Safety Of Healthcare Workers Research Articles

Stewardship of Personal Protective Equipment (PPE) During a Pandemic

BackgroundThe use of PPE is fundamental in protecting healthcare workers (HCWs) from being exposed to SARS-CoV2. The pandemic caused global PPE shortages forcing institutions to address appropriate utilization and conservation. Initial efforts to limit PPE distribution to avoid misuse and frequent changes in public health guidance created confusion and apprehension amongst HCWs.MethodsInfection Prevention and Control (IP&C) implemented a PPE stewardship initiative, consisting of daily rounds on patients positive or suspected of COVID-19. Principles included: 1.) supporting HCWs caring for these patients, 2.) assure implementation of infection prevention principles for a safe environment, 3.) advise on appropriate PPE and isolation precautions with respect to patient acuity, and 4.) promote best practices aligning with the most up-to-date guidance.Rounds addressed questions and concerns regarding PPE availability and utilization. We partnered with Nursing and Respiratory Therapy to alleviate demands on IP &C. The "PPE Spotters" team, monitored and optimized PPE utilization, supply, and distribution; provided training on donning/doffing, PAPR use, PPE reuse; and provided general support to HCWs for questions.ResultsWe measured number of isolation days of confirmed or suspected patients with COVID-19 and the numbers of N95 masks distributed to units during the 4-week period before (18.2 mask per isolation day) and the 8-week period after (3.0 masks per isolation day) the PPE Spotter team was formed. Our PPE stewardship efforts successfully limited N95 misuse as community COVID-19 burden increased.ConclusionsThis multi-disciplinary resource, particularly during periods of evolving PPE guidance and supply chain insecurity, was vital. Additionally, it expanded the pool of staff to advocate for HCW safety and IP&C principles.All HCWs can benefit from learning about this novel model that can be adapted to any institution and various scenarios. We recently adopted this model to support staff in psychiatry with an influx of patient volumes and their needs.

Major Factors affecting Health and Safety of Healthcare Workers During Covid-19 Pandemic

Introduction: Healthcare workers around the world are at risk of contracting an infectious disease including the recent Coronavirus Disease 19 epidemic which had a profound effect, especially on hospitals and health workers. However, at the national level in Ethiopia, there is a lack of data on the current state of health and safety of health care professionals. Therefore, the purpose of this study was to determine the status and the health and safety of healthcare workers in public hospitals in the continued COVID-19 pandemic. Objective: The purpose of this study was to determine the status of health and safety of healthcare workers and associated factors, at selected public hospitals in Addis Ababa in the continued Coronavirus Disease 19 pandemic. Methodology: An institution based cross-sectional study was conducted From January 1 to January 30, 2022, for 360 participants. A simple random technique was used to select study participants. Data were collected using self-administered questioners and entered into EPI info version 3.1 before being exported to SPSS Software (version 23) for analysis. Logistic regression was used to identify significant variables and control confounding factors. The strength of the association was measured using an adjusted odds ratio with a 95 percent confidence interval at a 5% level of significance. A P-value < 0.05 indicated a significant relationship between factors. Result: Out of a total of 360 study participants, 73.6% (95%Confidence Interval [CI]=68.9–78.3) had good occupational health and safety status. Work experiences(Adjusted Odds Ratio [AOR] =1.8, 95%Confidence Interval[CI]=1.12–3.2), Availability of Proper facemasks, (Adjusted Odds Ratio [AOR] =3, 95%Confidence Interval[CI]: 1.7–5.2), availability of disinfectants (Adjusted Odds Ratio [AOR] =2, 95%Confidence Interval[CI]=1.11–3.7), availability of water and handwashing facilities (Adjusted Odds Ratio [AOR] =2, 95%Confidence Interval[CI]=1.1–3.4), training on health and safety (Adjusted Odds Ratio [AOR]=1.8, 95%Confidence Interval[CI]=1.13–3.2) were significantly associated with health and safety status of health care workers. Conclusion: The findings indicated that health and safety status was generally good in the study area. Availability of personal protective equipment, availability of water and handwashing facilities, availability of cleaning and disinfectants, and provision of health and safety training were predictors favoring good OHS status for health professionals. Ministry of Health and specific policy makers should formulate health and safety policy and monitoring and evaluation health and safety in HCF should be implemented

Viral Anxiety Mediates the Influence of Intolerance of Uncertainty on Adherence to Physical Distancing Among Healthcare Workers in COVID-19 Pandemic.

