Christensen L, Rasmussen CS, Benfield T, Franc JM(99 Christensen L, Rasmussen CS, Benfield T, Franc JM. A randomized trial of instructor-led training versus video lesson in training health care providers in proper donning and doffing of personal protective equipment. Disaster Med Public Health Prep. 2020;14(4):514-20. https://doi.org/10.1017/dmp.2020.56
https://doi.org/10.1017/dmp.2020.56...
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2020
Denmark |
A Randomized Trial of Instructor-Led Training Versus Video Lesson in Training Health Care Providers in Proper Donning and Doffing of Personal Protective Equipment |
Compare instructor-led training with video-based instruction on donning and doffing PPE. Randomized Clinical Trial (pilot study). |
The average score for correct attire and unattire was 84.8/100 and 79.1/100 for the instructor-led group and 88/100 and 73.9/100 for the video group. There was no significant difference in scores between classes taught by instructor and video. Video training proved to be a fast and efficient method in terms of resources for training in response to the COVID-19 pandemic. |
Díaz-Guio DA, Ricardo-Zapata A, Ospina-Velez J, Gómes-Candamil G, Mora-Martinez S, Rodriguez-Morales A(1010 Díaz-Guio DA, Ricardo-Zapata A, Ospina-Velez J, Gómes-Candamil G, Mora-Martinez S, Rodriguez-Morales A. Cognitive load and performance of health care professionals in donning and doffing PPE before and after a simulation-based educational intervention and its implications during the COVID-19 pandemic for biosafety. Infez Med [Internet]. 2020 [cited 2020 Apr 13];28(suppl 1):111-7. Available from: https://pubmed.ncbi.nlm.nih.gov/32532947/
https://pubmed.ncbi.nlm.nih.gov/32532947...
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2020
Colombia |
Cognitive load and performance of health care professional in donning and doffing PPE before and after a simulation-based educational intervention and its implications during the COVID-19 pandemic for biosafety |
Assess the cognitive load and the performance of healthcare professionals in PPE donning and doffing before and after a simulation-based educational intervention. Quasi-experimental study. |
In the pre-test, all participants failed to don and doff PPE, 98.4% were contaminated. In the post-test, 100% were successful in donning PPE and 94.8% in doffing it; only 9.8% were contaminated. The greatest difficulties reported were in doffing the apron and the N95 mask. In response to the current COVID-19 pandemic, training activities in PPE donning and doffing provide a means of training personnel, reducing the cognitive burden and the risk of contamination of professionals. |
Wee LE, Fua TP, Chua YY, Ho AFW, Sim XYJ, Conceicao EP, et al(1111 Wee LE, Fua TP, Chua YY, Ho AFW, Sim XYJ, Conceicao EP, et al. Containing COVID-19 in the emergency department: the role of improved case detection and segregation of suspect cases. Acad Emerg Med. 2020;27(5):379-87. https://doi.org/10.1111/acem.13984
https://doi.org/10.1111/acem.13984...
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2020
Singapore |
Containing COVID-19 in the emergency department: the role of improved case detection and segregation of suspect cases |
Assess the impact of a strategy on case detection, resource utilization and infection control, related to COVID-19. Observational study. |
Most patients with respiratory syndrome (84.2%, 59/70) were detected in emergency screening, because they met the criteria for a suspected case. Of these, 34 met the official selection criteria; another 25 were detected by the broader internal screening criteria. There were no cases of nosocomial transmission of exposure in the emergency department. |
Wee LE, Sim XYJ, Conceicao EP, Tan BH, Venkatachalam I, LingML(1212 Wee LE, Sim XYJ, Conceicao EP, Tan BH, Venkatachalam I, Ling ML. Containing COVID-19 outside the isolation ward: the impact of an infection control bundle on environmental contamination and transmission in a cohorted general Ward. AJIC. 2020;48(9):1056-61. https://doi.org/10.1016/j.ajic.2020.06.188
https://doi.org/10.1016/j.ajic.2020.06.1...
