7
views
0
recommends
+1 Recommend
2 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      La interprofesionalidad y las acciones en la lucha contra la pandemia de la COVID-19: diálogos con los estudiantes de la salud Translated title: Interprofissionality and actions in the fight against COVID-19: dialogues with healthcare students

      other

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Resumen Objetivo principal: Relatar la experiencia generada a partir de la aplicación de un círculo de cultura virtual sobre interprofesionalidad para enfrentar la COVID-19. Desarrollo del círculo de cultura: Participaron 16 estudiantes universitarios de los cursos de medicina, enfermería, psicología, fisioterapia y farmacia. Se cubrieron las tres fases del círculo de cultura, haciendo analogía con la bata de laboratorio que es un implemento de trabajo común de los cursos anteriormente nombrados. Resultados principales: Los estudiantes consiguieron desvelar la interprofesionalidad en salud y resignificar su posible actuación como parte de un equipo. El sentimiento de miedo e inseguridad fueron constantes entre los participantes, probablemente influenciado por el contexto político y la inexistencia de planes coherentes con las autoridades mundiales de salud. Conclusión principal: La experiencia de participar en el círculo de cultura promovió la concienciación de los estudiantes acerca de las dificultades de ser inseridos en el sistema de salud.

          Translated abstract

          Abstract Objective: Report the experience generated from the application of a virtual culture circle on interprofessionalism to face the COVID-19 pandemic. Methods: Sixteen university students from the courses of: medicine, nursing, psychology, physiotherapy and pharmacy participated in the culture circle. In a playful way, the three phases of the culture circle invented were covered, making in analogy with the use of the lab coat, which is a common work implement of the aforementioned courses. Results: Students were able to reveal the interprofessionality in health and to redefine their possible performance as part of a team. The feeling of fear and insecurity were constant among the participants, probably influenced by the political context and the lack of coherent plans with the world health authorities. Conclusions: The experience of participating in the culture circle promoted the awareness of students about the difficulties of being inserted in the health system.

          Related collections

          Most cited references20

          • Record: found
          • Abstract: found
          • Article: not found

          The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus

          In December, 2019, a novel coronavirus outbreak of pneumonia emerged in Wuhan, Hubei province, China, 1 and has subsequently garnered attention around the world. 2 In the fight against the 2019 novel coronavirus (2019-nCoV), medical workers in Wuhan have been facing enormous pressure, including a high risk of infection and inadequate protection from contamination, overwork, frustration, discrimination, isolation, patients with negative emotions, a lack of contact with their families, and exhaustion. The severe situation is causing mental health problems such as stress, anxiety, depressive symptoms, insomnia, denial, anger, and fear. These mental health problems not only affect the medical workers' attention, understanding, and decision making ability, which might hinder the fight against 2019-nCoV, but could also have a lasting effect on their overall wellbeing. Protecting the mental health of these medical workers is thus important for control of the epidemic and their own long-term health. The local government of Wuhan has implemented policies to address these mental health problems. Medical staff infected with 2019-nCoV while at work will be identified as having work-related injuries. 3 As of Jan 25, 2020, 1230 medical workers have been sent from other provinces to Wuhan to care for patients who are infected and those with suspected infection, strengthen logistics support, and help reduce the pressure on health-care personnel. 4 Most general hospitals in Wuhan have established a shift system to allow front-line medical workers to rest and to take turns in high-pressured roles. Online platforms with medical advice have been provided to share information on how to decrease the risk of transmission between the patients in medical settings, which aims to eventually reduce the pressure on medical workers. Psychological intervention teams have been set up by the RenMin Hospital of Wuhan University and Mental Health Center of Wuhan, which comprise four groups of health-care staff. Firstly, the psychosocial response team (composed of managers and press officers in the hospitals) coordinates the management team's work and publicity tasks. Secondly, the psychological intervention technical support team (composed of senior psychological intervention experts) is responsible for formulating psychological intervention materials and rules, and providing technical guidance and supervision. Thirdly, the psychological intervention medical team, who are mainly psychiatrists, participates in clinical psychological intervention for health-care workers and patients. Lastly, the psychological assistance hotline teams (composed of volunteers who have received psychological assistance training in dealing with the 2019-nCoV epidemic) provide telephone guidance to help deal with mental health problems. Hundreds of medical workers are receiving these interventions, with good response, and their provision is expanding to more people and hospitals. Understanding the mental health response after a public health emergency might help medical workers and communities prepare for a population's response to a disaster. 5 On Jan 27, 2020, the National Health Commission of China published a national guideline of psychological crisis intervention for 2019-nCoV. 4 This publication marks the first time that guidance to provide multifaceted psychological protection of the mental health of medical workers has been initiated in China. The experiences from this public health emergency should inform the efficiency and quality of future crisis intervention of the Chinese Government and authorities around the world.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Serial interval of novel coronavirus (COVID-19) infections