IntroductionThe aims of this study were to examine the mediation effect of viral anxiety of healthcare workers on the influence of their intolerance of uncertainty on the adherence to physical distancing during the COVID-19 pandemic.MethodsAn online survey was conducted among 329 healthcare workers (female: 81.4%, nursing professionals: 59.0%, and shift workers: 22.3%) on November 29, 2021. Participants responded to questionnaires on adherence to physical distancing, health beliefs, and perceived social norms, and rating scales of the Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), Patient Health Questionnaire-9 items (PHQ-9), and the Intolerance of Uncertainty-12 items (IUS-12) scale.ResultsAdherence to physical distancing of healthcare workers was predicted by perceived benefits of physical distancing (β = 0.13, p = 0.01), personal injunctive norms (β = 0.32, p < 0.001), SAVE-6 score (β = 0.13, p = 0.02), and IUS-12 score (β = 0.10, p = 0.045) (adjusted R2 = 0.21, F = 22.3, p < 0.001). Viral anxiety mediated the association between intolerance of uncertainty and adherence to physical distancing but not the influence of perceived benefits and personal injunctive norms on adherence to physical distancing.ConclusionWe observed that viral anxiety of healthcare workers mediated the association between intolerance of uncertainty and adherence to physical distancing. During this pandemic, exploring adherence to physical distancing and its predicting factors will be helpful for the safety of healthcare workers and the patients for whom they care.

Evaluation of Telehealth Service for COVID-19 Outpatients: A Dashboard to Measure Healthcare Quality and Safety.

Due to the COVID-19 pandemic, changes and improvements regarding the organization have been made to adapt quickly at the Emergency Department (ED) of the Hospital Italiano de Buenos Aires, Argentina. This article describes the design, implementation, and use of an electronic dashboard which provided monitoring of patients discharged home, during follow-up with telehealth. It was useful to access essential information to organize and coordinate professional work and patients' surveillance, providing highly relevant data in real-time as proxy variables for quality and safety during home isolation. The implemented tool innovated in the integration of technologies within a real context. The information management was crucial to optimize services and decision-making, as well to guarantee safety for healthcare workers and patients.

State-wide genomic epidemiology investigations of COVID-19 in healthcare workers in 2020 Victoria, Australia: Qualitative thematic analysis to provide insights for future pandemic preparedness

SummaryBackgroundCOVID-19 has affected many healthcare workers (HCWs) globally. We performed state-wide SARS-CoV-2 genomic epidemiological investigations to identify HCW transmission dynamics and provide recommendations to optimise healthcare system preparedness for future outbreaks.MethodsGenome sequencing was attempted on all COVID-19 cases in Victoria, Australia. We combined genomic and epidemiologic data to investigate the source of HCW infections across multiple healthcare facilities (HCFs) in the state. Phylogenetic analysis and fine-scale hierarchical clustering were performed for the entire dataset including community and healthcare cases. Facilities provided standardised epidemiological data and putative transmission links.FindingsBetween March-October 2020, approximately 1,240 HCW COVID-19 infection cases were identified; 765 are included here, requested for hospital investigations. Genomic sequencing was successful for 612 (80%) cases. Thirty-six investigations were undertaken across 12 HCFs. Genomic analysis revealed that multiple introductions of COVID-19 into facilities (31/36) were more common than single introductions (5/36). Major contributors to HCW acquisitions included mobility of staff and patients between wards and facilities, and characteristics and behaviours of patients that generated numerous secondary infections. Key limitations at the HCF level were identified.InterpretationGenomic epidemiological analyses enhanced understanding of HCW infections, revealing unsuspected clusters and transmission networks. Combined analysis of all HCWs and patients in a HCF should be conducted, supported by high rates of sequencing coverage for all cases in the population. Established systems for integrated genomic epidemiological investigations in healthcare settings will improve HCW safety in future pandemics.FundingThe Victorian Government, the National Health and Medical Research Council Australia, and the Medical Research Future Fund.

