and 19.1% going to the toilet. A large proportion of the participants looked forward to modifications to the material of the suit (72.9%) and mask (53.4%) for heat dissipation and dehumidification, as well as anti-fogging goggles (60.2%), adding hydration equipment to PPE (53.4%), and using soft materials to reduce pressure (40%).ConclusionsThermal discomfort is common and degrades health physiology related to PPE in summer environments. This suggests that modifications to the current working practices are urgently required to improve the resilience of HCWs and enhance their services during pandemics.

Self-contamination following removal of two personal protective equipment suits: a randomized, controlled, crossover simulation trial

Healthcare personnel are often at high risk of contamination when participating in airway management and other aerosol-generating procedures. To explore the differences in self-contamination after removal of gown and coverall personal protective equipment (PPE) using an ultraviolet-fluorescent solution. This prospective, randomized, controlled crossover trial was set in a third-level university health centre in Buenos Aires, Argentina between August and October 2020. The study included 60 anaesthesia personnel volunteers, and no participants were excluded from the study. A two-period/two-intervention design was chosen; each intervention comprised audio-guided placement of PPE, full-body spraying of fluorescent solution, audio-guided removal of PPE, and self-contamination assessment through ultraviolet light scanning. The primary outcome was the mean within-participant difference (any traces) between PPE suits. Statistical significance was tested using t-tests for paired data. The allocation ratio was 25/35 (gown followed by coverall/coverall followed by gown). Self-contamination after removal of coveralls was greater than that after removal of gowns, with a mean within-participant difference of 11.45 traces (95% confidence interval 8.26-14.635; P<0.001). Significant differences were found for the number of self-contaminated body zones, small fluorescent traces and large fluorescent traces. Removal of a gown was associated with a markedly lower risk of self-contamination. Quick one-step removal of a gown and gloves may reduce self-contamination in the arm/hand area. Fluorescent solutions can help to identify self-contamination and compare outcomes between available PPE suits. Repeated training sessions and enhanced knowledge on self-contamination following removal of PPE are paramount. NCT04763304 (on ClinicalTrials.gov).

Simulation Based Ambulance and Crew Decontamination Advise During COVID-19 Pandemic.

This study involved a simulation of transportation and basic life support on ambulances carrying coronavirus disease 2019 (COVID-19) patients, using a specially modified mannequin. The mannequin used can spew a fluorescent solution from its mouth to simulate the droplets or vomitus made by the patient and can be detected using ultraviolet light illumination. We determined that the most frequently contaminated areas of an ambulance in the driver's cabin are the left front door's outer handle, driver's handler, gear lever, and mat. The most frequently contaminated area in the rear patient's cabin is the rear door, rear door lining, and handle over the roof. The most frequently contaminated areas before the removal of personal protective equipment (PPE) are the lower chest to the belly area, bilateral hands, lower rim of the gown, and shoes. After the removal of PPE, traces of fluorescence were observed over the neck, hands, and legs. We therefore suggest taking a bath immediately after PPE removal.

The sourcing and use of high physical resemblance personal protective equipment to train healthcare workers, improve confidence and conserve medical-grade equipment

Personal protective equipment (PPE) is essential for healthcare worker (HCW) safety. Conservation of PPE for clinical use during the COVID-19 pandemic reduced its availability for training, necessitating an innovative approach to sourcing high physical resemblance PPE (HPR-PPE). We present a case study of crowd-sourcing of HPR-PPE to train HCWs. Survey results indicated that HPR-PPE enabled high-fidelity practise of PPE application and removal, aided procedure recall, improved user confidence and was sufficiently similar to medical-grade PPE. HPR-PPE provided a novel and cost-effective alternative. We also demonstrated that medical-grade PPE can be sourced from non-medical institutions and businesses during a pandemic.

Booklet on the use of personal protective equipment during the COVID-19 pandemic: preventing facial skin injuries

Abstract Introduction: In the year 2020, Brazilian and global public health systems were overwhelemend by COVID-19, a pandemic highly transmissible by droplets and contact, mainly in enclosed areas and hospital environments. Objective: Create a booklet to instruct health professionals on the use of personal protective equipment (PPE) and preventive measures for facial skin injuries during the SARS-CoV-2 pandemic. Methods: The study was conducted from June to September 2020, adopting the following steps: situational diagnosis; literature review of the main health science databases; content selection and survey; drafting texts; creating illustrations; and diagramming the manual. Results: After the literature review, 26 articles were selected for the booklet. The material was prepared by the authors of this article and reviewed by a professional in the biomedical field, with expertise in standardizing procedures and tissue injury innovations. The final version contains four chapters and three algorithms, one with step-by-step instructions on donning PPE, one on removal and one containing preventive measures for PPE-related injuries. Conclusion: After an interactive review of the literature, a booklet was created that provides theoretical and practical foundations for health professionals on PPE donning and removal techniques, with a view to preventing facial injuries and COVID-19 infection.