            Highlights • The serial interval of novel coronavirus (COVID-19) infections was estimated from a total of 28 infector-infectee pairs. • The median serial interval is shorter than the median incubation period, suggesting a substantial proportion of pre-symptomatic transmission. • A short serial interval makes it difficult to trace contacts due to the rapid turnover of case generations.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              COVID-19 Personal Protective Equipment (PPE) for the emergency physician

              1 Introduction In December 2019, a novel corona virus infection was detected in Wuhan, China, Hubei province. Initial cases all had a common link to an large seafood and live animal marketplace. Corona viruses are a broad class of viruses that are responsible for most of the common colds, as well as several viral illnesses transmitted from animals to humans. They are so-named due to their similar appearance under electron microscopy to the sun's corona during a total solar eclipse (see Fig. 1, Fig. 2 1 , 2 ). The virus responsible for the current outbreak was originally called novel corona virus, now renamed SARS-CoV-2, since it is related to the SARS virus that caused an epidemic in China in 2002-2003 (postulated at that time to have originated in civet cats and then jumped to humans , and the MERS corona virus-related to transmission from camels https://www.cdc.gov/coronavirus/2019-nCoV/summary.html. The infection is now called COVID-19, and within a few weeks, it became clear that COVID-19 infection was easily spread from person to person, as there was an exponential rise in newly-reported cases seen in China. Travelers from China then spread the COVID-19 to other countries, causing the WHO to declare the epidemic a Global Health Emergency on January 30, 20203 . Simple recommendations of respiratory protection and glove use early on in the official guidance from health agencies contrasted sharply with wide coverage in the 24-hour news media, showing graphic pictures of civilian authorities and health care personnel in Asian countries wearing extensive protective gear reminiscent of that used for Ebola or even hazmat incidents. While initially it was felt that droplet transmission was most the likely mode, recommendations have been upgraded to airborne and contact transmission, since the natural course of this infection is still not completely understood, infectivity or contagiousness seems higher than SARS, and people seem to be able to transmit infection before they ever become symptomatic, and for some days after seemingly full recovery (https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html) (Figs. 3 4 , 3a 5 , 6 , 4a 7 ). Fig. 1 Coronavirus- CDC. Fig 1 Fig. 2 NASA: Sun's Corona during Solar Eclipse August 21, 2017. Fig 2 Fig. 3 CDC- airborne particles from a sneeze. Fig 3 Fig. 3a NIOSH- Approved N95 mask (above) and N95 duck bill and other styles (below). Fig 3a Fig. 4a fit testing N95 mask with qualitative solutions (isoamyl acetate, saccharine, etc.). Fig 4a 2 Types of transmission and precautions8 , 9 Emergency providers of patient care to persons with suspected COVID-19 infections or who will be in the same room or compartment with such patients should follow Standard, Contact, and Airborne Precautions, including the use of eye protection, as recommended by the CDC and WHO. Care should be in single isolated negative-pressure rooms. The following sections further explain these precautions. 3 Standard precautions10 The CDC defines standard precautions as common sense utilization of practices and PPE to protect healthcare workers from infections and to prevent spread of infection from patient to patient. This includes respiratory hygiene and cough etiquette, proper patient placement/isolation, handling and cleaning of patient care equipment, devices, laundry, clothing, and environment; and sharps and procedure safety. 4 Contact transmission11 Transmission of infection by skin-to-skin contact with an infected person, or by touching contaminated items from a person's room (fomites: patient care equipment, telephones, TV remote controls, countertops, as well as bedding, etc.). Wound drainage, as well as secretions or bodily fluids (vomitus, diarrhea, etc.) increase risks for contact transmission. Some notable pathogens transmitted by contact include norovirus, MRSA, C. difficile, VRE (vancomycin resistant enterococcus), CRE (carbepenum-resistant enterococcus), SARS, and MERS, among others. 5 Respiratory transmission Respiratory transmission of diseases can occur when people with certain infections talk, laugh, cough, sneeze, or sing. There are two types: droplet, and airborne. 