Dois anos de pandemia da COVID-19: implicações para as salas de hemodinâmica e suas práticas atuais

COVID-19 continues to overwhelm healthcare systems. During the peak of the pandemic, cardiac catheterization labs across the world observed a significant decrease in procedure volumes due to several reasons, including reallocation of medical resources, deployment of interventional cardiologists to the COVID-19 wards, and physician and patient concerns about viral transmission. In particular, structural heart disease interventions experienced a significant reduction in volume by more than 90%. To address these challenges, healthcare systems employed new safety measures and protocols, including COVID-19 rapid polymerase chain reaction pretesting, Personal Protective Equipment, and vaccination mandates to ensure safety of patients and healthcare workers. Although these measures partly addressed safety concerns, diagnosis and management of acute myocardial injury remained challenging throughout the pandemic. While the pathophysiological mechanisms leading to myocardial injury is not fully elucidated, most studies have suggested COVID-19 is a pro-inflammatory disease associated with a hypercoagulable state. Ongoing randomized studies are evaluating the efficacy of more aggressive antithrombic regimens in COVID-19. In addition, the presentation of acute coronary syndrome with concomitant COVID-19 infection is variable, more likely atypical, delayed, and is associated with higher rates of adverse cardiovascular events and death. It was necessary to implement protocols to expedite diagnosis, triage and management of patients with acute coronary syndrome, while minimizing the risk of viral transmission to hospital staff. Robotic percutaneous coronary intervention may offer in the future a potential solution to many of the safety concerns faced by interventional cardiologists during the COVID-19 era; however, it has its own set of limitations.

Needlestick and sharps injuries at a German university hospital: epidemiology, causes and preventive potential - a descriptive analysis.

To analyze the number, epidemiology and circumstances of needlestick and sharps injuries (NSSI) and exposures to body fluids and to identify further preventive measures to improve the occupational safety of health care workers (HCW). Setting: German university tertiary-care referral center. Retrospective study based on injury documentation sheets of the hospital's staff and faculty health service and, if given, on reports by continuity doctors and by the accident and emergency department in January 2014-June 2016. Altogether, 567 injuries were registered with a significant decrease of cases over the study period. The majority of accidents occurred in the operating theater (35%). Stress, time pressure, overstrain, carelessness and distraction were found to be the main reasons for injuries. At least 30% of the cases were preventable, mainly by wearing personal protective equipment (PPE), by proper disposal of an item and by early replacement of overfilled sharps containers (SC). In 20% of the cases involving an item, the injury was caused by a safety-engineered device (SED). Almost one-third of these injuries were attributable to an improper use of the SED. Despite many efforts made to reduce their number, NSSI still occur. Health care workers and students should be offered regular trainings to be sensitized to this topic and to learn the appropriate use of SED. Moreover, organizational measures must be taken, such as the provision of suitable PPE and safe SC. Strategies need to be established to improve the working conditions and reduce the stress level of HCW. Int J Occup Med Environ Health. 2022;35(5):497-507.

Dialysis practices during the COVID-19 pandemic: a survey from India

Introduction: The COVID-19 pandemic has been a challenging time for dialysis units worldwide. Nephrologists are faced with the difficult task of providing renal replacement therapy to COVID-19 patients and simultaneously prevent spread of COVID-19 in dialysis units. Objectives: We aimed to study the dialysis practices being followed during the COVID-19 pandemic. Patients and Methods: A questionnaire assessing treatment and preventive practices being followed in dialysis units during the COVID-19 pandemic was emailed to nephrologists and nephrology trainees practising in India. Responses were recorded electronically. Results: We received 173 valid responses. About 83.2% nephrologists were providing dialysis for COVID-19. Hemodialysis/slow low-efficient dialysis was the most common modality (65.2%) of renal replacement therapy (RRT) in COVID-19 acute kidney injury. In dialysis patients with suspicious symptoms, most common test to rule out COVID-19 was RT-PCR (reverse transcriptase polymerase chain reaction) + chest imaging ( 42.2%) followed by RT-PCR alone (34.1%). Around 80.9% nephrologists sought a negative RT-PCR in patients who had recovered from COVID-19 before discontinuation of isolation measures. Adherence to COVID-19 preventive measures varied between 15.2% (portable reverse osmosis disinfection) to 97.1% (mask wearing). Healthcare worker (HCW) training programme was present in 88.4% cases, paid leaves for COVID-19 in 89% and daily HCW symptom screen in 65.3%. The most frequently identified barrier to chronic kidney disease care was a delay in transplantation (66.5%). Accordingly, 20.8% reported a temporary closure of dialysis unit due to COVID-19 outbreak. Moreover, 63% of nephrologists counseled patients to choose peritoneal dialysis above hemodialysis as permanent RRT. Conclusion: Hemodialysis/slow low efficient dialysis is the preferred modality of RRT in COVID 19-AKI. Many nephrologists are counseling for peritoneal dialysis as superior to hemodialysis during COVID-19 for maintenance RRT. Preventive measure adherence is variable across centers. HCW safety has been addressed in most centers.

