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Establishing Healthcare Worker Performance and Safety in Providing Critical Care for Patients in a Simulated Ebola Treatment Unit: Non-Randomized Pilot Study

Improving the provision of supportive care for patients with Ebola is an important quality improvement initiative. We designed a simulated Ebola Treatment Unit (ETU) to assess performance and safety of healthcare workers (HCWs) performing tasks wearing personal protective equipment (PPE) in hot (35...

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Autores principales: Kiiza, Peter, Mullin, Sarah I., Teo, Koren, Goodman, Len, Perez, Adic, Pinto, Ruxandra, Thompson, Kelly, Piquette, Dominique, Hall, Trevor, Bah, Elhadj I., Christian, Michael, Hajek, Jan J., Kao, Raymond, Lamontagne, François, Marshall, John C., Mishra, Sharmistha, Murthy, Srinivas, Vanderschuren, Abel, Fowler, Robert A., Adhikari, Neill K. J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8622862/
https://www.ncbi.nlm.nih.gov/pubmed/34835011
http://dx.doi.org/10.3390/v13112205
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author Kiiza, Peter
Mullin, Sarah I.
Teo, Koren
Goodman, Len
Perez, Adic
Pinto, Ruxandra
Thompson, Kelly
Piquette, Dominique
Hall, Trevor
Bah, Elhadj I.
Christian, Michael
Hajek, Jan J.
Kao, Raymond
Lamontagne, François
Marshall, John C.
Mishra, Sharmistha
Murthy, Srinivas
Vanderschuren, Abel
Fowler, Robert A.
Adhikari, Neill K. J.
author_facet Kiiza, Peter
Mullin, Sarah I.
Teo, Koren
Goodman, Len
Perez, Adic
Pinto, Ruxandra
Thompson, Kelly
Piquette, Dominique
Hall, Trevor
Bah, Elhadj I.
Christian, Michael
Hajek, Jan J.
Kao, Raymond
Lamontagne, François
Marshall, John C.
Mishra, Sharmistha
Murthy, Srinivas
Vanderschuren, Abel
Fowler, Robert A.
Adhikari, Neill K. J.
author_sort Kiiza, Peter
collection PubMed
description Improving the provision of supportive care for patients with Ebola is an important quality improvement initiative. We designed a simulated Ebola Treatment Unit (ETU) to assess performance and safety of healthcare workers (HCWs) performing tasks wearing personal protective equipment (PPE) in hot (35 °C, 60% relative humidity) or thermo-neutral (20 °C, 20% relative humidity) conditions. In this pilot phase to determine the feasibility of study procedures, HCWs in PPE were non-randomly allocated to hot or thermo-neutral conditions to perform peripheral intravenous (PIV) and midline catheter (MLC) insertion and endotracheal intubation (ETI) on mannequins. Eighteen HCWs (13 physicians, 4 nurses, 1 nurse practitioner; 2 with prior ETU experience; 10 in hot conditions) spent 69 (10) (mean (SD)) minutes in the simulated ETU. Mean (SD) task completion times were 16 (6) min for PIV insertion; 33 (5) min for MLC insertion; and 16 (8) min for ETI. Satisfactory task completion was numerically higher for physicians vs. nurses. Participants’ blood pressure was similar, but heart rate was higher (p = 0.0005) post-simulation vs. baseline. Participants had a median (range) of 2.0 (0.0–10.0) minor PPE breaches, 2.0 (0.0–6.0) near-miss incidents, and 2.0 (0.0–6.0) health symptoms and concerns. There were eight health-assessment triggers in five participants, of whom four were in hot conditions. We terminated the simulation of two participants in hot conditions due to thermal discomfort. In summary, study tasks were suitable for physician participants, but they require redesign to match nurses’ expertise for the subsequent randomized phase of the study. One-quarter of participants had a health-assessment trigger. This research model may be useful in future training and research regarding clinical care for patients with highly infectious pathogens in austere settings.
