Personal protective equipment (PPE) is critical to protect healthcare workers (HCWs) from highly infectious diseases such as COVID-19. However, hospitals have been at risk of running out of the safe ...and effective PPE including personal protective clothing needed to treat patients with COVID-19, due to unprecedented global demand. In addition, there are only limited manufacturing facilities of such clothing available worldwide, due to a lack of available knowledge about relevant technologies, ineffective supply chains, and stringent regulatory requirements. Therefore, there remains a clear unmet need for coordinating the actions and efforts from scientists, engineers, manufacturers, suppliers, and regulatory bodies to develop and produce safe and effective protective clothing using the technologies that are locally available around the world. In this review, we discuss currently used PPE, their quality, and the associated regulatory standards. We survey the current state-of-the-art antimicrobial functional finishes on fabrics to protect the wearer against viruses and bacteria and provide an overview of protective medical fabric manufacturing techniques, their supply chains, and the environmental impacts of current single-use synthetic fiber-based protective clothing. Finally, we discuss future research directions, which include increasing efficiency, safety, and availability of personal protective clothing worldwide without conferring environmental problems.
This study investigates the forces that contributed to severe shortages in personal protective equipment in the US during the COVID-19 crisis. Problems from a dysfunctional costing model in hospital ...operating systems were magnified by a very large demand shock triggered by acute need in healthcare and panicked marketplace behavior that depleted domestic PPE inventories. The lack of effective action on the part of the federal government to maintain and distribute domestic inventories, as well as severe disruptions to the PPE global supply chain, amplified the problem. Analysis of trade data shows that the US is the world's largest importer of face masks, eye protection, and medical gloves, making it highly vulnerable to disruptions in exports of medical supplies. We conclude that market prices are not appropriate mechanisms for rationing inputs to health because health is a public good. Removing the profit motive for purchasing PPE in hospital costing models, strengthening government capacity to maintain and distribute stockpiles, developing and enforcing regulations, and pursuing strategic industrial policy to reduce US dependence on imported PPE will help to better protect healthcare workers with adequate supplies of PPE.
•Market failure and government failure contributed to PPE shortage during COVID-19•Dysfunctional hospital budgeting models disincentivize adequate inventories of PPE•Federal government failed to maintain and distribute domestic inventories of PPE•Pursue strategic industrial policy to reduce US dependence on PPE supply chain•Market prices are inappropriate mechanisms for rationing inputs to health, like PPE
The global COVID-19 pandemic has attracted considerable attention toward innovative methods and technologies for suppressing the spread of viruses. Transmission via contaminated surfaces has been ...recognized as an important route for spreading SARS-CoV-2. Although significant efforts have been made to develop antibacterial surface coatings, the literature remains scarce for a systematic study on broad-range antiviral coatings. Here, we aim to provide a comprehensive overview of the antiviral materials and coatings that could be implemented for suppressing the spread of SARS-CoV-2 via contaminated surfaces. We discuss the mechanism of operation and effectivity of several types of inorganic and organic materials, in the bulk and nanomaterial form, and assess the possibility of implementing these as antiviral coatings. Toxicity and environmental concerns are also discussed for the presented approaches. Finally, we present future perspectives with regards to emerging antimicrobial technologies such as omniphobic surfaces and assess their potential in suppressing surface-mediated virus transfer. Although some of these emerging technologies have not yet been tested directly as antiviral coatings, they hold great potential for designing the next generation of antiviral surfaces.
To survey healthcare workers (HCW) on availability and use of personal protective equipment (PPE) caring for COVID-19 patients in the intensive care unit (ICU).
A web-based survey distributed ...worldwide in April 2020.
We received 2711 responses from 1797 (67%) physicians, 744 (27%) nurses, and 170 (6%) Allied HCW. For routine care, most (1557, 58%) reportedly used FFP2/N95 masks, waterproof long sleeve gowns (1623; 67%), and face shields/visors (1574; 62%). Powered Air-Purifying Respirators were used routinely and for intubation only by 184 (7%) and 254 (13%) respondents, respectively. Surgical masks were used for routine care by 289 (15%) and 47 (2%) for intubations. At least one piece of standard PPE was unavailable for 1402 (52%), and 817 (30%) reported reusing single-use PPE. PPE was worn for a median of 4 h (IQR 2, 5). Adverse effects of PPE were associated with longer shift durations and included heat (1266, 51%), thirst (1174, 47%), pressure areas (1088, 44%), headaches (696, 28%), Inability to use the bathroom (661, 27%) and extreme exhaustion (492, 20%).
HCWs reported widespread shortages, frequent reuse of, and adverse effects related to PPE. Urgent action by healthcare administrators, policymakers, governments and industry is warranted.
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•Wide variability in what PPE is available for ICU staff caring for COVID-19 patients.•More than half report at least one PPE item missing or out of stock.•Adverse effects of wearing PPE reported by 80% of health care workers.•Adverse effects related to duration of a shift wearing PPE without taking a break.