Droplet aerosols transportation and deposition for three respiratory behaviors in a typical negative pressure isolation ward

Negative pressure isolation wards could provide safety for health care workers (HCWs) and patients infected with SARS-CoV-2. However, respiratory behavior releases aerosols containing pathogens, resulting in a potential risk of infection for HCWs. In this study, the spatiotemporal distribution of droplet aerosols in a typical negative pressure isolation ward was investigated using a full-scale experiment. In this experiment, artificial saliva was used to simulate the breathing behavior, which can reflect the effect of evaporation on droplet aerosols. Moreover, numerical simulations were used to compare the transport of droplet aerosols released by the three respiratory behaviors (breathing, speaking, and coughing). The results showed that droplet aerosols generated by coughing and speaking can be removed and deposited more quickly. Because reduction in the suspension proportion per unit time was much higher than that in the case of breathing. Under the air supply inlets, there was significant aerosol deposition on the floor, while the breathing area possessed higher aerosol concentrations. The risk of aerosol resuspension and potential infection increased significantly when HCWs moved frequently to these areas. Finally, more than 20% of the droplet aerosols escaped from the ward when the number of suspended aerosols in the aerosol space was 1%.

Special Pathogens Readiness in the United States: From Ebola to COVID-19 to Disease X and Beyond.

Special Pathogens Readiness in the United States: From Ebola to COVID-19 to Disease X and Beyond.

Development of a low-cost device for testing glove and condom leakage

BackgroundCurrently, hospital-acquired infections in healthcare workers and patients are a major concern. On the other hand, sexually transmitted infections and diseases, unwanted pregnancies, and unsafe abortions continue to be a public health concern, particularly in developing countries. Gloves are among the most commonly used personal protective equipment to safeguard healthcare workers' hands from contagious infections, and using a condom is strongly advised for people who have sexual relations with more than one partner. However, the quality of gloves and condoms in developing countries is a subject of concern. The usage of quality test instruments such as glove leakage test apparatus (GLTA), leakage testers by water level, the Ammonia leak testing method (ALTM), conductivity-based leakage testers, and water hang testers in developing countries is limited owing to cost, accessibility, and safety. The main purpose of this study was to develop and test a low-cost integrated device to test glove and condom leakage that is safe and easily accessible in resource poor settings. MethodIn this study, an integrated glove and condom leakage testing device for detecting pin holes and leakages is proposed. The device automatically fills a randomly selected condom and glove with a predetermined volume of water based on International Organization for Standardization (ISO) criteria. ResultsThe prototype of the proposed device was successfully developed and tested. The accuracy of 98.66% for filling condom samples with 300 ml of water and 99.29% for filling glove samples with 1000 ml of water was achieved. ConclusionThe implementation of the developed prototype in resource poor settings to test gloves and condom leakage has the potential to improve the safety of healthcare workers, patients, and the general public.

Physical problems of prolonged use of personal protective equipment during the COVID-19 pandemic: A scoping review.

BackgroundIt is widely believed that using personal protective equipment (PPE) provides high levels of protection for healthcare workers (HCWs) in the fight against coronavirus disease (COVID‐19). However, the long‐term use of PPE is inconvenient for HCWs and may cause physical discomfort. These factors could result in poor compliance and disrupt the health and safety of HCWs, which may negatively affect the patient's safety.ObjectiveThis study aimed to investigate the literature for the purpose of collecting convincing evidence of HCWs' physical problems associated with PPE use during the COVID‐19 pandemic.MethodsThis scoping review was conducted using PubMed, Embase, ProQuest, Science Direct, Springer, Biomed Central, and Google Scholar to identify the related literature.ResultsHCWs have experienced various physical disorders including skin, respiratory, musculoskeletal, nervous, urinary, and circulatory system problems that are associated with PPE in various body systems. Among these, skin problems were the most frequent physical problems.ConclusionsThe literature demonstrated the adverse impacts of using PPE on HCWs. Therefore, healthcare policymakers should take the appropriate measures to improve the work environment during the COVID‐19 pandemic, which could consequently prevent and mitigate the adverse effects of using PPE.

Correlation of human capital sustainability leadership style and resilience of the managers in airline operations group of an AIRLINE Company

correlation of human capital sustainability leadership style and resilience of the managers in airline operations group of an AIRLINE Company

Healthcare worker safety program in a coronavirus disease 2019 (COVID-19) alternate care site: The Javits New York Medical Station experience.