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spelling pubmed-86228622021-11-27 Establishing Healthcare Worker Performance and Safety in Providing Critical Care for Patients in a Simulated Ebola Treatment Unit: Non-Randomized Pilot Study Kiiza, Peter Mullin, Sarah I. Teo, Koren Goodman, Len Perez, Adic Pinto, Ruxandra Thompson, Kelly Piquette, Dominique Hall, Trevor Bah, Elhadj I. Christian, Michael Hajek, Jan J. Kao, Raymond Lamontagne, François Marshall, John C. Mishra, Sharmistha Murthy, Srinivas Vanderschuren, Abel Fowler, Robert A. Adhikari, Neill K. J. Viruses Article Improving the provision of supportive care for patients with Ebola is an important quality improvement initiative. We designed a simulated Ebola Treatment Unit (ETU) to assess performance and safety of healthcare workers (HCWs) performing tasks wearing personal protective equipment (PPE) in hot (35 °C, 60% relative humidity) or thermo-neutral (20 °C, 20% relative humidity) conditions. In this pilot phase to determine the feasibility of study procedures, HCWs in PPE were non-randomly allocated to hot or thermo-neutral conditions to perform peripheral intravenous (PIV) and midline catheter (MLC) insertion and endotracheal intubation (ETI) on mannequins. Eighteen HCWs (13 physicians, 4 nurses, 1 nurse practitioner; 2 with prior ETU experience; 10 in hot conditions) spent 69 (10) (mean (SD)) minutes in the simulated ETU. Mean (SD) task completion times were 16 (6) min for PIV insertion; 33 (5) min for MLC insertion; and 16 (8) min for ETI. Satisfactory task completion was numerically higher for physicians vs. nurses. Participants’ blood pressure was similar, but heart rate was higher (p = 0.0005) post-simulation vs. baseline. Participants had a median (range) of 2.0 (0.0–10.0) minor PPE breaches, 2.0 (0.0–6.0) near-miss incidents, and 2.0 (0.0–6.0) health symptoms and concerns. There were eight health-assessment triggers in five participants, of whom four were in hot conditions. We terminated the simulation of two participants in hot conditions due to thermal discomfort. In summary, study tasks were suitable for physician participants, but they require redesign to match nurses’ expertise for the subsequent randomized phase of the study. One-quarter of participants had a health-assessment trigger. This research model may be useful in future training and research regarding clinical care for patients with highly infectious pathogens in austere settings. MDPI 2021-11-02 /pmc/articles/PMC8622862/ /pubmed/34835011 http://dx.doi.org/10.3390/v13112205 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kiiza, Peter
Mullin, Sarah I.
Teo, Koren
Goodman, Len
Perez, Adic
Pinto, Ruxandra
Thompson, Kelly
Piquette, Dominique
Hall, Trevor
Bah, Elhadj I.
Christian, Michael
Hajek, Jan J.
Kao, Raymond
Lamontagne, François
Marshall, John C.
Mishra, Sharmistha
Murthy, Srinivas
Vanderschuren, Abel
Fowler, Robert A.
Adhikari, Neill K. J.
Establishing Healthcare Worker Performance and Safety in Providing Critical Care for Patients in a Simulated Ebola Treatment Unit: Non-Randomized Pilot Study
title Establishing Healthcare Worker Performance and Safety in Providing Critical Care for Patients in a Simulated Ebola Treatment Unit: Non-Randomized Pilot Study
title_full Establishing Healthcare Worker Performance and Safety in Providing Critical Care for Patients in a Simulated Ebola Treatment Unit: Non-Randomized Pilot Study
title_fullStr Establishing Healthcare Worker Performance and Safety in Providing Critical Care for Patients in a Simulated Ebola Treatment Unit: Non-Randomized Pilot Study
title_full_unstemmed Establishing Healthcare Worker Performance and Safety in Providing Critical Care for Patients in a Simulated Ebola Treatment Unit: Non-Randomized Pilot Study
title_short Establishing Healthcare Worker Performance and Safety in Providing Critical Care for Patients in a Simulated Ebola Treatment Unit: Non-Randomized Pilot Study
title_sort establishing healthcare worker performance and safety in providing critical care for patients in a simulated ebola treatment unit: non-randomized pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8622862/
https://www.ncbi.nlm.nih.gov/pubmed/34835011
http://dx.doi.org/10.3390/v13112205
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