A prospective clinical evaluation of a patient isolation hood during the COVID-19 pandemic.

COVID-19 Clinical study Hood Infections in healthcare workers Personal ventilation

Journal

Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
ISSN: 1036-7314
Titre abrégé: Aust Crit Care
Pays: Australia
ID NLM: 9207852

Informations de publication

Date de publication:
Jan 2022
Historique:
received: 11 01 2021
revised: 20 03 2021
accepted: 01 05 2021
pubmed: 20 6 2021
medline: 1 2 2022
entrez: 19 6 2021
Statut: ppublish

Résumé

Healthcare workers (HCWs) have frequently become infected with severe acute respiratory syndrome coronavirus 2 whilst treating patients with coronavirus disease 2019 (COVID-19). A variety of novel devices have been proposed to reduce COVID-19 cross-contamination. The aim of the study was (i) to test whether patients and HCWs thought that a novel patient isolation hood was safe and comfortable and (ii) to obtain COVID-19 infection data of hospital HCWs. This is a prospective cohort study of 20 patients, entailing HCW/patient questionnaires and safety aspects of prototype isolation hoods. COVID-19 data of HCWs were prospectively collected. Assessment of the hood's safety and practicality and adverse event reporting was carried out. The outcome measures are as follows: questionnaire responses, adverse event reporting, rates of infections in HCWs during the study period (20/6/2020 to 21/7/2020), and COVID-19 infections in HCWs reported until the last recorded diagnosis of COVID-19 in HCWs (20/6/2020 to 27/9/2020). Of the 64 eligible individual HCW surveys, 60 surveys were overall favourable (>75% questions answered in favour of the isolation hood). HCWs were unanimous in perceiving the hood as safe (60/60), preferring its use (56/56), and understanding its potential COVID-19 cross-contamination minimisation (60/60). All eight patients who completed the questionnaire thought the isolation hood helped prevent COVID-19 cross infection and was safe and comfortable. There were no reported patient safety adverse events. The COVID-19 attack rate from 20/6/2020 to 27/9/2020 among registered nurses was as follows: intensive care units (ICUs), 2.2% (3/138); geriatric wards, 13.2% (26/197); and COVID-19 wards, 18.3% (32/175). The COVID-19 attack rate among medical staff was as follows: junior staff, 2.1% (24/932); senior staff, 0.7% (4/607); aged care/rehabilitation, 6.7% (2/30); and all ICU medical staff, 8.6% (3/35). The isolation hood was preferred to standard care by HCWs and well tolerated by patients, and after the study, isolation hoods became part of standard ICU therapy. There was an association between being an ICU nurse and a low COVID-19 infection rate (no causality implied). ICU HCWs feel safer when treating patients with COVID-19 using an isolation hood.

Sections du résumé

BACKGROUND BACKGROUND
Healthcare workers (HCWs) have frequently become infected with severe acute respiratory syndrome coronavirus 2 whilst treating patients with coronavirus disease 2019 (COVID-19). A variety of novel devices have been proposed to reduce COVID-19 cross-contamination.
OBJECTIVES OBJECTIVE
The aim of the study was (i) to test whether patients and HCWs thought that a novel patient isolation hood was safe and comfortable and (ii) to obtain COVID-19 infection data of hospital HCWs.
METHODS METHODS
This is a prospective cohort study of 20 patients, entailing HCW/patient questionnaires and safety aspects of prototype isolation hoods. COVID-19 data of HCWs were prospectively collected. Assessment of the hood's safety and practicality and adverse event reporting was carried out.
OUTCOME MEASURES METHODS
The outcome measures are as follows: questionnaire responses, adverse event reporting, rates of infections in HCWs during the study period (20/6/2020 to 21/7/2020), and COVID-19 infections in HCWs reported until the last recorded diagnosis of COVID-19 in HCWs (20/6/2020 to 27/9/2020).
RESULTS RESULTS
Of the 64 eligible individual HCW surveys, 60 surveys were overall favourable (>75% questions answered in favour of the isolation hood). HCWs were unanimous in perceiving the hood as safe (60/60), preferring its use (56/56), and understanding its potential COVID-19 cross-contamination minimisation (60/60). All eight patients who completed the questionnaire thought the isolation hood helped prevent COVID-19 cross infection and was safe and comfortable. There were no reported patient safety adverse events. The COVID-19 attack rate from 20/6/2020 to 27/9/2020 among registered nurses was as follows: intensive care units (ICUs), 2.2% (3/138); geriatric wards, 13.2% (26/197); and COVID-19 wards, 18.3% (32/175). The COVID-19 attack rate among medical staff was as follows: junior staff, 2.1% (24/932); senior staff, 0.7% (4/607); aged care/rehabilitation, 6.7% (2/30); and all ICU medical staff, 8.6% (3/35).
CONCLUSIONS CONCLUSIONS
The isolation hood was preferred to standard care by HCWs and well tolerated by patients, and after the study, isolation hoods became part of standard ICU therapy. There was an association between being an ICU nurse and a low COVID-19 infection rate (no causality implied). ICU HCWs feel safer when treating patients with COVID-19 using an isolation hood.

Identifiants

pubmed: 34144863
pii: S1036-7314(21)00065-5
doi: 10.1016/j.aucc.2021.05.001
pmc: PMC8112290
pii:
doi:

Types de publication

Journal Article

Langues

eng

Pagination

28-33

Informations de copyright

Copyright © 2021 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of Interest A patent has been filed for the personal ventilation hood by the University of Melbourne/Western Health. The lead authors (F.M. and J.M.) were the leads in this patent application. All other authors have no conflicts of interest.

Auteurs

Forbes McGain (F)

Western Health, Melbourne, Australia; School of Public Health, University of Sydney, Sydney, Australia; Centre for Integrated Critical Care, University of Melbourne, Australia. Electronic address: Forbes.mcgain@wh.org.au.

Samantha Bates (S)

Western Health, Melbourne, Australia; Centre for Integrated Critical Care, University of Melbourne, Australia.

Jung Hoon Lee (JH)

Dept. Mechanical Engineering, University of Melbourne, Melbourne, Australia.

Patrick Timms (P)

Western Health, Melbourne, Australia.

Marion A Kainer (MA)

Western Health, Melbourne, Australia; Dept. Mechanical Engineering, University of Melbourne, Melbourne, Australia; Vanderbilt University School of Medicine, Nashville, TN, USA.

Craig French (C)

Western Health, Melbourne, Australia; Centre for Integrated Critical Care, University of Melbourne, Australia; Dept. of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.

Jason Monty (J)

Dept. Mechanical Engineering, University of Melbourne, Melbourne, Australia.

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Classifications MeSH