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Patient Safety In The Hospitalized Setting During A Pandemic

Identification of Problem

OVERVIEW

On January 31, 2020, the United States Secretary of Health and Human Services officially declared a public health emergency signifying the beginning of the COVID-19 pandemic for the U.S. (WhiteHouse.gov, 2019).

COVID-19 is a highly contagious and community spread disease

PROBLEM

Based on the highly contagious nature of COVID-19, do patients in hospitals who wear a mask have a lower risk of contracting the disease after exposure?

American Heart Association News. (May 4, 2020). Is it safe to go to the hospital during COVID-19 pandemic? Retrieved from https://www.heart.org/en/news/2020/05/04/is-it-safe-to-go-to-the-hospital-during-covid-19-pandemic-doctors-say-yes.

Impact on Nursing Practice

Two key impacts on nursing practice are:

Informing nurses so they can better educate patients on safety precautions to lower their risk of exposure

Encourage those who are dealing with medical issues to continue visiting hospitals, or other medical facilities, as needed instead of avoiding them for fear of exposure. For example, “an April study in the Journal of the American College of Cardiology said admissions for a serious type of heart attack known as STEMI dropped 38% after March 1, after the pandemic hit. In news reports, people have specifically cited coronavirus worries as the reason for avoiding hospitals” (Heart.org, 2020).

Whitehouse.gov. (March 13, 2019). Proclamation on Declaring a National Emergency Concerning the Novel Coronavirus Disease (COVID-19) Outbreak. Retrieved from https://www.whitehouse.gov/presidential-actions/proclamation-declaring-national-emergency-concerning-novel-coronavirus-disease-covid-19-outbreak/#:~:text=The%20Secretary%20of%20Health%20and,in%20response%20to%20COVID%2D19.

Describing the Research Process

PICOT question was created, which ended up being:Do patients in the hospital (P) who wear face masks (I) have a lower risk than those who do not wear a mask (C) of contracting COVID-19 (O) within 14 days of being exposed to a positive patient (T)?

Each individual looked at scholarly articles, to find evidence on the importance of wearing a face mask.

Keywords used in the research process included; “Covid - 19”, “Coronavirus”, “benefits of wearing a mask” “hospital setting” and “patient safety”.

Articles were selected by each member that would benefit the project the most.

Tatiana

Correlating Research Findings

The caution zone for exposure occurs when two people are within six feet of one another without a face mask (both persons) and one is showing symptoms of COVID-19 with exposure of at least 15 mins or more then the patient test positive (Demarco, 2020).

evidence is clear that masks can help prevent the spread of COVID-19 and that the more people wearing masks, the better.

rising disease prevalence and a clearer understanding that both pre-symptomatic and asymptomatic transmission leads to how COVID spreads

Studies have found that viral load peaks in the days before symptoms begin and that speaking is enough to expel virus-carrying droplets according to Dr. Peter Chin-Hong from the University of California San Francisco (Bai, 2020).

There is also a relationship between increased adherence to mask use, specifically, and effectiveness of reducing transmission to mask wearers (Lyu & Wehby, 2020).

Demarco, C. (2020). What counts as COVID-19 exposure. The University of Texas MD Anderson Center. Retrieved from https://www.mdanderson.org/cancerwise/what-counts-as-coronavirus-covid-19-exposure--how-does-contact-tracing-identify-who-has-been-exposed-to-covid-19.h00-159383523.htm

Lyu, W., & Wehby, G. L. (2020). Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US: Study examines impact on COVID-19 growth rates associated with state government mandates requiring face mask use in public. Health Affairs, 39(8), 1419-1425.

