Reduction in transfer of micro-organisms between patients and staff using short-sleeved gowns and hand/arm hygiene in intensive care during the COVID-19 pandemic: A simulation-based randomised trial
Rattachement africain : gb, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background Current personal protective equipment (PPE) practices in UK intensive care units involve “sessional” use of long-sleeved gowns, risking nosocomial infection transmitted via gown sleeves. Data from the first wave of the COVID19 pandemic demonstrated that these changes in infection prevention and control protocols were associated with an increase in healthcare associated bloodstream infections. We therefore explored the use of a protocol using short-sleeved gowns with hand and arm hygiene to reduce this risk. Methods ICU staff were trained in wearing short-sleeved gowns and using a specific hand and arm washing technique between patients (experimental protocol). They then underwent simulation training, performing COVID-19 intubation and proning tasks using either experimental protocol or the standard (long-sleeved) control protocol. Fluorescent powder was used to simulate microbial contamination, detected using photographs under ultraviolet light. Teams were randomised to use control or experimental PPE first. During the simulation, staff were questioned on their feelings about personal safety, comfort and patient safety. Results Sixty-eight staff and 17 proning volunteers were studied. Experimental PPE completely prevented staff contamination during COVID-19 intubation, whereas this occurred in 30/67 staff wearing control PPE ( p = .003, McNemar). Proning volunteers were contaminated by staff in 15/17 control sessions and in 1/17 with experimental PPE ( p = .023 McNemar). Staff comfort was superior with experimental PPE ( p< .001, Wilcoxon). Their personal safety perception was initially higher with control PPE, but changed towards neutrality during sessions ( p < .001 start, 0.068 end). Their impressions of patient safety were initially similar ( p = .87), but finished strongly in favour of experimental PPE ( p < .001). Conclusions Short-sleeved gowns with hand and forearm cleansing appear superior to sessional long-sleeved gowns in preventing cross-contamination between staff and patients.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Reduction in transfer of micro-organisms between patients and staff using short-sleeved gowns and hand/arm hygiene in intensive care during the COVID-19 pandemic: A simulation-based randomised trial
- Date Crossref
- 16/08/2022
- Éditeur
- SAGE Publications
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
Oxford University Hospitals NHS Trust pays non établi dans la noticeÉtablissement de santé
-
Maimonides Medical Center Department of General Surgery pays non établi dans la noticeÉtablissement de santé
-
University of Oxford Nuffield Department of Surgical Sciences pays non établi dans la noticeUniversité ou école supérieure
-
University of West London Richard Wells research centre pays non établi dans la noticeUniversité ou école supérieure
-
Whittington Health NHS Trust pays non établi dans la noticeÉtablissement de santé
-
University of Salford pays non établi dans la noticeUniversité ou école supérieure
-
Oxford University Hospitals Foundation Trust Adult Intensive Care Unit pays non établi dans la noticeUniversité ou école supérieure
-
School of Business pays non établi dans la noticeUniversité ou école supérieure
Oxford University Hospitals NHS Trust, Department of General Surgery — Maimonides Medical Center et Nuffield Department of Surgical Sciences — University of Oxford, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.