The COVID-19 pandemic has reemphasized the indispensable role of plastics in our daily life. Plastics in terms of personal protective equipment (PPEs) and other single-use medical equipment along ...with packaging solutions owing to their inherent properties have emerged as a life-savior for protecting the health and safety of the frontline health workers and the common citizens during the pandemic. However, plastics have been deemed as evil polluter due to their indiscriminate littering and mismanagement amid increased plastic usage and waste generation during this unprecedented crisis. This article reviews and assesses to dwell upon whether plastics in the time of pandemic are acting as protector of the public health or polluter of the environment. Considering the utilities and limitations of plastic along with its management or mismanagement, and the fate, an equitable appraisal suggests that the consumers' irresponsible behavior, and attitude and poor awareness, and the stress on waste management infrastructure in terms of collection, operation, and financial constraints as the major drivers, leading to mismanagement, turn plastic into an evil polluter of the environment. Plastic can be a protector if managed properly and complemented by the circular economy strategies in terms of reduction, recycle and recovery, and thereby preventing leakage into the environment. To safeguard the supply chain of PPEs, several decontamination techniques have been adopted worldwide ensuring their effective reprocessing to prioritize the circular economy within the system. Policy guidelines encouraging to adopt safer practices and sustainable technical solutions along with consumers' education for awareness creation are the need of the hour for preventing plastic to turn from protector with high utility to polluter.
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•COVID-19 pandemic has reemphasized the indispensable role of plastics in our daily life.•Usage of PPEs and packing materials amid COVID-19 is causing plastic pandemic worldwide.•Provisional reversal or stay on SUPs ban during COVID-19 may change consumers' behavior.•Effective decontamination for reprocessing of PPEs reduces plastic waste generation.•Automated waste management and product innovation may lead to environmental sustainability.
The COVID-19 pandemic has resulted in an unprecedented surge of production, consumption, and disposal of personal protective equipment (PPE) including face masks, disposable gloves, and disinfectant ...wipes, which are often made of single use plastic. Widespread public use of these items has imposed pressure on municipalities to properly collect and dispose of potentially infectious PPE. There has been a lack of structured monitoring efforts to quantify the emerging trend of improperly disposed of PPE debris. In this study, we present a baseline monitoring survey to describe the spatial distribution of PPE debris during the COVID-19 pandemic from the metropolitan city of Toronto, Canada. Our objectives were to: (1) quantify PPE debris types among surveyed areas and; (2) identify PPE debris densities and accumulation of surveyed areas. A total of 1306 PPE debris items were documented, with the majority being disposable gloves (44%), followed by face masks (31%), and disinfecting wipes (25%). Of the face masks, 97% were designed for single use while only 3% were reusable. Of the surveyed locations, the highest daily average densities of PPE debris were recorded in the large and medium-sized grocery store parking lots and the hospital district (0.00475 items/m2, 0.00160 items/m2, and 0.00133 items/m2 respectively). The two surveyed residential areas had the following highest PPE densities (0.00029 items/m2 and 0.00027 items/m2), while the recreational trail had the lowest densities (0.00020 items/m2). Assuming a business-as-usual accumulation, an estimated 14,298 PPE items will be leaked as debris in just the surveyed areas annually. To facilitate proper disposal of PPE debris by the public we recommend development of municipal efforts to improve PPE collection methods that are informed by the described PPE waste pathways.
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•Public use of personal protective equipment (PPE) results with improper disposal.•Of the 1306 PPE debris items recorded disposable gloves were the most abundant.•We surveyed residential areas, grocery parking lots, a trail and a hospital district.•The grocery store parking lot and hospital district resulted with the most debris.•Policy decisions about PPE waste management should be informed by monitoring surveys.
Aim
To explore nursing management issues within COVID‐19 narratives of Italian front‐line nurses.
Background
The COVID‐19 pandemic has dramatically affected health systems and professionals ...worldwide. Italian nurses have key messages for nursing leaders following their acute experiences in the pandemic.
Method
A descriptive qualitative study with thematic analysis.
Results
Twenty‐three testimonies from clinical nurses were analysed. Six macrothemes were identified as follows: organisational and logistic change; leadership models adopted to manage the emergency; changes in nursing approaches; personal protective equipment issues; physical and psychological impact on nurses; and team value/spirit.
Conclusions
Our testimonies highlighted the huge impact of COVID‐19 on the Italian nursing workforce, especially in terms of the high risks associated with caring for COVID‐19 patients, exacerbated by the shortage of appropriate personal protective equipment. Nurses had to care for their colleagues and live separately from their families to avoid infecting them, revealing nurses' resilience and the important role of effective and sensitive management.
Implications for Nursing Management
Nurse managers must be prepared for the impact of pandemics on staff and need to ensure availability and replacement of quality personal protective equipment, rehearse strategies for communicating with patients while wearing personal protective equipment and establish protocols for communicating with relatives.
Barrier Enclosure during Endotracheal Intubation Canelli, Robert; Connor, Christopher W; Gonzalez, Mauricio ...
The New England journal of medicine,
05/2020, Letnik:
382, Številka:
20
Journal Article
PDF
