Variations in Personal Protective Equipment Preparedness in Intensive Care Units during the COVID-19 Pandemic: A Survey of Asia-Pacific Countries

Rajamani, Arvind; Subramaniam, Ashwin; Shekar, Kiran; Haji, Jumana; Jian-ying, Luo; Bihari, Shailesh; Gullapalli, Navya; Renner, Markus; Alcancia, Claudia Maria; Ramanathan, Kollengode

doi:10.1101/2020.05.06.20093724

Cited by 3 publications

(7 citation statements)

References 27 publications

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“…1 ). In comparison to the original Asia-Pacific countries surveyed, 5 the PPE training in India improved significantly in phase 2 ( Fig. 1 ).…”

Section: R Esultsmentioning

confidence: 83%

“…The survey methodology is provided in detail in our original survey. 5 Following ethical approval, the survey weblink was distributed by e-mail, text message, and WhatsApp to qualified intensivists working in hospitals having a 24/7 Emergency/Casualty Department and an ICU capable of mechanically ventilating patients for >24 hours. In phase 1, it was sent to intensivists across six Asia-Pacific countries, including India between March 25, 2020, and April 06, 2020.…”

Section: Aterials and M Ethodsmentioning

confidence: 99%

“… Training patterns in India in phase 1 and phase 2 survey compared to other Asia-Pacific countries (Australia, New Zealand, Hong Kong, Singapore and Philippines) 5 which were surveyed in phase 1. Four main domains (1) donning/doffing (2) Intubation (3) Transporting (4) Training for cleaners and waste disposal …”

Section: R Esultsmentioning

confidence: 99%

“…4 In a recent survey of intensivists from ICUs in six Asia-Pacific countries conducted by our group, the level of pandemic preparedness in Indian ICUs was compared to the other countries. 5 Since India is a unique country comprising of heterogeneous health systems, we conducted this follow-up survey in Indian ICUs to help evaluate this issue better and propose solutions to improve PPE preparedness that may potentially minimize HCW infections.…”

Section: Introductionmentioning

confidence: 99%

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State of Personal Protective Equipment Practice in Indian Intensive Care Units amidst COVID-19 Pandemic: A Nationwide Survey

Haji¹,

Subramaniam

Kumar³

et al. 2020

Indian Journal of Critical Care Medicine

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A bstract Background Optimal personal protective equipment (PPE) preparedness is key to minimize healthcare workers (HCW) infection with COVID-19. This two-phase survey evaluated PPE preparedness (adherence to Ministry of Health India (MoH) PPE-recommendations; HCW-training; PPE-inventory; PPE-breach management) in Indian intensive care units (ICU). Materials and methods The phase 1 survey was distributed electronically to intensivists from 481 Indian hospitals between March 25, 2020, and April 06, 2020, as part of a multinational survey. Phase 2 was repeated in 320 Indian hospitals between April 20, 2020, and April 30, 2020. Results Response rate was 25% from 22 states. PPE practice varied between states and between private, government, and medical colleges. Between phase 1 and phase 2, all aspects of PPE training improved: donning/doffing 43% vs 66%, respectively; p value <0.01); safe waste disposal practices (38% vs 52%; p value = 0.09); intubation training (18% vs 31%; p value = 0.05); and transport (18% vs 31%; p value = 0.05). Perception of confidence for adequate PPE-training improved from 39 to 53% ( p value = 0.26). In all, 47 to 60% ICUs adhered to MoH recommendations. Wearing N95-masks at all times increased from 47 to 60% ( p value = 0.89). Very few ICUs provided quantitative/qualitative N95 masks fit testing (12% vs 29%; p value <0.01). Low-cost practices like “buddy-system” for donning-doffing (27% vs 44%; p value = 0.02) and showering after PPE breach (10% vs 8%; p value = 0.63) were underutilized. There was reluctance to PPE reuse. In all, 71% were unaware/diffident about PPE inventory. Conclusion Despite interstate variability, most ICUs conformed to MoH recommendations. This survey conducted during initial pandemic phase demonstrated improved PPE preparedness uniformly across India with scope for further improvement. We suggest implementation of quality improvement measures to improve pandemic preparedness and minimize HCW infection rates, focused on regular PPE training, buddy system, and PPE-breach management. How to cite this article Haji JY, Subramaniam A, Kumar P, Ramanathan K, Rajamani A. State of Personal Protective Equipment Practice in Indian Intensive Care Units amidst COVID-19 Pandemic: A Nationwide Survey. Indian J Crit Care Med 2020;24(9):809–816.

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“…1 ). In comparison to the original Asia-Pacific countries surveyed, 5 the PPE training in India improved significantly in phase 2 ( Fig. 1 ).…”

Section: R Esultsmentioning

confidence: 83%

Section: Aterials and M Ethodsmentioning

confidence: 99%

Section: R Esultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

State of Personal Protective Equipment Practice in Indian Intensive Care Units amidst COVID-19 Pandemic: A Nationwide Survey

Haji¹,

Subramaniam

Kumar³

et al. 2020

Indian Journal of Critical Care Medicine

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View full text Add to dashboard Cite

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“…This reduced the spread of COVID-19 infections among HCWs compared to that seen in other countries and hence contributed to overall safety in the country. 35…”

Section: Public Health Education and Trainingmentioning

confidence: 99%

COVID-19, flattening the curve: recommendations towards control and managing a second wave

Fenemigho

Ukponmwan

Nnakwue

et al. 2020

Journal of Global Health Reports

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Flattening the coronavirus disease (COVID-19) curve has been one of the most important public health targets since the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) worldwide. In this review, we examined measures that were key to flattening the curve in countries that have succeeded in achieving this against other countries. The most consistent factors seen from studies were aggressive testing, contact tracing, social distancing, quarantine measures, and innovative technology. These factors were reported to have helped achieve drop in the number of daily new cases reported. Countries like South Korea and Australia employed extensive testing of their residents as a means of curbing the pandemic and limiting its spread. China and Spain employed tracking software and artificial intelligence (AI) in ensuring that infected individuals remained isolated for the recommended number of days and that close contacts of positive cases were tested and quarantined as well. While efforts towards developing a vaccine are still ongoing, and the possibility of a second wave in many countries, we discussed pertinent public health measures and recommendations.

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Development and validation of a tool to appraise guidelines on SARS-CoV-2 infection control strategies in healthcare workers

Subramaniam

Reddy

Kadam

et al. 2022

Australian Critical Care

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Variations in Personal Protective Equipment Preparedness in Intensive Care Units during the COVID-19 Pandemic: A Survey of Asia-Pacific Countries

Cited by 3 publications

References 27 publications

State of Personal Protective Equipment Practice in Indian Intensive Care Units amidst COVID-19 Pandemic: A Nationwide Survey

State of Personal Protective Equipment Practice in Indian Intensive Care Units amidst COVID-19 Pandemic: A Nationwide Survey

COVID-19, flattening the curve: recommendations towards control and managing a second wave

Development and validation of a tool to appraise guidelines on SARS-CoV-2 infection control strategies in healthcare workers

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