PPE Usage Research Articles

523. COVID-19 Preparedness in Hospice and Palliative Care

BackgroundDue to the emergence of COVID-19 and resulting pandemic, there is an increased demand for palliative care and hospice care services. However, the impact of COVID-19 on the hospice and palliative agencies is unknown.MethodsAn electronic survey was disseminated via the Hospice & Palliative Nurses Association newsletter, posted to the Sigma Theta Tau Hospice and Palliative Care Community Group discussion board and advertised through social media from May 7–28, 2020. Summary statistics were computed.ResultsWe collected 36 surveys representing all U.S. regions. Most respondents (78%) reported that their agency has cared for confirmed COVID-19 patients. Only half of agencies had access to laboratory facilities for surveillance and detection of the presence of outbreaks in both patients and staff (58%) and the ability to test patients and providers for COVID-19 (55%). Due to COVID-19, participants stated that the agency added new protocols regarding aerosol-generating procedures policies (58%), use of surface barriers (61%) and PPE usage (e.g. donning and doffing) in patient homes (56%). The majority (76%) reported that their agency required field clinicians to call ahead to ascertain COVID-19 exposure/symptoms before a home visit.More than half (58%) reported that their agency lacked supplies, including N95 respirators (45%), cleaning/disinfectant product (23%), alcohol based sanitizer (18%), eye protection (18%), gowns (18%), and surgical masks (14%). Overall, participants shared that field clinicians had to reuse (76%), extend (73%) or ration (30%) PPE supplies. Respondents reported that their agency accessed supplemental PPE through state/local resources (67%), private/community donations (67%), and do-it-yourself efforts (55%). One third (31%) reported that their agency was experiencing staffing shortages due to COVID-19; of these, 60% reported that shortages were due to staff infected with/quarantined due to COVID-19.ConclusionOur findings suggest that COVID-19 has presented significant challenges for palliative care and hospice agencies as they provide care to patients and families at an unprecedented rate.Disclosures All Authors: No reported disclosures

Prevalence of Occupational Skin Diseases and its Predisposing Factors in Leather Tanning Workers of Southern India

Skin diseases are a major occupational health issue in tannery workers because of work related exposure to various toxic chemicals used in tanning process. In the present study, prevalence of various skin diseases and predisposing factors in tannery workers were investigated.A cross sectional study including 114 tannery workers (male-89; female-25) employed at different tanneries of Southern India was carried out. Face to face interview with pre-designed questionnaire and health examination was conducted. Skin samples obtained from the participants were subjected to microscopic examination and microbial culture for diagnosis of skin diseases. The prevalence of occupational skin disorders were 39% among the study participants. Contact dermatitis (16%), skin infections (16%), eczematous lesions (7%) and nail discoloration (1.75%) wereidentified. Skin infections of fungal origin were identified among 11.4% of subjects. The skin infections of fungi; tenia corporis, tenia cruris, tenia unguium, tenia versicolor, tenia pedis and Pityriosis versicolor were identified. Bacterial skin infections identified were associated with contact dermatitis. Lack of PPE usage was reported among 30% of workers. Hazardous working environment, chemical exposure, humidity and lack of PPEusage were significantly associated with increased skin disease incidence(p<0.05), indicating the major predisposing factorsfor Occupation skin diseases.The findings of the study emphasize that,workers in the pre-tanning section and tanning sections are more vulnerable to occupational skin diseases.Compliance to use of PPEs, engineering controls to reduce exposure, education, frequent health surveillance and early identification & treatment could mitigate the occupational skindiseasesamongtannery workers.

EFEK PAPARAN KRONIS PESTISIDA TERHADAP KADAR ASPARTAT AMINOTRANSFERASE (AST) DAN ALANIN AMINOTRANSFERASE (ALT) PADA SUBYEK PETANI

Farmers in Indonesia are very dependent on pesticides to protect their crops from pests. Farmers are one of the subjects who are susceptible to pesticides and can cause disease due to pesticide accumulation. One of the disease that can arise due to exposure to pesticides is liver damage. This study wanted to determine the effect of pesticide exposure on liver damage seen from AST and ALT enzyme levels using farmer respondents in the Mojokerto area of 25 respondents. From the results of the study it was found that AST levels were influenced by age (P = 0.017), length of work (P = 0.035), and PPE usage (P = 0.044), while age, work period, length of work and usage of PPE did not significantly influence to ALT levels. It can be concluded that age, length of work and use of PPE affect AST levels. Therefore, to prevent the occurrence of pesticide poisoning, farmers must obey the rules on the use of pesticides such as using PPE regularly and always consuming healthy food.

