Department of Microbiology, All India Institute of Medical Sciences, Raipur, Chhatisgarh, India.
Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhatisgarh, India.
PLoS One. 2022 May 17;17(5):e0268582. doi: 10.1371/journal.pone.0268582. eCollection 2022.
Healthcare workers (HCWs) stand the risk of acquiring infection directly, while attending to patients or indirectly while handling and testing patient specimens. Considering this, the present study was planned to assess Personal Protective Equipment (PPE) breaches and exposures among HCWs working in COVID-19 wards/ screening areas and to evaluate their COVID-19 positivity rates post-exposure concerning the level of exposure, type of PPE breach, and the cadre of HCWs exposed in COVID-19 wards.
This retrospective cross-sectional study involved the analysis of all instances of PPE breaches which occurred during a period of nine months from June 2020 to February 2021 at a tertiary care level hospital in Central India. The analysis included all exposures involving any cadre of HCWs that occurred while handling the patients or while doffing the contaminated PPE in COVID -19 wards.
A total of 347 PPE breaches were analyzed from the available records of the Hospital Infection Control team repository. Amongst the 347 breaches, 268 (77.2%) were classified as low-risk exposures and 79 (22.8%) as high-risk exposures. Cadre wise distribution of high and low-risk exposures revealed that, PPE breaches occurred most commonly in the category of nursing officers (n = 174, 50.1%). Among all of the breaches, 15.2% of high-risk exposures and 2.6% of low-risk exposures resulted in COVID-19 positivity with a cumulative positivity of 5.4%. Collectively, non-mask related breaches accounted for the majority (63.2%) of the positive COVID-19 cases.
Appropriate use of PPE by HCWs is vital for their protection. However, breaches in the use of PPE may occur while managing COVID-19 patients due to physical and mental exhaustion among HCWs resulting from work overload. Early identification and appropriate management of HCWs with high-risk exposures can help prevent transmission to other hospital staff and patients, thus preserving resources and workforce.
医护人员（HCWs）在照顾患者时直接面临感染风险，而在处理和检测患者样本时则间接面临感染风险。考虑到这一点，本研究旨在评估在 COVID-19 病房/筛查区工作的 HCWs 的个人防护装备（PPE）破损和暴露情况，并评估他们在 COVID-19 暴露后的 COVID-19 阳性率，考虑到暴露水平、PPE 破损类型以及在 COVID-19 病房中暴露的 HCWs 干部级别。
这项回顾性横断面研究分析了 2020 年 6 月至 2021 年 2 月在印度中部一家三级护理医院发生的九个月期间发生的所有 PPE 破损情况。分析包括在 COVID-19 病房中处理患者或脱下污染的 PPE 时发生的所有涉及任何 HCWs 干部级别的暴露情况。
从医院感染控制团队存储库的现有记录中分析了 347 例 PPE 破损情况。在 347 例破损中，268 例（77.2%）被归类为低风险暴露，79 例（22.8%）为高风险暴露。按干部级别划分的高风险和低风险暴露分布显示，PPE 破损最常见于护理人员类别（n = 174，50.1%）。在所有破损中，15.2%的高风险暴露和 2.6%的低风险暴露导致 COVID-19 阳性，累积阳性率为 5.4%。总体而言，非口罩相关破损占阳性 COVID-19 病例的大多数（63.2%）。
HCWs 正确使用 PPE 对其保护至关重要。然而，由于 HCWs 因工作量过大而导致身心疲惫，在管理 COVID-19 患者时，PPE 的使用可能会出现破损。及早识别和适当管理高风险暴露的 HCWs 有助于防止传播给其他医院工作人员和患者，从而节省资源和劳动力。
