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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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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. |
format | Online Article Text |
id | pubmed-8622862 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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