Barriers for Resuming Endoscopy Service in the Context of COVID-19 Pandemic: A Global Survey

Introduction: An outbreak of coronavirus disease 19 (COVID-19) has altered the dynamic of world’s healthcare system, including endoscopic practices. Curious about the situation in different endoscopic units across the globe, the study was designed to evaluate different aspects of practice resumption worldwide.Methods: An online questionnaire was created and distributed by national/regional representatives. Redcap® platform was used as the interface; afterwards, Microsoft Excel 2016 and Prism 5 were utilized for data analysis.Results: A total of 307 responses from 47 countries/regions was collected, from which 290 valid answers were inducted and further analyzed. Almost half (47%) were in post-peak period by August, 2020. Many units were not designated to be COVID-oriented facility. About 15.5% of centers remained unrecovered, mainly in North and South America; those were recovered, training was still withheld significantly. Nevertheless, opened centers kept safety measurement strictly. Though patient load was decreased by 37% in most centers, waiting list was increased 0-25%. Among many surveillance methods, body temperature, PCR and chest CT prevailed the be the most commonly used. 74.8% claimed to have increased post-procedural disinfection time and 68.2% also observed an increased in per-case inspection. PPE usage was implemented highly and shortage of these posed as one of the resumption barriers. Post-procedural patient surveillance was not reinforced.Conclusions: The study reflected closely the global revolution of the pandemic. Shortage in staff and PPE as well as difficulty in training resumption remained barriers worldwide. Incapacity of patient post-procedural surveillance raised concerns in disease control.Funding Statement: None to declare.Declaration of Interests: None to declare.Ethics Approval Statement: The study was approved by the Institutional Review Board of the National Liver Institute, Menoufia University, Egypt (NLI IRB 00003413) in June 2020, protocol number 00203/2020.

Phase 3 of COVID-19: Treat your patients and care for your radiographers. A designed projection for an aware and innovative radiology department

Abstract Since the spread of Covid-19 outbreak, healthcare workers (HCWs) have faced an unprecedented and unpredictable situation on the frontlines. The aim of this document is therefore to provide useful and operative recommendations to radiographers who perform imaging services, such as chest X-ray (XR) and Computer Tomography (CT) scans to three types of patients: negative, suspected or suffering from Severe Acute Respiratory Syndrome by Coronavirus (SARS-CoV-2). It is paramount to design two different paths’ layouts for patients entering the Radiology Department. One path should care for the confirmed and suspected SARS-CoV-2 patients, whereas the other path should be for negative patients. A setting envisaging two radiographers is highly recommended when managing Covid-19 patients. One radiographer fully-equipped with proper personal protective equipment (PPE) should deal with the patient in the scanning or x-ray room. The second one should stay in the console room wearing essential PPE. Disinfection plays a crucial role in reducing the risk of disease transmission. Moreover, having clear protocols is key to ensure personal safety and avoid cross-infections. Taking care of patients and HCWs, such as radiographers, is crucial to minimize the risk of disease transmission. Within a Radiology Department, different designed pathways should be taken into consideration both for everyday and epidemic/pandemic healthcare situations. Though Covid-19 pandemic has been a harsh experience in terms of world health and care systems for patients and health professionals - being radiographers among the most involved - we must not miss this chance to learn from what happened. There is the need to address wider causes through learning and in order to prevent failures. The distinction between passive learning (where lessons are identified but not put into practice) and active learning (where those lessons are embedded into an organization’s culture and practices) is crucial in understanding why truly effective learning so often fails to take place.

