Dataset Information

DVT Protocol Optimization to Minimize Healthcare Worker Exposure in COVID-19.

ABSTRACT: OBJECTIVES:There are no societal ultrasound guidelines detailing appropriate patient selection for deep vein thrombosis (DVT) imaging in COVID-19 patients nor are there protocol recommendations aimed at decreasing exposure time for ultrasound technologists. We aimed to provide COVID-19 specific protocol optimization recommendations limiting ultrasound technologist exposure while optimizing patient selection. METHODS:A novel two-pronged algorithm was implemented to limit the DVT ultrasound studies on COVID-19 patients prospectively which included direct physician communication with the care team and a COVID-19 specific imaging protocol was instated to reduce ultrasound technologist exposure. In order to assess pretest risk of DVT, sensitivity and specificity of serum D-Dimer in 500-unit increments from 500 to 8000 ng/mL and a receiver operating characteristic curve (ROC) to assess performance of serum D-Dimer in predicting DVT was generated. Rates of DVT, pulmonary embolism (PE) and scan times were compared using t-test and Fisher's exact test (before and after implementation of the protocol). RESULTS:Direct physician communication resulted in cancellation or deferral of 72% of requested exams in COVID-19 positive patients. A serum D-Dimer > 4000ng/mL yielded a sensitivity of 80% and a specificity of 70% (CI: 0.54-0.86) for venous thromboembolism. Using the COVID-19 specific protocol, there was a significant (50%) reduction in scan time (p<0.0001) in comparison with conventional protocol. CONCLUSION:A direct physician communication policy between imaging physician and referring physician resulted in deferral or cancellation of a majority of requested DVT ultrasound exams. An abbreviated COVID-19 specific imaging protocol significantly decreased exposure time to the ultrasound technologist.

SUBMITTER: Dua A

PROVIDER: S-EPMC7418643 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Deep vein thrombosis protocol optimization to minimize healthcare worker exposure in coronavirus disease-2019.

Dua Anahita A Thondapu Vikas V Rosovsky Rachel R Hunt David D Latz Christopher C Waller H David HD Manchester Scott S Patell Rushad R Romero Javier J Ghoshhajra Brian B Eagleton Matthew M Brink James J Hedgire Sandeep S

Journal of vascular surgery. Venous and lymphatic disorders 20200811 2

<h4>Objective</h4>There are no societal ultrasound (US) guidelines detailing appropriate patient selection for deep vein thrombosis (DVT) imaging in patients with COVID-19, nor are there protocol recommendations aimed at decreasing exposure time for US technologists. We aimed to provide COVID-19-specific protocol optimization recommendations limiting US technologist exposure while optimizing patient selection.<h4>Methods</h4>A novel two-pronged algorithm was implemented to limit the DVT US studi ...[more]

PMID: 32795617

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Project description:IntroductionThe COVID-19 pandemic is creating immense psychosocial disturbance. While global, broad-based research is being conducted, little is known about the effects of the COVID-19 pandemic on health and well-being or how protective and resilience factors influence the human response in Australian rural and regional communities. Rural and regional communities often have less resources to deal with such public health emergencies and face additional environmental adversity. Healthcare workers, including those in rural and regional areas, have felt the immediate impacts of COVID-19 in a multitude of ways and these impacts will continue for years to come. Therefore, this study aims to describe and understand the impacts of the COVID-19 pandemic on the rural and regional healthcare workforce within the Loddon Mallee region, Victoria, Australia.Methods and analysisThis prospective cohort of rural and regional healthcare workers will be recruited and followed over 3 years to examine the effects of the COVID-19 pandemic on their health and well-being. Self-administered online questionnaires will be administered every 6 months for a 36-month period. Multiple outcomes will be assessed; however, the primary outcomes are emotional health and well-being and psychological resilience. Emotional health and well-being will be measured using validated instruments that will assess multiple domains of the emotional health and well-being continuum.Linear and logistic regression and latent growth curve modelling will be used to examine the association between baseline and follow-up participant emotional health, well-being and resilience while adjusting for potentially time-varying confounding variables. Participant characteristics measured at baseline will also be tested for association with incident health, morbidity, mortality and health service utilisation outcomes at follow-up.Ethics and disseminationEthical approval has been obtained through the Bendigo Health Human Research Ethics Committee. The study findings will be disseminated through international conferences, international peer-reviewed journals and social media.Trial registration numberACTRN12620001269921.

Project description:ObjectiveExplore how previous work during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak affects the psychological response of clinical and non-clinical healthcare workers (HCWs) to the current COVID-19 pandemic.MethodsA cross-sectional, multi-centered hospital online survey of HCWs in the Greater Toronto Area, Canada. Mental health outcomes of HCWs who worked during the COVID-19 pandemic and the SARS outbreak were assessed using Impact of Events-Revised scale (IES-R), Generalized Anxiety Disorder scale (GAD-7), and Patient Health Questionnaire (PHQ-9).ResultsAmong 3852 participants, moderate/severe scores for symptoms of post- traumatic stress disorder (PTSD) (50.2%), anxiety (24.6%), and depression (31.5%) were observed among HCWs. Work during the 2003 SARS outbreak was reported by 1116 respondents (29.1%), who had lower scores for symptoms of PTSD (P = .002), anxiety (P < .001), and depression (P < .001) compared to those who had not worked during the SARS outbreak. Multivariable logistic regression analysis showed non-clinical HCWs during this pandemic were at higher risk of anxiety (OR, 1.68; 95% CI, 1.19-2.15, P = .01) and depressive symptoms (OR, 2.03; 95% CI, 1.34-3.07, P < .001). HCWs using sedatives (OR, 2.55; 95% CI, 1.61-4.03, P < .001), those who cared for only 2-5 patients with COVID-19 (OR, 1.59; 95% CI, 1.06-2.38, P = .01), and those who had been in isolation for COVID-19 (OR, 1.36; 95% CI, 0.96-1.93, P = .05), were at higher risk of moderate/severe symptoms of PTSD. In addition, deterioration in sleep was associated with symptoms of PTSD (OR, 4.68, 95% CI, 3.74-6.30, P < .001), anxiety (OR, 3.09, 95% CI, 2.11-4.53, P < .001), and depression (OR 5.07, 95% CI, 3.48-7.39, P < .001).ConclusionPsychological distress was observed in both clinical and non-clinical HCWs, with no impact from previous SARS work experience. As the pandemic continues, increasing psychological and team support may decrease the mental health impacts.

Dataset Information

DVT Protocol Optimization to Minimize Healthcare Worker Exposure in COVID-19.

Publications

Deep vein thrombosis protocol optimization to minimize healthcare worker exposure in coronavirus disease-2019.

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