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

Haji, Jumana Yusuf; Subramaniam, Ashwin; Kumar, Pankaj; Ramanathan, Kollengode; Rajamani, Arvind

doi:10.5005/jp-journals-10071-23550

Cited by 27 publications

(13 citation statements)

References 13 publications

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“…Adherence to safety protocol should be promoted by a “culture of safety”. 37 As GPs usually work in teams with other health-care workers, their inclusion would be important to assess “culture of safety” in their respective workplaces. Meanwhile, determinants of mental health problems in this study were not exhaustive and there could be non-COVID-19 mental health determinants that may affect mental health of our respondents.…”

Section: Discussionmentioning

confidence: 99%

Determinants of Mental Health and Practice Behaviors of General Practitioners During COVID-19 Pandemic in Bali, Indonesia: A Cross-sectional Study

Sitanggang¹,

Wirawan²,

Wirawan³

et al. 2021

RMHP

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Purpose: We aim to study the level of mental health distress and COVID-19 prevention in practice behaviors among general practitioners (GPs) in Bali, Indonesia, as well as their determinants. Methods: We conducted a cross-sectional online survey. Survey recruitment material was disseminated by purposive snowballing through regional professional association as well as research team's personal acquaintances. The survey measured mental health status by DASS-21 questionnaire and practice behavior by a questionnaire based on WHO recommendations for hand hygiene and PPE use during the COVID-19 pandemic. We conducted multivariate analyses to identify independent determinants for mental health and practice behavior. Results: Analyses included 635 (41.75%) of GPs in Bali. Mental health status was relatively good with prevalence of depression, anxiety, and stress of 13.2%, 19.7%, and 11% respectively, lower than previous studies in Indonesia and elsewhere. Practice behavior, however, was not considerably lower with only 65.4% and 32.1% reported consistent hand hygiene and recommended PPE use respectively. Routine optional PPE use was reported by 23.6% of respondents. Long working hours and fear of COVID-19 was identified as detrimental to mental health while consistent hand hygiene improved it. Meanwhile, workplace, work setting, and fear of COVID-19, were identified as determinants for PPE use. GPs working in primary health centers and private hospitals were also found to have less adherence to hand hygiene protocols. Conclusion: Our results showed relatively good mental health status along with inadequate infection prevention in practice behavior of GPs in Bali, Indonesia. Intervention should be made to improve practice behavior. Determinants of practice behavior identified in this study could help to pinpoint intervention targets.

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Section: Discussionmentioning

confidence: 99%

Determinants of Mental Health and Practice Behaviors of General Practitioners During COVID-19 Pandemic in Bali, Indonesia: A Cross-sectional Study

Sitanggang¹,

Wirawan²,

Wirawan³

et al. 2021

RMHP

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“…However, due to lack of availability of resources, very few centers are doing it currently. 3 , 22 A reliable point-of-care diagnostic test for leak around the respirators, however, is urgently needed.…”

Section: Discussionmentioning

confidence: 99%

“…During the COVID-19 pandemic, N95 respirators are commonly used as part of personal protective equipment (PPE) for healthcare workers (HCWs). 1 – 3 The N95 respirators block at least 95% of the particles >0.3 µm in size. 4 The respirator efficiency is dependent on an adequate seal, and there is no guarantee of its efficiency unless it is fit-tested for each user.…”

