Dataset Information

Personal protective equipment use by health-care workers in intensive care units during the COVID-19 pandemic in Japan: comparative analysis with the PPE-SAFE survey.

ABSTRACT:

Aim

We investigated personal protective equipment (PPE) use and supply shortage, training, and adverse events among health-care workers (HCWs) in the intensive care unit (ICU) during the coronavirus disease (COVID-19) pandemic in Japan and compared the results with an international survey that used the same methodology.

Methods

This Web-based survey was carried out from 14 April to 6 May, 2020, in Japan and included HCWs directly involved in ICU management of COVID-19 patients. A survey invitation was emailed using the Japanese Society of Intensive Care Medicine's mailing list.

Results

We analyzed 460 valid responses from among 976 responses. The N95/FFP2 mask (77%) was the most frequently used, although half of our respondents reported reuse of single-use N95/FFP2 masks. The median duration (1 h) of uninterrupted PPE use per shift was less than that in the international study. The most common PPE-related adverse event was experiencing intense heat (75%). Logistic regression analysis revealed that being a nurse was independently associated with experiencing intense heat.

Conclusion

Shortage of PPE and frequent mask reuse were prevalent during the COVID-19 pandemic in Japan. Intense heat is the most significant symptom, especially for nurses, even with short-duration PPE use. Strategies to protect HCWs from dehydration and intense heatstroke are needed.

SUBMITTER: Unoki T

PROVIDER: S-EPMC7537292 | biostudies-literature | 2020 Jan-Dec

REPOSITORIES: biostudies-literature

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Publications

Personal protective equipment use by health-care workers in intensive care units during the COVID-19 pandemic in Japan: comparative analysis with the PPE-SAFE survey.

Unoki Takeshi T Tamoto Mitsuhiro M Ouchi Akira A Sakuramoto Hideaki H Nakayama Asami A Katayama Yukiko Y Miyazaki Satoko S Yamada Toru T Fujitani Shigeki S Nishida Osamu O Tabah Alexis A

Acute medicine & surgery 20200101 1

<h4>Aim</h4>We investigated personal protective equipment (PPE) use and supply shortage, training, and adverse events among health-care workers (HCWs) in the intensive care unit (ICU) during the coronavirus disease (COVID-19) pandemic in Japan and compared the results with an international survey that used the same methodology.<h4>Methods</h4>This Web-based survey was carried out from 14 April to 6 May, 2020, in Japan and included HCWs directly involved in ICU management of COVID-19 patients. A ...[more]

PMID: 33042559

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Project description:BackgroundThere has been a surge in coronavirus disease 2019 admissions to intensive care units (ICUs) in Asia-Pacific countries. Because ICU healthcare workers are exposed to aerosol-generating procedures, ensuring optimal personal protective equipment (PPE) preparedness is important.ObjectiveThe aim of the study was to evaluate PPE preparedness across ICUs in six Asia-Pacific countries during the initial phase of the coronavirus disease 2019 pandemic, which is defined by the World Health Organization as guideline adherence, training healthcare workers, procuring stocks, and responding appropriately to suspected cases.MethodsA cross-sectional Web-based survey was circulated to 633 level II/III ICUs of Australia, New Zealand (NZ), Singapore, Hong Kong (HK), India, and the Philippines.FindingsTwo hundred sixty-three intensivists responded, representing 231 individual ICUs eligible for analysis. Response rates were 68-100% in all countries except India, where it was 24%. Ninety-seven percent of ICUs either conformed to or exceeded World Health Organization recommendations for PPE practice. Fifty-nine percent ICUs used airborne precautions irrespective of aerosol generation procedures. There were variations in negative-pressure room use (highest in HK/Singapore), training (best in NZ), and PPE stock awareness (best in HK/Singapore/NZ). High-flow nasal oxygenation and noninvasive ventilation were not options in most HK (66.7% and 83.3%, respectively) and Singapore ICUs (50% and 80%, respectively), but were considered in other countries to a greater extent. Thirty-eight percent ICUs reported not having specialised airway teams. Showering and "buddy systems" were underused. Clinical waste disposal training was suboptimal (38%).ConclusionsMany ICUs in the Asia-Pacific reported suboptimal PPE preparedness in several domains, particularly related to PPE training, practice, and stock awareness, which requires remediation. Adoption of low-cost approaches such as buddy systems should be encouraged. The complete avoidance of high-flow nasal oxygenation reported by several intensivists needs reconsideration. Consideration must be given to standardise PPE guidelines to minimise practice variations. Urgent research to evaluate PPE preparedness and severe acute respiratory syndrome coronavirus 2 transmission is required.

Project description:BackgroundPersonal-protective equipment (PPE)-preparedness, defined as adherence to guidelines, healthcare worker (HCW) training, procuring PPE stocks and responding appropriately to suspected cases, is crucial to prevent HCW-infections.ObjectivesTo perform a follow-up survey to assess changes in PPE-preparedness across six Asia-Pacific countries during the COVID-19 pandemic.MethodsA prospective follow-up cross-sectional, web-based survey was conducted between 10/08/2020 to 01/09/ 2020, five months after the initial Phase 1 survey. The survey was sent to the same 231 intensivists across the six Asia-Pacific countries (Australia, Hong Kong, India, New Zealand, Philippines, and Singapore) that participated in Phase 1. The main outcome measure was to identify any changes in PPE-preparedness between Phases 1 and 2.FindingsPhase 2 had responses from 132 ICUs (57%). Compared to Phase 1 respondents reported increased use of PPE-based practices such as powered air-purifying respirator (40.2% vs. 6.1%), N95-masks at all times (86.4% vs. 53.7%) and double-gloving (87.9% vs. 42.9%). The reported awareness of PPE stocks (85.6% vs. 51.9%), mandatory showering policies following PPE-breach (31.1% vs. 6.9%) and safety perception amongst HCWs (60.6% vs. 28.4%) improved significantly during Phase 2. Despite reported statistically similar adoption rate of the buddy system in both phases (42.4% vs. 37.2%), there was a reported reduction in donning/doffing training in Phase 2 (44.3% vs. 60.2%). There were no reported differences HCW training in other areas, such as tracheal intubation, intra-hospital transport and safe waste disposal, between the 2 phases.ConclusionsOverall reported PPE-preparedness improved between the two survey periods, particularly in PPE use, PPE inventory and HCW perceptions of safety. However, the uptake of HCW training and implementation of low-cost safety measures continued to be low and the awareness of PPE breach management policies were suboptimal. Therefore, the key areas for improvement should focus on regular HCW training, implementing low-cost buddy-system and increasing awareness of PPE-breach management protocols.

Dataset Information

Personal protective equipment use by health-care workers in intensive care units during the COVID-19 pandemic in Japan: comparative analysis with the PPE-SAFE survey.

Aim

Methods

Results

Conclusion

Publications

Personal protective equipment use by health-care workers in intensive care units during the COVID-19 pandemic in Japan: comparative analysis with the PPE-SAFE survey.

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