In March 2020, New York City became the epicenter of the coronavirus disease 2019 (COVID-19) pandemic in the United States. Because healthcare facilities were overwhelmed with patients, the Jacob K. Javits Convention Center was transformed into the nation's largest alternate care site: Javits New York Medical Station (hereafter termed Javits). Protecting healthcare workers (HCWs) during a global shortage of personal protective equipment (PPE) in a nontraditional healthcare setting posed unique challenges. We describe components of the HCW safety program implemented at Javits. Javits, a large convention center transformed into a field hospital, with clinical staff from the US Public Health Service Commissioned Corps and the US Department of Defense. Key strategies to ensure HCW safety included ensuring 1-way flow of traffic on and off the patient floor, developing a matrix detailing PPE required for each work activity and location, PPE extended use and reuse protocols, personnel training, and monitoring adherence to PPE donning/doffing protocols when entering or exiting the patient floor. Javits staff who reported COVID-19 symptoms were immediately isolated, monitored, and offered a severe acute respiratory coronavirus virus 2 (SARS-CoV-2) reverse-transcriptase polymerase chain reaction (RT-PCR) test. A well-designed and implemented HCW safety plan can minimize the risk of SARS-CoV-2 infection for HCWs. The lessons learned from operating the nation's largest COVID-19 alternate care site can be adapted to other environments during public health emergencies.

POSITIVE IMPACT OF AN AUTOMATED PRE-ANALYTICAL &amp; POST-ANALYTICAL WORKFLOW SYSTEM IN A TERTIARY HIGH-VOLUME REFERRAL CLINICAL LABORATORY

Context: Handling of biological samples in a laboratory is labour intensive complex process and automation has become a necessity for optimizing health care costs, reduce medical errors and to aid in safety of healthcare workers. Biological Sample handling in the sample reception area involves sample tube de-capping for ready processing, sorting section-wise, scanning the sample to track its progress, distribution to various analysers and archival for storage. The aim of the present study is to evaluate the positive effects of an automatic pr Objective: e analytical automation in our clinical laboratory workow. We recently installed Beckman Automate 2550 analyser for our wor Design: kow pre &amp; post analytical automation.This preanalytical unit processes blood specimens through automated specimen sorting, centrifugation, de-capping, labelling, aliquoting, and placement of the processed specimen in the analytical rack. We analysed the system by processing samples to test the salient features of this system. Turnaround time with increase in volume of tests with no additional manpower was analysed pre &amp; post automation. The turnaround ti Results: me (TAT) of various laboratory processes demonstrated a signicant improvement. The number of errors experienced in tube sorting with manual processing, sorting mislabelled tubes, unlabelled tubes, specimen lost, wrong destination entered for tubes and tube mismatch was decreased post-implementation of the system. Also, increased workload was handled by the sorter efciently. Conclusions: Reduction time in pre analytical processing and sorting of samples led to signicant improvements in TAT and specimen processing after automation. The manual errors &amp; manhours associated with sorting, labelling, aliquoting the blood samples also reduced. These results conclude that automated sample sorting improves specimen accessioning and processing workow.

HALO CleanSpace PAPR evaluation: Communication, respiratory protection, and usability.

To evaluate a relatively new half-face-piece powered air-purifying respirator (PAPR) device called the HALO (CleanSpace). We assessed its communication performance, its degree of respiratory protection, and its usability and comfort level. This simulation study was conducted at the simulation center of the Royal Melbourne Hospital. In total, 8 voluntary healthcare workers participated in the study: 4 women and 4 men comprising 3 nursing staff and 5 medical staff. We performed the modified rhyme test, outlined by the National Institute for Occupational Safety and Health (NIOSH), for the communication assessment. We conducted quantitative fit test and simulated workplace protection factor studies to assess the degree of respiratory protection for participants at rest, during, and immediately after performing chest compression. We also invited the participants to complete a usability and comfort survey. The HALO PAPR met the NIOSH minimum standard for speech intelligibility, which was significantly improved with the addition of wireless communication headsets. The HALO provided consistent and adequate level of respiratory protection at rest, during and after chest compression regardless of the device power mode. It was rated favorably for its usability and comfort. However, participants criticized doffing difficulty and perceived communication interference. The HALO device can be considered as an alternative to a filtering face-piece respirator. Thorough doffing training and mitigation planning to improve the device communication performance are recommended. Further research is required to examine its clinical outcomes and barriers that may potentially affect patient or healthcare worker safety.