Precautions and Importance of PPE - Assessment of Knowledge Among Dental Health Care Workers - A Questionnaire Based Study

Healthcare workers are at constant risk due to the infections which occur due to exposure of blood and other body fluids from infected patients. Standard precautions must be taken like maintenance of personal hygiene, use of personal protective equipment, etc. to stay safe. Thus, this study assesses the knowledge of health care workers on the importance of PPE in order to improve the awareness towards the usage of PPE during essential periods of risk. The study setting was done through an online survey among health care workers. The collected data were then analyzed in SPSS online software and the results were plotted in the form of bar graphs. From the data, it is inferred that knowledge of PPE among health care workers is well known in the majority of the responders. But more awareness must be created on the importance of PPE for the safety and welfare of all health care workers. Health care workers are at constant risk due to the infections which can occur due to exposure of blood and other body fluids. PPE plays a major role in protecting against these infections. Thus, it is important and mandatory to wear them on a daily basis for a safe and protective work environment.

Masking Up: A COVID-19 Face-off between Anti-Mask Laws and Mandatory Mask Orders for Black Americans

Mandatory PPE orders during COVID-19 have forced Black Americans to weigh the dangers of disease against the dangers of selective enforcement and racial profiling. In states with civil rights-era anti-mask laws, both wearing and eschewing masks could lead to police interaction. This Article argues that anti-mask laws were only superficially intended to protect Black Americans, continue to harm minorities during COVID-19, and should be repealed. It motivates this policy by empirically showing the ineffectiveness of anti-mask laws and the statistically significant relationships between PPE usage patterns and race. A revisionist legal history reveals anti-mask laws’ racist underpinnings, further motivating their repeal.https://coviddynamic.caltech.edu/https://osf.io/wjdrf/https://www.californialawreview.org/covid-19-mask-orders-black-americans/

TMT Editorial: The Future of Virtual Health – Near Term Analysis of the COVID-19 Pandemic

Telehealth has received a lot of attention over the past few months as healthcare providers necessarily shifted. This was initiated by the need to decrease virus exposure and PPE usage, and then further enabled by pro-telehealth reimbursement and regulatory changes. What lessons were learned that help us envision what the future might look like over the next 12 months?

Sarcoma Care Practice in India During COVID Pandemic: A Nationwide Survey.

BackgroundAmidst the COVID-19 pandemic, management of cancer has been one of the most intensely debated topics across the globe. We conducted an online survey to determine the consistency/or the lack of it, in the management of sarcoma patients between centres and the changes in policies.MethodsA twenty-five question online survey was conducted among practicing physicians over a period of 10 days using online portal (surveymonkey.com). It was followed by a critical analysis based on responses to each question.ResultsOf 194 medical professionals who participated, 80% were surgeons and 53% were working in government institutes. Most respondents (81%) continued their practice with some modifications. In OP majority (67%) relied only on symptom, contact enquiry and temperature recording for screening. COVID-19 testing was done more (43%) in IP patients. Most of institutes (83%) followed rotational policy to reduce the number of staff at risk while 57% offered an alternate accommodation. 52.3% continued chemotherapy for all patients while radiotherapy for all was offered by 45%. In metastatic cases, majority preferred either no treatment or non-surgical intervention (71%).84.5% believed in adapting changes (42%—avoid supra major surgeries, 27%—Operating only emergency cases and 15.5%—High grade sarcomas with curative intent) in surgical management of sarcomas. For benign bone tumors, majority (71%) agreed on adapting changes while 25% agreed on deferring all cases. 69% preferred teleconsultations for follow-up. Complete PPE were being used for all aerosol generating procedures by 44%. Only two thirds agreed with their institutes policy of PPE usage and COVID-19 testing.ConclusionThis survey has highlighted disparity on COVID-19 screening and management in various institutes across the country. This will act as a reference point for tracking future trends in bone and soft tissue tumor management guidelines, as the COVID-19 scenario unfolds globally and particularly in India.

How 3D printing and social media tackles the PPE shortage during Covid – 19 pandemic

During the recent Covid-19 pandemic, additive Technology and Social Media were used to tackle the shortage of Personal Protective Equipment. A literature review and a social media listening software were employed to explore the number of the users referring to specific keywords related to 3D printing and PPE. Additionally, the QALY model was recruited to highlight the importance of the PPE usage. More than 7 billion users used the keyword covid or similar in the web while mainly Twitter and Facebook were used as a world platform for PPE designs distribution through individuals and more than 100 different 3D printable PPE designs were developed.