Section: Introductionmentioning

confidence: 99%

Prediction of N95 Respirator Fit from Fogging of Eyeglasses: A Pilot Study

Kyaw¹,

Johns²,

Lim³

et al. 2021

Indian Journal of Critical Care Medicine

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A bstract Aim and objective Fogging of eyeglasses while wearing N95 respirators is common. It is commonly held that the N95 respirator has a poor fit if there is fogging of eyeglasses. We conducted this prospective, pilot study to determine if fogging of eyeglasses predicts poor fit of N95 respirator. Materials and methods Seventy volunteer healthcare workers from a tertiary intensive care unit in Sydney, Australia participated. The participants donned one of the following N95 respirators: three-panel flat-fold respirator (3M 1870), cup-shaped respirator (3M 1860), or a duckbill respirator. After a satisfactory “user seal check” as recommended by the manufacturer, the participants donned eyeglasses and checked for fogging. A quantitative fit test (QnFT) of the respirator was then performed (using PortaCount Respirator Fit Tester 8048, TSI Inc., Minnesota, USA). A fit factor of <100 on quantitative fit testing indicates poor fit. The sensitivity and specificity for fogging of eyeglasses (index test) to predict the poor fit of N95 respirator was determined, compared to QnFT (gold standard test). Results Fogging of eyeglasses as a predictor of poor respirator fit (i.e., fit factor <100 on QnFT) had sensitivity of 71% (95% CI, 54–85%) and specificity 46% (95% CI, 29–63%). The odds ratio of fogging as a predictor for poor fit was 2.10 (95% CI, 0.78–5.67), with a two-tailed p -value of 0.22 (not significant). The receiver operating characteristic curve for fogging of eyeglasses as a diagnostic test had the area under the curve of 0.59. Conclusion Fogging of eyeglasses is neither a sensitive nor a specific predictor for poor fit of N95 respirators. How to cite this article Kyaw S, Johns M, Lim R, Stewart WC, Rojas N, Thambiraj SR, et al. Prediction of N95 Respirator Fit from Fogging of Eyeglasses: A Pilot Study. Indian J Crit Care Med 2021;25(9):976–980.

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“…The detailed methodology of the survey is published elsewhere. 18 , 19 The survey was distributed to HCWs from private hospitals, government hospitals, and medical college hospitals in two phases—Phase 1 between 25/03/2020 and 06/04/2020 and phase 2 between 20/04/20 and 30/04/20. As this article primarily deals with clinical management issues, we only included the responses from intensivists/anesthetists with direct responsibility of admitting/managing patients in ICU.…”

Section: Aterials and M Ethodsmentioning

confidence: 99%

Non-invasive Oxygen Strategies to Manage Confirmed COVID-19 Patients in Indian Intensive Care Units: A Survey

Subramaniam

Haji²,

Kumar³

et al. 2020

Indian Journal of Critical Care Medicine

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A bstract Background About 5% of hospitalized coronavirus disease 2019 (COVID-19) patients will need intensive care unit (ICU) admission for hypoxemic respiratory failure requiring oxygen support. The choice between early mechanical ventilation and noninvasive oxygen therapies, such as, high-flow nasal oxygen (HFNO) and/or noninvasive positive-pressure ventilation (NPPV) has to balance the contradictory priorities of protecting healthcare workers by minimizing aerosol-generation and optimizing resource management. This survey over two timeframes aimed to explore the controversial issue of location and noninvasive oxygen therapy in non-intubated ICU patients using a clinical vignette. Materials and methods An online survey was designed, piloted, and distributed electronically to Indian intensivists/anesthetists, from private hospitals, government hospitals, and medical college hospitals (the latter two referred to as first-responder hospitals), who are directly responsible for admitting/managing patients in ICU. Results Of the 204 responses (125/481 in phase 1 and 79/320 in phase 2), 183 responses were included. Respondents from first-responder hospitals were more willing to manage non-intubated hypoxemic patients in neutral pressure rooms, while respondents from private hospitals preferred negative-pressure rooms ( p < 0.001). In both the phases, private hospital doctors were less comfortable to use any form of noninvasive oxygen therapies in neutral-pressure rooms compared to first-responder hospitals (low-flow oxygen therapy: 72 vs 50%, p < 0.01; HFNO: 47 vs 24%, p < 0.01 and NPPV: 38 vs 28%, p = 0.20). Interpretation Variations existed in practices among first-responder and private intensivists/anesthetists. The resource optimal private hospital intensivists/anesthetists were less comfortable using noninvasive oxygen therapies in managing COVID-19 patients. This may reflect differential resource availability necessitating resolution at national, state, and local levels. How to cite this article Subramaniam A, Haji JY, Kumar P, Ramanathan K, Rajamani A. Noninvasive Oxygen Strategies to Manage Confirmed COVID-19 Patients in Indian Intensive Care Units: A Survey. Indian J Crit Care Med 2020;24(10):926–931.

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

Cited by 27 publications

References 13 publications

Determinants of Mental Health and Practice Behaviors of General Practitioners During COVID-19 Pandemic in Bali, Indonesia: A Cross-sectional Study

Determinants of Mental Health and Practice Behaviors of General Practitioners During COVID-19 Pandemic in Bali, Indonesia: A Cross-sectional Study

Prediction of N95 Respirator Fit from Fogging of Eyeglasses: A Pilot Study

Non-invasive Oxygen Strategies to Manage Confirmed COVID-19 Patients in Indian Intensive Care Units: A Survey

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