Aerosol Box Use in Reducing Health Care Worker Contamination During Airway Procedures (AIRWAY) Study: Secondary Workload and Provider Outcomes in a Simulation-Based Trial.

IF 4 2区 医学 Q1 CRITICAL CARE MEDICINE Pediatric Critical Care Medicine Pub Date : 2024-10-01 Epub Date: 2024-06-05 DOI:10.1097/PCC.0000000000003535
Dana Singer Harel, Yiqun Lin, Carl Y Lo, Adam Cheng, Jennifer Davidson, Todd P Chang, Clyde Matava, Michael Buyck, Guylaine Neveu, Natasha Collia, Jabeen Fayyaz, Keya Manshadi, Arielle Levy, Stephanie Pellerin, Jonathan Pirie
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引用次数: 0

Abstract

Objectives: An aerosol box aims to reduce the risk of healthcare provider (HCP) exposure to infections during aerosol generating medical procedures (AGMPs), but little is known about its impact on workload of team members. We conducted a secondary analysis of data from a prospective, multicenter, randomized controlled trial evaluating the impact of aerosol box use on patterns of HCP contamination during AGMPs. The objectives of this study are to: 1) evaluate the effect of aerosol box use on HCP workload, 2) identify factors associated with HCP workload when using an aerosol box, and 3) describe the challenges perceived by HCPs of aerosol box use.

Design: Simulation-based randomized trial, conducted from May to December 2021.

Setting: Four pediatric simulation centers.

Subjects: Teams of two HCPs were randomly assigned to control (no aerosol box) or intervention groups (aerosol box).

Interventions: Each team performed three scenarios requiring different pediatric airway management (bag-valve-mask [BVM] ventilation, laryngeal mask airway [LMA] insertion, and endotracheal intubation [ETI] with video laryngoscopy) on a simulated COVID-19 patient. National Aeronautics and Space Administration-Task Load Index (NASA-TLX) is a standard tool that measures subjective workload with six subscales.

Measurements and main results: A total of 64 teams (128 participants) were recruited. The use of aerosol box was associated with significantly higher frustration during LMA insertion (28.71 vs. 17.42; mean difference, 11.29; 95% CI, 0.92-21.66; p = 0.033). For ETI, there was a significant increase in most subscales in the intervention group, but there was no significant difference for BMV. Average NASA-TLX scores were all in the "low" range for both groups (range: control BVM 23.06, sd 13.91 to intervention ETI 38.15; sd 20.45). The effect of provider role on workloads was statistically significant only for physical demand ( p = 0.001). As the complexity of procedure increased (BVM → LMA → ETI), the workload increased in all six subscales ( p < 0.05).

Conclusions: The use of aerosol box increased workload during ETI but not with BVM and LMA insertion. Overall workload scores remained in the "low" range, and there was no significant difference between airway provider and assistant.

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气雾剂盒用于减少医护人员在气道操作过程中的污染(AIRWAY)研究:模拟试验中的次要工作量和医护人员成果。
目的:气溶胶盒旨在降低医护人员(HCP)在产生气溶胶的医疗过程(AGMP)中受到感染的风险,但人们对其对团队成员工作量的影响知之甚少。我们对一项前瞻性多中心随机对照试验的数据进行了二次分析,该试验评估了气溶胶盒的使用对 AGMP 过程中 HCP 污染模式的影响。本研究的目标是1)评估喷雾盒的使用对 HCP 工作量的影响;2)确定使用喷雾盒时与 HCP 工作量相关的因素;3)描述 HCP 在使用喷雾盒时感受到的挑战:设计:基于模拟的随机试验,2021 年 5 月至 12 月进行:四个儿科模拟中心:由两名保健医生组成的小组被随机分配到对照组(无喷雾盒)或干预组(喷雾盒):每个小组对一名模拟 COVID-19 患者实施三种需要不同儿科气道管理的情景(袋阀面罩 [BVM] 通气、喉罩气道 [LMA] 插入和视频喉镜气管插管 [ETI])。美国国家航空航天局任务负荷指数(NASA-TLX)是一种标准工具,通过六个分量表测量主观工作量:共招募了 64 个团队(128 名参与者)。使用气雾剂盒与 LMA 插入过程中更高的挫败感明显相关(28.71 vs. 17.42;平均差异,11.29;95% CI,0.92-21.66;p = 0.033)。就 ETI 而言,干预组的大多数分量表都有显著提高,但 BMV 没有显著差异。两组的 NASA-TLX 平均得分均在 "低 "范围内(范围:对照组 BVM 23.06,sd 13.91;干预组 ETI 38.15;sd 20.45)。医疗服务提供者的角色对工作量的影响仅在体力需求方面具有统计学意义(p = 0.001)。随着手术复杂程度的增加(BVM → LMA → ETI),所有六个分量表的工作量都增加了(p < 0.05):结论:使用喷雾盒会增加 ETI 期间的工作量,但在插入 BVM 和 LMA 时不会。总体工作量评分仍处于 "低 "范围,气道提供者和助手之间没有显著差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pediatric Critical Care Medicine
Pediatric Critical Care Medicine 医学-危重病医学
CiteScore
7.40
自引率
14.60%
发文量
991
审稿时长
3-8 weeks
期刊介绍: Pediatric Critical Care Medicine is written for the entire critical care team: pediatricians, neonatologists, respiratory therapists, nurses, and others who deal with pediatric patients who are critically ill or injured. International in scope, with editorial board members and contributors from around the world, the Journal includes a full range of scientific content, including clinical articles, scientific investigations, solicited reviews, and abstracts from pediatric critical care meetings. Additionally, the Journal includes abstracts of selected articles published in Chinese, French, Italian, Japanese, Portuguese, and Spanish translations - making news of advances in the field available to pediatric and neonatal intensive care practitioners worldwide.
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