Nurse’s Roles in Protecting Cancer Patients During COVID-19 Pandemic

Nurses during COVID-19 pandemic outbreak will be front line health care worker providing care for all patient including cancer patients. Cancer patients were vulnerable group that need to be prevented from getting COVID-19. This study will describe the roles of nurses to protect cancer patients during this outbreak. The role of nurses preventing transmission in outpatient including conducting medical distancing to reduce number of patient visit health care. This can be done through screening by phone. Chemotherapy unit, nurses can prevent transmission through physical distancing, providing education and surface cleaning more often than usual in between patient. Oncology ward, nurses need to educate patient family regarding no hospital policy visit. This will reduce number of exposure people to people. The use of PPE wisely due to shortage of resources in may hospital facilities by reducing number of team member entering patient’s room, selectively usage of PPE required for certain nursing procedures, and nurses can perform number of procedures at once whenever nurses enter patients’ room. During this crisis, nurses also need to maintain their mental health by managing their stress and anxiety by balancing between work and rest during shifts, eat sufficient food and healthy, and avoid alcohol and tobacco. Stay connected with friends and family through digital media. Hence, nurses can stay healthy so they care for patients during this pandemic.

The Effect of Dosage, Number of Pesticides, Personal Protective Equipment Usage, Direction, Time, Duration and Spraying Frequency of Kolinesterase Content on Farmers in Gawu-Gawu Bouso Village North Gunungsitoli Sub-District, Gunungsitoli City

Pesticide poisoning occurs when there is a certain amount of pesticide material that reaches and / or enters the body. Pesticide poisoning is influenced by many factors including dose, amount, time, length, direction and frequency of spray. This study was an observational study using a cross sectional design that aims to determine the effect of dosage, amount of pesticides, PPE usage, direction, time, duration and frequency of spraying on the level of cholesteresterase farmers in Gawu-Gawu Bouso Village, Gunungsitoli Utara District, Gunungsitoli City. The population includes farmers and farm laborers who spray pesticides in Gawu-Gawu Bouso Village, Gunungsitoli Utara District with 44 research samples. Data analysis uses univariate, bivariate (chi-square test) and multivariate analysis with logistic regression. The results of the bivariate analysis showed that there were 6 independent variables that had a significant relationship with cholinestrase namely dose, amount, direction of spray, time, duration and frequency of spray. This is indicated by the significance value of the 6 independent variables is <0.05. Multivariate test results showed that there were 4 of the 7 independent variables that had a significant effect on cholinesterase ie dose, amount, time, and frequency of spray) (p<0.05) while the other 3 variables namely personal protective equipment, spray direction and duration had no significant effect . The most influential variable on colliniestarase is dose.

STRATEGI PENGELOLAAN PENGGUNAAN ALAT PELINDUNG DIRI (APD) DI LABORATORIUM KLINIK KOTA PEKANBARU

The number of work accidents in Indonesia tends to increase. There were 157.313 cases of work accidents during 2018. The laboratory is a workplace that has many potential hazards such as spills, chemical explosive reactions, punctured needles, exposure to infectious material. Workers in the laboratory are required to use the appropiate PPE, which is a lab coat, shoes, masks and gloves. Managers must provide proper PPE at work. Ineffective use, leads a problem that arises in the field. Management strategies for utilizing appropriate PPE usage are needed to improve the health status of workers. Percentage of clinical laboratory workers in Pekanbaru City (54,01%) and the availability of work guidelines in the form of SOP (65%), which classified as the quite good. The practice of PPE usege and the role of managers in managing, supplying, procuring and number of PPE is also classified as good category. Waste management in the laboratory uses a third party. Policy in the form of rewards (35%), administration of decrees/ sanctions (55%), availability of PPE signs / symbols (30%), providing training to each officer (40%) and implementation health insurance in the form of MCU (50%) and vaccination (10%) is classified as poor category. Determination of management strategies for the use of PPE in the Pekanbaru clinical laboratory in this study using the SWOT calculation. The right strategy used from the results of the SWOT calculation is the survival strategy. The disadvantage is that there are no signs / symbols of PPE guidelines when entering the laboratory and the threat is that PPEwaste that has been used without being managed properly according to B3 waste regulations will contaminate the environment.

