Department of Emergency Medicine, Máxima Medical Centre, Veldhoven, Noord-Brabant, The Netherlands
Department of Emergency Medicine, Máxima Medical Centre, Veldhoven, Noord-Brabant, The Netherlands.
Emerg Med J. 2021 Mar;38(3):224-228. doi: 10.1136/emermed-2020-210292. Epub 2020 Dec 21.
Personal protective equipment (PPE) used by healthcare workers was scarce during the COVID-19 pandemic The aim of this study was to assess whether telemedicine (using iPads) reduced PPE use in emergency department (ED) patients who were treated in contact isolation, and whether telemedicine had a positive effect on patient anxiety and satisfaction.
We conducted a prospective single centre before-and-after study including ED patients ≥18 years who were treated in contact isolation. PPE use, the Hospital Anxiety Scale and the 15-item Picker Patient Experience Questionnaire were compared between the control period (8 April to 14 April 2020) and intervention period (15 April to 24 April 2020).
We included 25 patients in each period. PPE use per patient was higher for physicians in the control period (mean 1.7; 95% CI 1.5 to 1.9) compared with the intervention period (mean 1.2; 95% CI 1.0 to 1.3, p<0.01). Total PPE use per patient contact for ED physicians decreased from 42 out of 42 patient contacts in the control period, to 29 out of 66 patient contacts in the intervention period (difference 54.3%; 95% CI 50.1% to 58.6%, p<0.01). Reported anxiety and satisfaction were not significantly different.
PPE use by physicians can successfully be reduced by using telemedicine in the ED without increasing anxiety or dissatisfaction. This study was a first step to gain experience with telemedicine in the ED which has the potential to reduce PPE use in future pandemics or other patients with an indication for contact isolation.
在 COVID-19 大流行期间，医护人员使用的个人防护设备（PPE）短缺。本研究旨在评估在接触隔离治疗的急诊科（ED）患者中使用远程医疗（使用 iPad）是否可以减少 PPE 的使用，以及远程医疗是否对患者的焦虑和满意度产生积极影响。
我们进行了一项前瞻性单中心前后对照研究，纳入了在接触隔离治疗的≥18 岁 ED 患者。在对照期（2020 年 4 月 8 日至 14 日）和干预期（2020 年 4 月 15 日至 24 日）比较了 PPE 使用、医院焦虑量表和 15 项 Picker 患者体验问卷。
我们在每个时期纳入了 25 例患者。与干预期相比，对照组中医生每位患者的 PPE 使用量更高（平均 1.7；95%CI 1.5 至 1.9）（平均 1.2；95%CI 1.0 至 1.3，p<0.01）。ED 医生每位患者接触的总 PPE 使用量从对照期的 42 名患者接触减少到干预期的 66 名患者接触（差异 54.3%；95%CI 50.1%至 58.6%，p<0.01）。报告的焦虑和满意度没有显著差异。
在 ED 中使用远程医疗可以成功减少医生的 PPE 使用，而不会增加焦虑或不满。这项研究是 ED 中远程医疗经验的第一步，它有可能在未来的大流行或其他需要接触隔离的患者中减少 PPE 的使用。
