Efficacy of remote audio-visual system versus standard onsite buddy system to monitor the doffing of personal protective equipment during COVID-19 pandemic: An observational study

IF 1.9 4区医学 Q3 HEALTH POLICY & SERVICES International Journal of Health Planning and Management Pub Date : 2024-01-01 DOI:10.1002/hpm.3754

Michelle Shirin Lazar, Venkata Ganesh, Naveen Naik B, Ajay Singh, G. D. Puri, Sukhpal Kaur

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Abstract

Objectives

Literature states a higher self-contamination rate among healthcare workers (HCWs) while doffing personal protective equipment (PPE). During the Covid-19 pandemic, onsite trained observers were not always available to monitor PPE compliance. The remote audio-visual doffing surveillance (RADS) system has the potential to overcome this limitation. We aimed to compare the efficacy of this real-time RADS system against the onsite buddy system for monitoring the doffing of PPE.

Methods

This prospective, observational study was carried out at our tertiary care centre in northern India. 200 HCWs who cared for Covid-19 patients in the intensive care units/operation theatres were included. Group A included HCWs who performed doffing with the help of an onsite trained observer and group B included HCWs who performed doffing with the RADS system. An independent observer noted the error at any step using the CDC doffing checklist, in both groups. An online questionnaire to analyse the level of satisfaction post-doffing was also surveyed.

Results

The proportion of errors committed during doffing was significantly lower in group B compared to group A with a low relative risk of 0.34 (95% CI 0.22–0.51) (p < 0.001) (Figure 1A,B). In both groups, there was no difference in HCWs feedback regarding the ease of the system and fear of committing an error. Though the perceived quality of monitoring was felt better with onsite buddy, the overall confidence rating of being safe after doffing was better with the RADS system.

Conclusion

Real-time RADS system may be more effective than the onsite buddy system for ensuring the safety of HCWs during doffing PPE. HCWs level of satisfaction related to the ease and anxiety with the monitoring systems were comparable. RADS system can reduce reliance on HCW resources and can integrate well into existing healthcare systems.

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在 COVID-19 大流行期间，远程视听系统与标准现场伙伴系统在监测个人防护设备脱落方面的功效：观察研究。

目的：文献指出，医护人员（HCW）在脱下个人防护设备（PPE）时的自我污染率较高。在 Covid-19 大流行期间，现场训练有素的观察员并非总能监测个人防护设备的合规性。远程视听脱卸监测（RADS）系统有可能克服这一局限性。我们的目的是比较这种实时 RADS 系统与现场伙伴系统在监测个人防护设备脱落方面的功效：这项前瞻性观察研究在印度北部的三级医疗中心进行。研究对象包括 200 名在重症监护室/手术室护理 Covid-19 患者的医护人员。A 组包括在经过现场培训的观察员帮助下进行脱衣的医护人员，B 组包括使用 RADS 系统进行脱衣的医护人员。两组均由一名独立观察员使用疾病预防控制中心的脱帽核对表记录任何步骤的错误。此外，还进行了在线问卷调查，以分析脱帽后的满意度：结果：与 A 组相比，B 组在脱帽过程中发生错误的比例明显较低，相对风险为 0.34（95% CI 0.22-0.51）（P 结论：实时 RADS 系统可能会减少脱帽过程中的错误：在确保医护人员在脱下个人防护设备时的安全方面，实时 RADS 系统可能比现场伙伴系统更有效。医护人员对监测系统的易用性和焦虑程度的满意度相当。RADS 系统可减少对医护人员资源的依赖，并能很好地融入现有的医疗保健系统。

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来源期刊

International Journal of Health Planning and Management Multiple-

CiteScore

4.50

自引率

3.70%

发文量

197

期刊介绍： Policy making and implementation, planning and management are widely recognized as central to effective health systems and services and to better health. Globalization, and the economic circumstances facing groups of countries worldwide, meanwhile present a great challenge for health planning and management. The aim of this quarterly journal is to offer a forum for publications which direct attention to major issues in health policy, planning and management. The intention is to maintain a balance between theory and practice, from a variety of disciplines, fields and perspectives. The Journal is explicitly international and multidisciplinary in scope and appeal: articles about policy, planning and management in countries at various stages of political, social, cultural and economic development are welcomed, as are those directed at the different levels (national, regional, local) of the health sector. Manuscripts are invited from a spectrum of different disciplines e.g., (the social sciences, management and medicine) as long as they advance our knowledge and understanding of the health sector. The Journal is therefore global, and eclectic.