Development and Validation of Tool to Appraise Guidelines on SARS-CoV-2 Infection Prevention Strategies in Healthcare Workers

Subramaniam, Ashwin; Mallikarjuna, Reddy; Zubarev, Alexander; Umesh, Kadam; Zhengjie, Lim; Anstey, Chris; Bihari, Shailesh; Haji, Jumana; Subhathra, Karunanithi; Ramanathan, Kollengode; Jian-ying, Luo; Mara, Neil; Safari, Mitra; Rajamani, Arvind; Rubulotta, Francesca; Svensk, Erik; Kiran, Shekar

doi:10.2139/ssrn.3618322

Cited by 2 publications

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“…None of the recommendations are evidencebased (such as by identifying contamination using UV light for luminescent particles) or based on robust simulation work, as shown by a systematic review appraising PPE guidelines worldwide that our group has just completed. 31 Multiple guidelines may contribute to variations in respiratory PPE-usage across ICUs. For instance, one-third of respondents followed the WHO recommendations of reserving N95/P2 masks exclusively for AGPs, while 60% (especially in HK and Singapore) followed the practice of routinely using N95/P2 masks, irrespective of AGPs, which is advocated by ANZICS.…”

Section: Resultsmentioning

confidence: 99%

Personal protective equipment preparedness in Asia-Pacific intensive care units during the coronavirus disease 2019 pandemic: A multinational survey

Rajamani

Subramaniam

Shekar

et al. 2021

Australian Critical Care

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Section: Resultsmentioning

confidence: 99%

Personal protective equipment preparedness in Asia-Pacific intensive care units during the coronavirus disease 2019 pandemic: A multinational survey

Rajamani

Subramaniam

Shekar

et al. 2021

Australian Critical Care

Self Cite

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“…16 Reassurance from policy makers in stock, PPE quality and reporting, and post-exposure policies would all help improve HCW productivity in stressful situations. 17 We strongly recommend an immediate commencement of PPE training in every hospital and/or ICU. The infection prevention guidelines should be regularly updated as the pandemic progresses with time.…”

Section: Discussionmentioning

confidence: 98%

“…Other key strategies include implementation of low-cost measures, such as buddy systems and cultivate a safety-culture environment that improves the HCW well-being during such pandemics. 17 Infection prevention goes beyond PPE-use and requires systematic measures to improve preparedness and safety culture to ensure the safety and well-being of HCWs during such pandemics. 17 While PPE provides immediate physical and psychological safety to the HCWs, incorporation of engineering and administrative solutions will aid in bringing in an enduring culture of safety in health systems, thereby improving HCW morale and well-being.…”

Section: Discussionmentioning

confidence: 99%

State of Personal Protective Equipment Practice in Indian Intensive Care Units amidst COVID-19 Pandemic: A Nationwide Survey

Haji¹,

Subramaniam

Kumar³

et al. 2020

Indian Journal of Critical Care Medicine

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A bstract Background Optimal personal protective equipment (PPE) preparedness is key to minimize healthcare workers (HCW) infection with COVID-19. This two-phase survey evaluated PPE preparedness (adherence to Ministry of Health India (MoH) PPE-recommendations; HCW-training; PPE-inventory; PPE-breach management) in Indian intensive care units (ICU). Materials and methods The phase 1 survey was distributed electronically to intensivists from 481 Indian hospitals between March 25, 2020, and April 06, 2020, as part of a multinational survey. Phase 2 was repeated in 320 Indian hospitals between April 20, 2020, and April 30, 2020. Results Response rate was 25% from 22 states. PPE practice varied between states and between private, government, and medical colleges. Between phase 1 and phase 2, all aspects of PPE training improved: donning/doffing 43% vs 66%, respectively; p value <0.01); safe waste disposal practices (38% vs 52%; p value = 0.09); intubation training (18% vs 31%; p value = 0.05); and transport (18% vs 31%; p value = 0.05). Perception of confidence for adequate PPE-training improved from 39 to 53% ( p value = 0.26). In all, 47 to 60% ICUs adhered to MoH recommendations. Wearing N95-masks at all times increased from 47 to 60% ( p value = 0.89). Very few ICUs provided quantitative/qualitative N95 masks fit testing (12% vs 29%; p value <0.01). Low-cost practices like “buddy-system” for donning-doffing (27% vs 44%; p value = 0.02) and showering after PPE breach (10% vs 8%; p value = 0.63) were underutilized. There was reluctance to PPE reuse. In all, 71% were unaware/diffident about PPE inventory. Conclusion Despite interstate variability, most ICUs conformed to MoH recommendations. This survey conducted during initial pandemic phase demonstrated improved PPE preparedness uniformly across India with scope for further improvement. We suggest implementation of quality improvement measures to improve pandemic preparedness and minimize HCW infection rates, focused on regular PPE training, buddy system, and PPE-breach management. How to cite this article Haji JY, Subramaniam A, Kumar P, Ramanathan K, Rajamani A. State of Personal Protective Equipment Practice in Indian Intensive Care Units amidst COVID-19 Pandemic: A Nationwide Survey. Indian J Crit Care Med 2020;24(9):809–816.

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Development and Validation of Tool to Appraise Guidelines on SARS-CoV-2 Infection Prevention Strategies in Healthcare Workers

Cited by 2 publications

References 0 publications

Personal protective equipment preparedness in Asia-Pacific intensive care units during the coronavirus disease 2019 pandemic: A multinational survey

Personal protective equipment preparedness in Asia-Pacific intensive care units during the coronavirus disease 2019 pandemic: A multinational survey

State of Personal Protective Equipment Practice in Indian Intensive Care Units amidst COVID-19 Pandemic: A Nationwide Survey

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