6 Droplet12 Droplet transmission occurs when a patient coughs, sneezes, or talks, which generates infected droplets that can contact the eyes nose, or mouth of another person causing infection. These droplets are fairly large and do not remain airborne for long and settle out fairly quickly. Simply placing a disposable mask on the patient will reduce transmissibility to healthcare workers. Diseases transmitted by droplets are influenza, meningococcal disease, H. flu (HIB), mycoplasma, whooping cough, rubella, and mumps, among others. Droplet particles are larger than those exhibiting airborne transmission (see below), and therefore simply maintaining a distance of at least 6 feet away from the patient may be adequate. Negative pressure rooms are not required, but patients are generally isolated in single-patient rooms. Disposable surgical masks and procedure masks are protective to healthcare workers for droplet transmission, but many institutions err on the side of caution and recommend N95 masks for prevention of any respiratory transmission. A recent study showed simple medical procedure mask use was just as effective as N95 respirator use for influenza prevention in the outpatient healthcare setting.13 While predominant thought is that the coronaviruses are transmitted via droplets (like influenza), the quick spread of this epidemic and contagiousness suggests airborne particles may be more possible (see below). 7 Airborne14 Airborne transmission refers to situations where smaller droplet nuclei or dust particles containing the pathogen can remain suspended in air for long periods of time (2 hours or more), and can travel a much greater distance from the patient, since they stay suspended longer. Patients with COVID-19 and other airborne transmissible diseases require negative pressure rooms. Other diseases exhibiting airborne transmission include TB, chicken pox (varicella), and measles. These diseases are much more transmissible than droplet, and a higher level of respiratory protection is needed. NIOSH recommends N95 respirators that have been properly fit-tested for all personnel caring for COVID-19 patients (see below). 8 Personal Protective Equipment (PPE) 8.1 Respiratory N-95 respirators (see Fig 3 & Fig 3a & Fig. 4 15 ) are required for airborne protection from COVID-19. Per OSHA regulations, HCW must be properly fit-tested with either a qualitative or quantitative device to ensure the mask makes a proper seal with the wearer's skin and offers adequate protection. Users must be clean shaven for mask use as well as for the fit test. Numerous brands are available from multiple manufacturers16 (see photos from NIOSH webiste below). Users with beards cannot be fit tested with an N95, since an adequate seal is not possible17 . HCW with beards can use a powered air-purifying respirator (PAPR) with a hood, since these function without the need for a tight skin seal and therefore also do not require fit testing (see photos). Fig. 4 face shield and N95 for airborne protection. Fig 4 N95 designation is from NIOSH, meaning it is actually a dust-mist respirator which filters out 95% of small particles, but is not resistant to oil (N= Not; 95= 95% filtration efficiency). An R95 has the same filtering capacity but is recommended for oily solvents (R= recommended). Higher designations such as P100 mean they filter out 99.99% of particles (P= particles; 100=essentially 100% efficiency). Higher levels of protection (i.e., R95, P100) are acceptable if a situation calls for N95 and an N95 is not available, but lower levels of protection (i.e., simple procedure or surgical mask) are not (Fig. 9). Some of the styles of N95 masks available: Photos courtesy of 3M, Kimberly-Clark, and Moldex 18 . Since OSHA declares N95 masks for HCW as respirators, their use is governed by the OSHA Respiratory Protection Standard 1910.13419 . Employers must have a program in place with the following components: • Written worksite specific procedures; • Program evaluation; • Selection of an appropriate respirator approved by NIOSH • Training • Fit testing • Inspection, cleaning, maintenance, and storage (for loose-fitting hoods- N/A to disposable single-use N95 masks) • Medical evaluations Paragraph 1910.134(e)(2)(i) of the standard explains that the medical evaluations are to be performed by a physician or other licensed health care professional (PLHCP) identified by the employer to perform medical evaluations using a medical questionnaire or an initial medical examination that obtains the same information as the medical questionnaire. The employer shall ensure that a follow-up medical examination is provided for an employee who gives a positive response to any question among questions 1 through 8 in Section 2, Part A of Appendix C 20 or whose initial medical examination demonstrates the need for a follow-up medical examination. Questions 10-15 and all of part B regarding full-face respirators do not apply to HCW using N95 or loose fitting PAPR hoods. Since the N95 respirator is a negative pressure respirator, if the PLHCP finds a medical condition that may place the employee's health at increased risk if the respirator is used, the employer shall provide a PAPR (such as the