Edukasi Resiko Penularan Penyakit Melalui Sampah pada Pemulung Sampah di Tempat Penampungan Sementara Kelurahan Bukit Tunggal Kota Palangka Raya

Waste pickers are the riskiest group for diseases transmission through waste. Waste pickers have no sufficient knowledge about Personal Protective Equipment usage at work. Likewise, several waste pickers at Temporary Shelters located in Kelurahan Bukit Tunggal, Jekan Raya, Palangka Raya, Indonesia. This community service aimed to provide education and training about the reduction of disease transmission risks through waste at Temporary Shelters. These activities involved field surveys, interviews, education and outreach, training and demonstrations, and distribution of Personal Protective Equipment for waste pickers. The solution offered to solve the problems is to educate on disease transmission risks through waste, education, training and demonstration of PPE usage at work, and distribution of Personal Protective Equipment for waste pickers. The community service for 27 waste pickers in several TPS located in Bukit Tunggal was well implemented. The survey result shows the level of usage of Personal Protective Equipment on waste pickers, which is Not Wear 36.25%, Use Non-Routine 16.03% and Use Routine 47.5%. This series of activities can improve the scavenger's insights into the dangers and prevention of transmitting disease through waste.

RISK ASSESSMENT OF OVERHEAD CRANE (OHC) DOUBLE GIRDER OPERATION IN THE KAPAL NIAGA DIVISION IN PT PAL INDONESIA (PERSERO

Background: PT PAL Indonesia (Persero) operates Overhead Crane Double Girder tool everyday. The operation of the device have some risk of material hazard, material pinched, material scratched, fracture and passed away. Purpose: The purpose of this research was to assess the level of risk of occupational injury on the operation of Overhead Crane Double Girder. Methods: This research was a descriptive observational one. This study focuses on the operation of Overhead Crane Double Girder in the Kapal Niaga division PT PAL Indonesia (Persero) which consist of the preparation and operation phase. Result: The initial risk level categorized as high-risk level of 44% and a moderate risk level of 56%. The most frequently prevention measure ware routine check, compliance of SOP and PPE usage on workers. Implementation of control efforts resulted in a moderate risk rate of 44% and a low risk level of 56%. Conclusion: Recommendation of control for PT PAL Indonesia (Persero) performs routine maintenance both on equipment and overhead crane function double girder, application and compliance of operating SOP, and operator must have driving license of overhead crane double girder and experience in the field, if applied properly then final risk level to be 100% low.

FACTORS RELATED TO THE USE OF PERSONAL PROTECTIVE EQUIPMENT IN SHIPYARD WELDERS

Welders can be exposed to occupational hazard. One way to prevent is by using proper PPE.There are many factors that relate to the use of PPE in welders. This was an observational analytic study with cross sectional design. The population of the study was welders of PT. X's Commerce Ship Division. The number of the sample was 52 welders who was selected randomly. Data were collected by means of questionnaires and observation checklist. The results of this study were welders of PT. X's Commerce Ship Division used enough personal protective equipment. There was significant correlation between antecedent variable (i.e. perceptions about potential hazards and PPE usage) with the used of PPE. Consequence variable (i.e. reward) was significantly correlate with the used of PPE. It can be concluded that perceptions about potential hazards and PPE usage,and reward are factors that relate to the use of PPE in welders of PT. X Commercial Ship Division. The suggestion is evaluate the reward system for the suitability of the use of personal protective equipment in welders. Keyword: determinant factors, the use of personal PPE, welders

A cross-sectional study to assess the health profile of street sweepers and sanitary workers in a zone of Greater Chennai Corporation, Tamil Nadu, India

Background: Sweepers and sanitary workers are getting exposed to hazardous dust during their work. The health profile of the sanitary workers and utilization of health services are not clearly known. This study aimed to assess the health profile and associated risk factors among street sweepers and sanitary workers.Methods: A community based cross sectional study was conducted among 73 street sweepers and sanitary workers in a zone of Greater Chennai Corporation by multistage sampling method, during November 2016 to December 2016 using a semi structured questionnaire.Results: Among the respondents 67.1% were females, 2/3rd of them belonged to the age group of 30-40 years. Majority of them (82.2%) had reported to have musculoskeletal problems followed by respiratory problems (61.6%), ophthalmic problems (53.4%), skin problems (38.4%), mental health problems (39.7%). Most of the respondents had multiple problems. Musculoskeletal problems were more common among the female workers (p=0.002). Health problems like headache, fatigue, giddiness were more common among the workers who worked for >5 years (p=0.006). The utilization of health services was better among those workers who had formal school education (p=0.042).Conclusions: This study concludes majority of them have musculoskeletal problems followed by respiratory problems and ophthalmic problems. Usage of personal protective equipments and utilization of health services by the sweepers and sanitary workers were poor. Hence steps have to be taken to improve the health status by subjecting them to periodic screening and sensitization programs on usage of PPE.