Evaluation of appropriate usage of PPE among healthcare providers during COVID-19 pandemic

Background: Shortage of personal protective equipment (PPE), inadequate staff training regarding PPE usage, and confused PPE guidance led to infections and deaths among healthcare workers in many countries. Protection of healthcare workers is needed as they are delivering essential services during the pandemic time. So, the main aim of our study is to evaluate the appropriate use of PPE among healthcare providers (HCPs) during COVID-19 pandemic. Materials and Methods: An observational cross-sectional study was conducted among the HCPs of India during September and October. A 15-item self-administered questionnaire was used, and Excel 2019 and SPPS 24 were used for statistical analysis. A χ2 test was performed to determine the role of sociodemographic characteristics on appropriate usage of PPE. Results: One hundred and eighteen HCPs have participated in our study. About 44.9% of the study participants know the proper way of donning the PPE, and 38.9% of the study participants know the proper way of doffing the PPE. About 40.6% of the study participants were aware of place for PPE removal and how to dispose a PPE; 69.49% of the study participants were aware of guidelines of donning and doffing of PPE recommended by the Centers for Disease Control and Prevention and World Health Organization. Conclusion: The prevalence of breathing difficulty, headaches, suffocation, dehydration, hair problems, and skin irritation/maceration among frontline healthcare personnel using PPE during pandemic was seen. Appropriate usage of PPE is vital in safeguarding the HCPs and restriction of the spread of viral infection in the hospital setting.

472. The Utility of Infectious Diseases E-consults in the Era of COVID-19

BackgroundDuring the COVID-19 pandemic, rapid Infectious Diseases (ID) consultation has been required to answer novel questions regarding SARS-CoV-2 testing and infection prevention. We sought to evaluate the utility of e-consults to triage and provide rapid ID recommendations to providers.MethodsWe performed a retrospective study reviewing ID e-consults in three institutions in the North Texas region: Clements University Hospital (CUH), Parkland Hospital and Health System (PHHS), and the VA North Texas Health Care System (VA) from March 1, 2020 to May 15, 2020. Variables collected include age, sex, ethnicity, comorbidities, time to completion, reason for consult and outcome of consult (initiation or removal of personal protective equipment (PPE) and recommendation to test or retest for COVID-19).ResultsWe performed all analysis using R studio (Version 1.3.959). Characteristics of 198 patients included: 112(57%) male, 86(43%) female, 86(43%) Caucasian, 71(36%) Hispanic, 42(21%) African American, 6(3%) Asian and mean(sd) age of 55.1(15.9). Patient comorbidities included: 89(45%) with a heart condition, 77(39%) diabetes, 30(15%) asthma and 14(7%) liver disease.Median time to completion for all hospitals was 4 hours(h); ((CUH (4h) vs PHHS (2h), p< 0.05; VA (5.5h) vs PHHS (2h) p< 0.05)). Most common reasons for e-consult included: (63)32% regarding re-testing ((CUH 14(21%) vs PHHS 43(50%), p< 0.05; CUH vs VA 14(27%), p< 0.05; PHHS vs VA, p< 0.05)), (61)31% testing ((CUH 25(37%) vs PHHS 39(45%), p< 0.05; CUH vs VA 7(16%), p< 0.05; PHHS vs VA, p< 0.05)) and 61(31%) infection prevention (IP). Based on the e-consult recommendation, 53(27%) of patients were tested ((CUH 31(45%) vs PHHS 11(13%), p< 0.05, CUH vs VA 11(25%), PHHS vs VA, p< 0.05)), 45(23%) were re-tested, 44(22%) of patients had PPE started on and 19% had PPE removed ((CUH 0(0%) vs PHHS 16(19%), p< 0.05; CUH vs VA 21(48%), p< 0.05; PHHS vs VA, p< 0.05)).Reason for Consult ConclusionE-consult services can provide prompt ID input during the COVID-19 pandemic, minimizing the risk of infection to the patient and health care workers while preserving PPE and testing supplies.Disclosures Roger Bedimo, MD, MS, Gilead Sciences (Consultant)Merck & Co. (Advisor or Review Panel member)ViiV Healthcare (Advisor or Review Panel member, Research Grant or Support)

Heat Stress and Thermal Perception amongst Healthcare Workers during the COVID-19 Pandemic in India and Singapore.