hood described above and pictured in Fig. 5, Figs. 5 and 6 21 ). Fig. 5 . Fig 5 Figs. 5 and 6 PAPR loose fitting hood with HEPA filters (no fit test required; suitable for bearded HCWs). Figs 5 and 6 Fit testing for the N95 respirators is required, but can be performed qualitatively using isoamyl acetate (banana oi), saccharin solution, or Bitrex© Fig. 4a (see Fig. 4a), or quantitative using an approved device, such as Port-a-Count® (see Fig. 7, Fig. 8 ) 22 . The fit test must be performed with exact make, model, and size of respirator the HCW with be using in the workplace. Qualitative testing does not compromise the mask integrity and therefore after the test the employee can take the N95 with them for future single use (important consideration in time sof shortages). Quantitative fit tests require insertion of a probe through the mask, compromising mask integrity, and therefore the N95 must be discarded after a quantitative fit test. Fit testing is not required for loose-fitting PAPR hoods (which are used primarily by HCW with facial hair that does not allow a proper seal), because the breathing zone environment is under positive pressure and therefore a tight seal is not required for proper function and protection. Fig. 7 Fit testing N95 mask with PortaCount®. Fig 7 Fig. 8 Portacount® quantitative fit test device. Fig 8 Fig. 9 Simple procedure mask with integrated face shield (not an N95). Used by general public. This could be worn on top of N95 for eye protection. Fig 9 9 Contact23 Contact PPE includes a single pair of disposable patient examination gloves. Change gloves if they become torn or heavily contaminated. A more conservative approach would include double gloving and frequent changing of outer gloves when soiled or torn, with full removal when at risk tasks are completed. In addition, a disposable isolation gown is required. Many facilities are using clothing that has a hood integrated into a zip-up gown or full jumpsuit-type clothing, with a face shield worn along with an N95; a procedure or surgical mask that has a built-in face shield could be worn over an N95 for the eye protection if goggles or face shields aren't available (see photos). All personnel must be mindful of not touching their face while working. Upon completion of patient care activities in the negative pressure respiratory isolation room, clinicians should remove gown first, then mask and face shield, and discard PPE; then remove gloves and perform hand hygiene. Used PPE should be discarded in accordance with routine procedures. Ancillary personnel (ambulance drivers, medics, and techs/aids who help move patients onto stretchers), should wear all above-recommended PPE. After completing patient care/transport duties, and before entering clean areas, personnel should remove and dispose of their PPE and perform hand hygiene to avoid contaminating clean areas. In addition to the PPE described above, EMS clinicians should exercise caution if an aerosol-generating procedure, such as bag valve mask (BVM) ventilation, oropharyngeal suctioning, endotracheal intubation, nebulizer treatment, continuous positive airway pressure (CPAP), bi-phasic positive airway pressure (biPAP), or resuscitation involving emergency intubation or cardiopulmonary resuscitation (CPR) is necessary. BVMs, and other ventilatory equipment, should be equipped with HEPA filtration to filter expired air.
                Bookmark

                Author and article information

                Journal
                index
                Index de Enfermería
                Index Enferm
                Fundación Index (Granada, Granada, Spain )
                1132-1296
                1699-5988
                June 2021
                : 30
                : 1-2
                : 124-128
                Affiliations
                [3] Chapecó Santa Catarina orgnameUniversidade Federal da Fronteira Sul Brazil
                [1] Chapecó Santa Catarina orgnameUniversidade Federal da Fronteira Sul Brazil
                [4] Chapecó Santa Catarina orgnameUniversidade Federal de Santa Catarina orgdiv1Departamento de Enfermería Brazil
                [2] Chapecó Santa Catarina orgnameUniversidade do Estado de Santa Catarina orgdiv1Departamento de Enfermería Brazil
                Article
                S1132-12962021000100027 S1132-1296(21)03000100027
                20755c74-39c7-43c4-9e08-f5a8cf5769dc

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 28 July 2020
                : 10 August 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 5
                Product

                SciELO Spain

                Categories
                Academia

                Patient Care Team,Relaciones interpersonales,Infecciones por coronavirus,Schools,Educación Superior,Grupo de atención al paciente,Instituciones académicas,Interpersonal Relations,Coronavirus Infections,Education Higher

                Comments

                Comment on this article