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2020
Singapore |
Containing COVID-19 outside the isolation ward: the impact of an infection control bundle on environmental contamination and transmission in a cohorted general Ward |
To evaluate the impact of an infection control package on contamination and environmental transmission and transmission in a cohorted general cohort, with suspected cases of COVID-19. Observational study. |
Sampling from the patients' environment was positive for SARS-CoV-2 in 5 of the 28 cases; in patients who needed supplemental oxygen, there was a greater chance of environmental contamination. Only 3 healthcare professionals (1.2%) required quarantine. No transmission from patient to healthcare professional has been documented. The implementation of an intervention package to mitigate the transmission of COVID-19 in the studied setting proved to be effective. |
Evans HL, Thomas CS, Bell LH, Hink AB, O'Driscoll S, Tobin CT et al(1313 Evans HL, Thomas CS, Bell LH, Hink AB, O’Driscoll S, Tobin CT, et al. Development of a sterile personal protective equipment donning and doffing procedure to protect surgical teams from SARS-CoV-2 Exposure during the COVID-19 Pandemic. Surg Infect. 2020;21(8):671-6. https://doi.org/10.1089/sur.2020.140
https://doi.org/10.1089/sur.2020.140...
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2020
USA |
Development of a Sterile Personal Protective Equipment Donning and Doffing Procedure to Protect Surgical Teams from SARS-CoV-2 Exposure during the COVID-19 Pandemic. |
Develop a standardized protocol regarding the placement and donning and doffing sterile PPE in a surgical environment during COVID-19. Observational study. |
The procedures for donning and doffing PPE were printed and attached in the operating rooms and procedure areas. These procedures provided the team of professionals with the first specific education in a sterile environment for PPE donning and doffing. The presence of a dofficer proved to be important to prevent these deviations and potential contamination events in donning/doffing. |
Reusken CB, Buiting A, Bleeker-Rovers C, Diederen B, Hooiveld M, Friesema H, et al(1414 Reusken CB, Buiting A, Bleeker-Rovers C, Diederen B, Hooiveld M, Friesema H, et al. Rapid assessment of regional SARS-CoV-2 community transmission through a convenience sample of healthcare workers, the Netherlands, March 2020. Euro Surveill. 2020;25(12):2000334. https://doi.org/10.2807/1560-7917.ES.2020.25.12.2000334
https://doi.org/10.2807/1560-7917.ES.202...
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2020
The Netherlands |
Rapid assessment of regional SARS-CoV-2 community transmission through a convenience sample of healthcare workers, the Netherlands, March 2020 |
To evaluate community transmission in Noord-Brabant, the Netherlands, in healthcare professionals with mild respiratory complaints and without an SARS-CoV-2 epidemiological link. Observational study. |
Healthcare professionals with mild respiratory complaints and no epidemiological link were tested for SARS -CoV-2. Of 1,097 professionals tested in 9 hospitals, 45 (4.1%) were positive. Of the six hospitals with contaminated professionals, two were responsible for 38 professionals. The results suggest transmission in the community unnoticed, with a potential risk of nosocomial transmission. |
Fregene TE, Nadarajah P, Buckley JF, Bigham S, NangaliaV(1515 Fregene TE, Nadarajah P, Buckley JF, Bigham S, Nangalia V. Use of in situ simulation to evaluate the operational readiness of a high-consequence infectious disease intensive care unit. Anaesthesia. 2020;76(6):733-8. https://doi.org/10.1111/anae.15048
https://doi.org/10.1111/anae.15048...
)2020
United Kingdom |
Use of in situ simulation to evaluate the operational readiness of a high-consequence infectious disease intensive care unit |
Identify potential problems, test the robustness of the systems and inform the modification of standard operating procedures for a patient with COVID-19 admitted to an ICU. Observational study. |
The simulations revealed several important latent risks and made it possible to implement corrective measures before the admission of patients with COVID-19. In-situ simulation is recommended for teams working in sectors that must receive patients with COVID-19, in order to detect their own unique risks and assist in the creation of local guidelines. |
Min L, Shou-Zhen C, Ke-Wei X, Yang Y, Qing-Tang Z, Hui Z, et al(1616 Min L, Shou-Zhen C, Ke-Wei X, Yang Y, Qing-Tang Z, Hui Z, et al. Use of personal protective equipment against coronavirus disease 2019 by healthcare professionals in Wuhan, China: cross sectional study. BMJ. 2020;369:2195. https://doi.org/10.1136/bmj.m2195
https://doi.org/10.1136/bmj.m2195...