AN ANALYSIS OF THE FACTOR AFFECTING SUBSTANDARD PRACTICE OF PERSONAL PROTECTIVE EQUIPMENT (PPE) USAGE IN CEMENT INDUSTRY MAINTENANCE WORKERS

ABSTRACT Background: Repair and maintenance work of machine has high risk and hazard that could potentially lead to work accident. The use of PPE is the final hazard control effort that serves to reduce the severity of work accident 5 . This study analyzed the effect of age, self-efficacy, PPE training, and PPE availability on substandard practice of PPE usage in maintenance workers. Materials and Methods: This study was an observational study with cross-sectional design. Subject of the study amounted to 54 maintenance workers. The independent variables were consisted of age, self-efficacy, PPE training, and PPE availability. The dependent variable was substandard practice of PPE usage. Data collection techniques used questionnaire to find out age, self-efficacy, PPE training, PPE availability, and observation to know substandard practice of PPE usage. Result: The p value of age = 0.021, the p value of self-efficacy = 0.089, the value of PPE training = 0.000, and the p value of PPE availability = 0.345. Based on multiple logistic regression test, if (p < 0.05) hence it has a significant influence to substandard practice of PPE usage. Conclusion: self-efficacy and PPE availability have no effect on substandard practice of PPE usage. Age and PPE training significantly affect the substandard practice of PPE usage in maintenance workers. Keywords: age, self-efficacy, PPE training, substandard practice

Nurses’ Awareness of Infection Control Measures, and the Role and Effect in Patient and Family Education

Background: Healthcare Associated Infections are serious problems in healthcare sector that threatened patient safety since decades till present. The proper adherence to infection control measures is a major factor in reducing these infections. Objectives: The objectives of this study were, to assess the level of nurses’ awareness with infection control measures in Lebanon and to determine its role in implementing patient and family education. Methodology and Results: A quantitative study was done. Questionnaires were distributed over 260 nurses, and 260 patients and family members at four well known hospitals in Lebanon. The study showed a high level of infection control awareness (81.57 %) among Lebanese nurses, and showed that Lebanese hospitals are training their nurses on IC topics (99.1 % of nurses were trained). As for patients and family members’ education, the JCI accredited hospital showed the highest level of education on infection control measures (58.3 %). Conclusion and Recommendations: The study showed that nurses who had a high awareness in infection control educated more their patients and family members on these measures than nurses with low awareness. (64.1 % and 42.1 % when educating on respiratory hygiene, p=0.013, 86.2 % and 57.9 % when educating on usage of PPE, p=0.000, 89.2 % and 68.4 % when educating on the reason for isolation, p=0.001). The major recommendations were to enhance the culture that believes in the partnership between patients, their families and healthcare providers at the hospitals level, and to include a new standard in the Lebanese Accreditation Standards that requires educating patients and family members on infection control measures at the Ministry of Public Health level.

Needle Stick Injuries Prevention by Implementing Proper Techniques and Educating Health Care Personnel

Instead of various Health education programmes, HBV vaccine availability, good supply of personal protective equipment, Biomedical waste management rules in many hospitals and laboratories, needle stick injury precautions were not following. The aim of the study is to assess the needle stick injuries rate after implementation of proper techniques in hospital and educating health care personnel regarding needle stick injuries. Structured questionnaire gave to control and case group to answer in the month of may 2016 after educating them regarding needle stick injuries and implementing proper techniques to avoid needle stick injuries. After obtaining the answers to this questionnaire from studied health care personnel, all the results were analyzed. In this study 23% of PPE usage increased, 27% increased in knowing patient status about HBV, HCV, HIV, 77% increase in entering incident into register, 13% and 15% improvement in post exposure test and counseling respectively in case group. All Health care Personnel should follow the universal precautions related to the particular procedure. Education trainings should focus on rules of biomedical waste management, needle exchange program, no re-capping of needle guidelines to reduce needle stick injury exposure and transmission of blood borne viruses.