Bai, N. (2020). Still Confused About Masks? Here’s the Science Behind How Face Masks Prevent Coronavirus. University of California San Francisco. Retrieved from https://www.ucsf.edu/news/2020/06/417906/still-confused-about-masks-heres-science-behind-how-face-masks-prevent

Summarizing Validity of Qualitative & Quantitative

The articles used as evidence follow studies that test the accuracy of masks protecting against COVID. Article 1 or Community USe of Face Masks and CoVID-19: Evidence from a Natural Experiment of State Mandates in the U.S. would be a “cohort study” and the other a “systematic review”. This would make article 2, or Still Confused About Masks? Here’s the Science Behind How Face Masks Prevent Coronavirus a higher quality of information then article 1 according to the Evidence pyramid. The articles have limited bias as they are based on actual events and numbers.

Findings

On March 11, 2020, the WHO announced that the COVID-19 outbreak can be characterized as a pandemic (WhiteHouse.gov, 2019).

Adequate Personal Protective Equipment is needed by healthcare workers to protect themselves from the virus when working with patient who have the virus (Rangachari & Woods, 2020).

Hospitals have put a restriction on visitors to limit the exposure of the virus, they have also required mask to be worn (Preventing Coronavirus Transmission in the Hospital Setting, 2020).

When states required mask to be worn out in public, there was a decrease in cases presented. Studies show when mandating the use of a face mask more than 200,000 cases could be prevented (Lyu & Wehby, 2020)

Tatiana

Recommendations

Social distance

6ft

Frequent hand washing in between patients

Hand sanitizer or 20 secs with soap

Limit the amount of people allowed in area

Elevator max 3-4 people

Wear a mask

Surgical mask, cloth face covering, or N95

Implementation

Non medically required surgeries on HOLD

Policy change notification and teaching to employees

Adequate education will create standard for healthcare personnel

Proper donning and removal of PPE teaching

Limit visitation to patients

Implement virtual consultations/visitations

Limit exposure

Mandatory screening prior to entering hospital/ admittance to hospital

Nasopharyngeal Swab (Covid-19 Test)

Temperature and screening questions done before entering hospital

Conclusion

To conclude, in march a worldwide pandemic that raised the issue of how to stop the spread of COVID-19. Which lead to whether or not patients in the hospitals should be wearing a mask to keep themselves safe. This information found for this problem impacts the nursing practice because it provides education for nurses on how to keep themselves and their patients safe, as well as continue to encourage their patients to continue seeking treatment when they need. The PICOT question asked within this presentation is “Do the patients in the hospital who wear face masks have a lower risk than those who do not wear a mask of contracting COVID-19 within 14 days of being exposed to a positive patient?”. Research was done by reading scholarly articles within the last 5 years about studies done with face masks and the spread of COVID. Finding showed that masks are helpful in spreading COVID throughout the hospital, recommendations include social distancing, hand hygiene practices, limiting people and wearing a mask. Finally, to implement these recommendations non emergent surgeries are put on hold, vital education is given to all hospital staff, visitors are limited in the hospital and mandatory covid checks before entering the hospital.

References:

Liang, M., Gao, L., Cheng, C., Zhou, Q., Uy, J. P., Heiner, K., & Sun, C. (2020). Efficacy of face mask in preventing respiratory virus transmission: A systematic review and meta-analysis. Travel medicine and infectious disease, 36, 101751. https://doi.org/10.1016/j.tmaid.2020.101751

Patient Safety During the Pandemic. (2020). Retrieved October 13, 2020, from https://www.yalemedicine.org/patient_guide/patient-safety.html

Preventing Coronavirus Transmission in the Hospital Setting. (2020). Retrieved October 13, 2020, from https://www.jointcommission.org/resources/news-and-multimedia/webinars/coronavirus-webinar-replays/preventing-coronavirus-transmission-in-the-hospital-setting/

Rangachari, P., & Woods, J. L. (2020, June 15). Preserving Organizational Resilience, Patient Safety, and Staff Retention during COVID-19 Requires a Holistic Consideration of the Psychological Safety of Healthcare Workers. Retrieved October 13, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345925/

References

Patient Safety During the Pandemic. (2020). Retrieved October 13, 2020, from https://www.yalemedicine.org/patient_guide/patient-safety.html