The need for healthcare workers (HCWs) to wear personal protective equipment (PPE) during the coronavirus disease 2019 (COVID-19) pandemic heightens their risk of thermal stress. We assessed the knowledge, attitudes, and practices of HCWs from India and Singapore regarding PPE usage and heat stress when performing treatment and care activities. One hundred sixty-five HCWs from India (n = 110) and Singapore (n = 55) participated in a survey. Thirty-seven HCWs from Singapore provided thermal comfort ratings before and after ice slurry ingestion. Differences in responses between India and Singapore HCWs were compared. A p-value cut-off of 0.05 depicted statistical significance. Median wet-bulb globe temperature was higher in India (30.2 °C (interquartile range [IQR] 29.1–31.8 °C)) than in Singapore (22.0 °C (IQR 18.8–24.8 °C)) (p < 0.001). Respondents from both countries reported thirst (n = 144, 87%), excessive sweating (n = 145, 88%), exhaustion (n = 128, 78%), and desire to go to comfort zones (n = 136, 84%). In Singapore, reports of air-conditioning at worksites (n = 34, 62%), dedicated rest area availability (n = 55, 100%), and PPE removal during breaks (n = 54, 98.2%) were higher than in India (n = 27, 25%; n = 46, 42%; and n = 66, 60%, respectively) (p < 0.001). Median thermal comfort rating improved from 2 (IQR 1–2) to 0 (IQR 0–1) after ice slurry ingestion in Singapore (p < 0.001). HCWs are cognizant of the effects of heat stress but might not adopt best practices due to various constraints. Thermal stress management is better in Singapore than in India. Ice slurry ingestion is shown to be practical and effective in promoting thermal comfort. Adverse effects of heat stress on productivity and judgment of HCWs warrant further investigation.

A care escalation framework to address lapses in donning and doffing of personal protective equipment during the COVID-19 pandemic

A care escalation framework to address lapses in donning and doffing of personal protective equipment during the COVID-19 pandemic

Mastery Learning Ensures Correct Personal Protective Equipment Use in Simulated Clinical Encounters of COVID-19.

IntroductionThe correct use of personal protective equipment (PPE) limits transmission of serious communicable diseases to healthcare workers, which is critically important in the era of coronavirus disease 2019 (COVID-19). However, prior studies illustrated that healthcare workers frequently err during application and removal of PPE. The goal of this study was to determine whether a simulation-based, mastery learning intervention with deliberate practice improves correct use of PPE by physicians during a simulated clinical encounter with a COVID-19 patient.MethodsThis was a pretest-posttest study performed in the emergency department at a large, academic tertiary care hospital between March 31–April 8, 2020. A total of 117 subjects participated, including 56 faculty members and 61 resident physicians. Prior to the intervention, all participants received institution-mandated education on PPE use via an online video and supplemental materials. Participants completed a pretest skills assessment using a 21-item checklist of steps to correctly don and doff PPE. Participants were expected to meet a minimum passing score (MPS) of 100%, determined by an expert panel using the Mastery Angoff and Patient Safety standard-setting techniques. Participants that met the MPS on pretest were exempt from the educational intervention. Testing occurred before and after an in-person demonstration of proper donning and doffing techniques and 20 minutes of deliberate practice. The primary outcome was a change in assessment scores of correct PPE use following our educational intervention. Secondary outcomes included differences in performance scores between faculty members and resident physicians, and differences in performance during donning vs doffing sequences.ResultsAll participants had a mean pretest score of 73.1% (95% confidence interval [CI], 70.9–75.3%). Faculty member and resident pretest scores were similar (75.1% vs 71.3%, p = 0.082). Mean pretest doffing scores were lower than donning scores across all participants (65.8% vs 82.8%, p<0.001). Participant scores increased 26.9% (95% CI of the difference 24.7–29.1%, p<0.001) following our educational intervention resulting in all participants meeting the MPS of 100%.ConclusionA mastery learning intervention with deliberate practice ensured the correct use of PPE by physician subjects in a simulated clinical encounter of a COVID-19 patient. Further study of translational outcomes is needed.

Transcatheter Aortic Valve Replacement in the Coronavirus Disease 2019 (COVID-19) Era.

Transcatheter Aortic Valve Replacement in the Coronavirus Disease 2019 (COVID-19) Era.

Supporting cardiac patients during the COVID-19 pandemic

Supporting cardiac patients during the COVID-19 pandemic