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2020
China |
Use of personal protective equipment against coronavirus disease 2019 by healthcare professionals in Wuhan, China: cross sectional study |
Examine the protective effects of personal protective equipment suitable for healthcare professionals who care for patients with COVID-19. Observational study. |
All 420 study participants had direct contact with patients with COVID-19 and underwent at least one aerosol-generating procedure. No participant reported symptoms related to COVID-19, all tests being negative for SARS-CoV-2 and IgM or IgG antibodies. Despite the high risk of exposure, professionals were adequately protected. Health systems must prioritize the acquisition and distribution of PPE and provide adequate training in its use. |
Tan W, Ye Y, Yang Y, Chen Z, Yang X, Zhu C, et al (1717 Tan W, Ye Y, Yang Y, Chen Z, Yang X, Zhu C, et al. Whole-Process emergency training of personal protective equipment helps healthcare workers against COVID-19 Design and Effect. J Occup Environ Med;2020, 62(6):420-3. https://doi.org/10.1097/JOM.0000000000001877
https://doi.org/10.1097/JOM.000000000000...
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2020
China |
Whole-Process Emergency Training of Personal Protective Equipment Helps Healthcare Workers Against COVID-19
Design and Effect |
Develop an emergency PPE training program for healthcare professionals under the threat of COVID-19 and evaluate the effect of the program. Quasi-experimental study. |
The scores of post-test were significantly better when compared to those of pre-test. Among all the PPE, the N95 respirator and the apron needed more training. This training program significantly improved the performance of participants. |
Jin YH, Huang Q, Wang YY, Zeng XT, Luo LS, Pan ZY(1818 Jin YH, Huang Q, Wang YY, Zeng XT, Luo LS, Pan ZY. Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a crosssectional survey. Mil Med Res. 2020;7(1):24. https://doi.org/10.1186/s40779-020-00254-8
https://doi.org/10.1186/s40779-020-00254...
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2020
China |
Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey |
Explore the route of SARS-CoV-2 infection, the influence and management procedures of healthcare professionals. Observational study. |
Among the 103 professionals included in the study, 87 (84.5%) thought they were infected in the hospital work environment. Swab collection and physical examination were the procedures considered to be the most likely to cause infection by nurses and doctors, respectively. Forty-three (41.8%) considered the infection related to the use of common PPE (masks and gloves). The main mode of transmission perceived was not to maintain protection when working at a short distance and to have contact with infected cases. |
Razzini K, Castrica M, Menchetti L, Maggi L, Negroni L, Orfeo NV, et al(1919 Razzini K, Castrica M, Menchetti L, Maggi L, Negroni L, Orfeo NV, et al. SARS-CoV-2 RNA detection in the air and on surfaces in the COVID-19 ward of a hospital in Milan, Italy. Science Total Environ. 2020;742:e140540. https://doi.org/10.1016/j.scitotenv.2020.140540
https://doi.org/10.1016/j.scitotenv.2020...
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2020
Italy |
SARS-CoV-2 RNA detection in the air and on surfaces in the COVID-19 ward of a hospital in Milan, Italy |
To evaluate the contamination of air and surfaces by SARS-CoV-2 RNA in the COVID-19 ward of an Italian hospital. Observational study. |
Overall, 24.3% of the smear samples were positive, but none of them were collected in clean areas. The rate of positivity was higher in the contaminated (35.0%) and semi-contaminated (50.0%) areas. The most contaminated surfaces were hand sanitizer dispensers (100.0%), medical equipment (50.0%), touch screens (50.0%), shelves (40.0%), protective grids ( 33.3%) and door handles (25.0%). All air samples collected in the contaminated area were positive, while the viral RNA was not detected in semi-contaminated or clean areas. The results show the need for rigorous disinfection, hand hygiene and the need for airborne isolation precautions. |
Rivett L, Sridhar S, Sparkes D, Routledge M, Jones NK, Forrest S, et al(2020 Rivett L, Sridhar S, Sparkes D, Routledge M, Jones NK, Forrest S, et al. Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission. Elife. 2020;11(9):e58728. https://doi.org/10.7554/eLife.58728
https://doi.org/10.7554/eLife.58728...
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2020
United Kingdom |
Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission |
Present the initial findings of a comprehensive employee screening program at the Cambridge University Hospitals NHS Foundation Trust. Observational study. |
Among asymptomatic professionals, 3% tested positive for SARS-CoV-2. 12/30 (40%) had symptoms compatible with COVID-19> 7 days before the test. The results demonstrate the usefulness of a comprehensive screening of healthcare professionals with minimal symptoms or asymptomatic. This approach is critical for protecting patients and healthcare professionals. |
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Source: Moher et al. (2009)(