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个人防护装备对印度南部一家三级护理医院中参与COVID-19防治工作的医护人员的影响

The Impact of Personal Protective Equipment on Healthcare Workers on COVID-19 Duty in a Tertiary Care Hospital in South India.

作者信息

Haward Raymond, G Ridhima, Kalyan Meenakshi

机构信息

Medical School, Vydehi Institute of Medical Science and Research Centre, Bangalore, IND.

Internal Medicine, Vydehi Institute of Medical Science and Research Centre, Bangalore, IND.

出版信息

Cureus. 2023 Jul 14;15(7):e41910. doi: 10.7759/cureus.41910. eCollection 2023 Jul.

Abstract

Context The proper usage of personal protective equipment (PPE) must be prioritised for health care workers (HCWs), where shortages and prolonged use of personal protective equipment can threaten safety in essential health services. Aims To evaluate the effect of personal protective equipment on the health and well-being of HCWs, physicians, nurses, and technicians on duty for COVID-19 rotational postings. Settings and design This cross-sectional study was done by simple random sampling. Methods and materials This study was conducted at a tertiary care centre in South India to assess the utilisation of personal protective equipment (PPE) during the second wave of COVID-19. A physical questionnaire was distributed to a total of 266 healthcare workers, aged 20 to 50, who had worked for a minimum of three consecutive days between May and August 2021. The objective of the study was to evaluate the effectiveness of PPE use among healthcare workers during the second wave of the COVID-19 pandemic. Statistical analysis The data analysis in this study was conducted using IBM Statistical Package for Social Sciences (SPSS) version 19 (IBM Corp., Armonk, New York). The mean and standard deviation, or median, were used to present continuous variables, while frequency and percentage were used to present categorical variables. Furthermore, the minimum sample size required for this study was calculated to be 246 participants. Results The survey included 266 healthcare workers. The mean+/-SD of age was 28.18+/-5.64 and consisted of females (54.51%) and males (45.48%). The postings were in emergency (13.15%), intensive care unit (30.82%), and ward (56.01%), respectively. The HCWs who used PPE for four to seven days reported more symptoms than those who used it for one to three days. Discomforts experienced while wearing PPE were chest suffocation (49.62%), difficulty in performing intubation (36.09%), difficulty in seeing clearly (68.79%), dizziness (49.62%), excessive sweating (75.56%), micturition desire (52.63%), nausea (42.48%), retro-auricular pain (56.76%), stomach burns (27.44%), and thirst or dry throat (78.57%). The symptoms suffered after doffing were tiredness (69.17%), dry mouth (67.29%), dizziness (43.60%), headache (55.63%), chest suffocation (36.46%), dry skin (57.14%), reduced ability to concentrate (48.12%), dark-coloured urine (55.63%), reduced alertness (42.48%), and stomach burns (28.94%). The first thoughts after doffing were to drink water (68.42%), eat something (36.09%), clean yourself (61.27%), urinate (33.08%), and have some rest (29.32%), respectively. 81 (30.45%). The HCWs suffered skin injuries while wearing gloves. The time for restoring after a shift was 12 hours (37.59%), 24 hours (34.21%), 36 hours (11.65%), and 48 hours (16.59%). Pressure sores were reported on the forehead by 53 (19.92%) participants, the nose by 54 (20.30%), the cheek by 31 (11.65%), and behind the ear by 77 (65.71%) participants. The optimal size of PPE was experienced only by 76 (28.57%) participants, while 73 (27.44%) of them felt tight and 117 (43.98%) felt loose. Conclusions To minimise discomfort while managing infectious diseases, HCWs can adopt several practices like taking regular breaks, ensuring humane working hours, utilising high-quality PPE, and wearing properly fitting gear. By implementing these measures, HCWs can enhance their ability to handle infectious diseases effectively while prioritising their comfort and well-being.

摘要

背景 医护人员必须优先正确使用个人防护装备(PPE),因为个人防护装备短缺和长时间使用会威胁基本医疗服务的安全。

目的 评估个人防护装备对参与新冠肺炎轮值工作的医护人员、医生、护士和技术人员的健康和福祉的影响。

设置与设计 本横断面研究采用简单随机抽样方法。

方法和材料 本研究在印度南部的一家三级护理中心进行,以评估新冠肺炎第二波疫情期间个人防护装备(PPE)的使用情况。向266名年龄在20至50岁之间、在2021年5月至8月期间连续工作至少三天的医护人员发放了纸质问卷。本研究的目的是评估新冠肺炎疫情第二波期间医护人员使用个人防护装备的有效性。

统计分析 本研究使用IBM社会科学统计软件包(SPSS)第19版(IBM公司,纽约州阿蒙克)进行数据分析。均值和标准差或中位数用于呈现连续变量,而频率和百分比用于呈现分类变量。此外,本研究所需的最小样本量经计算为246名参与者。

结果 调查包括266名医护人员。年龄的均值±标准差为28.18±5.64,其中女性占54.51%,男性占45.48%。工作岗位分别为急诊科(13.15%)、重症监护室(30.82%)和病房(56.01%)。使用个人防护装备四至七天的医护人员报告的症状比使用一至三天的医护人员更多。佩戴个人防护装备时出现的不适症状有胸部憋闷(49.62%)、插管困难(36.09%)、视物不清(68.79%)、头晕(49.62%)、多汗(75.56%)、有排尿欲望(52.63%)、恶心(42.48%)、耳后疼痛(56.76%)、胃部烧灼感(27.44%)以及口渴或咽干(78.57%)。脱卸个人防护装备后出现的症状有疲劳(69.17%)、口干(67.29%)、头晕(43.60%)、头痛(55.63%)、胸部憋闷(36.46%)、皮肤干燥(57.14%)、注意力下降(48.12%)、尿液颜色加深(55.63%)、警觉性降低(42.48%)以及胃部烧灼感(28.94%)。脱卸个人防护装备后的首要想法分别是喝水(68.42%)、吃东西(36.09%)、清洁身体(61.27%)、排尿(33.08%)以及休息(29.32%)。81名(30.45%)医护人员在戴手套时出现了皮肤损伤。轮班后恢复所需时间为12小时(37.59%)、24小时(34.21%)、36小时(11.65%)和48小时(16.59%)。53名(19.92%)参与者的前额出现压疮,54名(20.30%)参与者的鼻子出现压疮,31名(11.65%)参与者的脸颊出现压疮,77名(65.71%)参与者的耳后出现压疮。只有76名(28.57%)参与者体验到了个人防护装备的最佳尺寸,而其中73名(27.44%)感觉紧,117名(43.98%)感觉松。

结论 为了在管理传染病时将不适降至最低,医护人员可以采取多种做法, 如定期休息、确保合理的工作时长、使用高质量的个人防护装备以及穿戴合身的装备。通过实施这些措施,医护人员可以在优先考虑自身舒适度和福祉的同时,提高有效应对传染病的能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ab/10425167/9f4aee70ccab/cureus-0015-00000041910-i01.jpg

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