Building safe environments for healthcare during the pandemic through safer procedures

Shishir Agarwal, MD, Terumo India, Amit Garg, Director – Medical & Clinical Affairs and Strategy Planning and Gaurav Chhillar, Director TIS Business share some standard operating procedures that were developed that healthcare workers across the country can follow 

At the epicentre of the entire pandemic management is the healthcare sector with mounting responsibilities and frontline management never seen before. In addition to the enormous demands of managing the pandemic and ensuring maximum recoveries, there has also been an unexpected fall-out – non-COVID patients are reluctant to visit hospitals, labs and health centres for health checks and consultations over fears of contracting infections.

Misconceptions and fear of COVID among people is making them doubtful about their safety. This can place further stress on the already overburdened healthcare system in the country, as lifestyle ailments such as obesity, diabetes, cardiac issues, hypertension need constant monitoring.

Healthcare providers are also facing a shortage of medical workforce and as per the Indian Medical Association COVID-19 data, 2238 doctors have been infected so far and 382 doctors have lost lives fighting the pandemic. According to the latest available Ministry of Health and Family Welfare data, 87,000 healthcare workers have tested positive and 573 have lost their lives across various states in India.

As people are still deliberating on whether it is safe to avail healthcare services, it is our duty to raise awareness that service providers are following all the safety methods required, the staff is trained in infection control and protocols and that specific guidelines and standard operating procedures for safety are in place. As an industry, it is vital that we communicate two crucial facts.

The first being that healthcare services are safe and the second being that the cost of delaying the detection and treatment of lifestyle diseases will be heavier. At Terumo, we have channelised our efforts in this direction by drafting standard operating procedures that healthcare workers across the country can follow. These SOPs are divided into three main categories for easy understanding – infrastructural, administrative and behavioural changes.

It is important to convey the message that patient safety is of utmost important while entering Cath labs. All equipment should be set in place and kept covered till it is used. Any staff entering the lab should be in personal protective gear and all non-essential and mobile equipment should be removed from the room. All the switches and control panels should be covered with plastics and should be changed between patients. It is important to ensure all necessary precautions are looked into before entering the cath lab. Stipulated instructions should be followed while wearing the PPE kit. The PPE should be the correct size and should be a long-sleeved water-resistant theatre gown that has a fitted FFP3/2 respirator along with long visor/face shield, gloves, elastic theatre hat and safety glasses. Foot covers/footwear that can be cleaned are better and any jewellery under the kit should be avoided. Contaminated gowns and outer gloves should never leave the lab, and it is important to always wear an FFP2/ N95 mask inside the lab.

Providers should be extremely careful while handling dead bodies and treat them with utmost respect and precaution. This can help avoid the risk of infection transmission. All the instruments and devises used on any patient must be disinfected and the staff attending the deceased must ensure utmost protection. Plugging oral and nasal orifices helps prevent leakage of body fluids. The body should be kept in a leakproof plastic body bag. It is important to disinfect & sanitize the mortuary after a body is taken out.

Tracing the contact to control the impact is very important. If there is a case of a patient testing positive, it is important to track all people who are at high risk by identifying the type of contact – primary, secondary or tertiary. This can be done by reviewing the list of patients who shared the room and by keeping a tab on the list of visitors who visited the patient or any other patient in the room. It is equally important to ensure that biomedical waste is carefully discarded following all hygiene protocols. The bags and containers used in COVID wards should be labelled separately. The bags should be sealed tightly and placed in leak proof containers. Using dedicated four colour-coded bins is also helpful.

The SOPs can be downloaded using the QR code or the link given below:

Link for SOPs: https://www.terumoindia.com/campaign/2020/google/

It needs to be emphasised that patients need not be kept in hospitals for longer than necessary. Limiting hospital stay is essential to keep infections at bay. It is also important to educate patients and caregivers on post-discharge precautions. Healthcare service providers need to raise awareness that service premises are safe and ready for the people. While COVID is a challenging situation for all of us, it is important to not let this pandemic affect the country’s burden of non-communicable diseases.