Access to Essential Personal Safety, Availability of Personal Protective Equipment and Perception of Healthcare Workers During the COVID-19 in Public Hospital in West Shoa.

IntroductionThe pandemic of coronavirus disease-2019 has fundamentally changed the physician–patient relationship due to health care workers’ being at high risk of getting COVID-19 infection from their patients. Therefore, healthcare workers are a priority to be protected and prevent transmission within a healthcare setting.ObjectiveTo assess the actual and perceived personal safety of healthcare workers practicing in public hospitals.Methods and MaterialsA descriptive cross-sectional study design was done among 361 health professionals in West Shoa. A simple random sampling technique was used to select representative respondents. Data was collected by a pretested, self-administered questionnaire. The collected data was entered into EPI-Info and exported to STATA for analysis. Descriptive statistics were used to present the data.ResultsA total of 361 healthcare workers responded to the question with a 97% response rate. The median age of the study participants was 29. Of the total participants, access to personal protective equipment was: hand sanitizer 322 (89.2%), disposable gloves 285 (78.9%), face mask 280 (77.6%), KN95 face mask 163 (45.2%) and facial protective shields 112 (31%). One hundred sixty-nine (46.8%) of the study participants reported that their hospital has personal safety policies and procedures. One hundred sixty-one (44%) reported that they perceived no support, while only 35 (9.7%) participants reported that they perceived full support from their hospital. Furthermore, the participants perceived that their local concerned bodies took fewer necessary measurements to defend physical integrity in the workplace (mean 2.86 SD = 3.34).ConclusionThere are many healthcare workers who have limited access to the majority of essential PPE. The majority of study participants perceived limited support from their health facilities, hospitals and local concerned bodies. Therefore, hospitals and local public health authorities should increase access to PPE to protect healthcare workers.

Safety of Health Care Workers in a War Zone—A European Issue

Safety of Health Care Workers in a War Zone—A European Issue

The Seroprevalence of SARS-CoV-2 Antibodies among HealthCare Workers in University Hospital in Krakow before the Era of Vaccination.

Background: Knowledge of occupational health is crucial to the safety of healthcare workers in the pandemic period. The aim of our study was the rating of SARS-CoV-2 seroprevalence in connection with selected demographic, social, and organizational factors, as well as the identification of key elements determining the safety of HCWs and patients of the University Hospital in Krakow. Methods: This was a non-interventional, uncontrolled, open, single-center, cross-sectional online survey on the preparedness for the COVID-19 epidemic and the seroprevalence of medical and non-medical HCWs and students. Serum specimens from 1221 persons were tested using an immunoassay analyzer based on the ECLIA technique for the anti-SARS-CoV-2 antibodies IgM + IgG. Results: The total seroprevalence was 42.7%. In medical students it was 25.2%, while in physicians it was 43.4% and in nurses/midwives it was 48.1%. Of those who tested positive, 21.5% did not know their serological status. The use of personal protective equipment did not have any significant impact on the result of testing for anti-SARS-CoV-2 antibodies. The risk of developing the disease was not influenced by sex, professional work experience, workplace, or intensity of contact with the patient. Among the studied elements, only care of COVID-19 patients significantly increased the risk. The protective factor was starting work between the waves of the epidemic (June–September 2020). Conclusions: PPE is only one element of infection prevention and control—without other components, such as hand hygiene, it can be dangerous and contribute to self-infection. It is also very important to test healthcare workers. Not being aware of the COVID-19 status of HCWs poses a threat to other staff members, as well as patients and the family and friends of the infected. Thus, extreme caution should be applied when employing respirators with exhalation valves during the COVID-19 pandemic.

Pulmonary Procedures in the COVID-19 Era.

Purpose of ReviewThe purpose of this review is to discuss the impact of the COVID-19 pandemic on pulmonary procedures, including new guidelines, restrictions, techniques, and overall effect on patient care.Recent FindingsSARS-CoV-2 predominately impacts the pulmonary system and can result in a severe lower respiratory tract infection. Early guidelines based largely on data from the SARS epidemic recommended significant restrictions on procedure volume out of concern for healthcare worker safety. Newer data suggests relative safety in performing airway and pleural procedures as long as appropriate precautions are followed and new techniques are utilized. The introduction of effective vaccines and more reliable testing has led to a re-expansion of elective procedures.SummaryMany guidelines and expert statements exist for the management and practice of pulmonary procedures during the COVID-19 pandemic. A flexible and individualized approach may be necessary as our understanding of COVID-19 continues to evolve.