Covid-19 pandemisinde ameliyathane çalışanı olarak kendimizi nasıl koruduk: 2 yıllık ameliyathane deneyimi

Öz

Amaç: Covid-19 virüsü, insanlar arasında yakın temas ve damlacık yoluyla hızla bulaşan viral bir hastalıktır. Çin'den dünyanın geri kalanına kolayca ve birkaç ay içinde yayılmıştır. Covid-19 hakkındaki sınırlı bilgi ve hayatın rutinini değiştirmiş olması, ülkelerin her yerinde ve her bölümünde olduğu gibi ister istemez hastaneleri ve birçok ameliyathane ortamını da etkilemiştir. Bu makalenin amacı, hastanemizde kişisel korunma yöntemlerinin kullanımını ele almak, iki yılı aşkın süren pandemi döneminde ameliyathanede çalışan personelimizin güncel korunma yöntemleri ile ameliyathanede virüs maruziyetini ve aşılamanın hastalık şiddeti üzerindeki etkilerini incelemek ve değerlendirmektir. Gereç ve yöntem: Bu çalışma, Etik Kurul onayı alındıktan sonra Mart 2020-2022 tarihleri arasında Pamukkale Üniversitesi Tıp Fakültesi ameliyathane personelinden elde edilen prospektif verilere dayalıdır. Hastanenin izole bir bölümü olan ameliyathanelerde sağlık çalışanlarının Covid-19 virüsüne karşı kişisel koruyucu ekipman kullanımı, virüse maruz kalma durumları, aşılanma durumları ve hastanede yatış durumları Covid-19‘un ilk döneminden itibaren değerlendirildi. Aynı zamanda gruplar aşılama öncesi ve aşılama sonrası olmak üzere 2 farklı zaman dilimine ayrıldı. Kişisel koruyucu ekipman kullanımı, Covid-19 enfeksiyonu geçirme durumu, hastalık durumunda belirtileri, hastaneye yatışları, aşılanma durumu ve aşı doz sayısı incelendi. Bu süre içinde hastanede işine son verilen insanlar çalışma dışı bırakıldı. Bulgular: Veriler sağlık çalışanlarının aşılanması öncesi ve sonrası olmak üzere 2 farklı zaman noktasında toplanmıştır. 144 katılımcının demografik verileri, kişisel koruyucu ekipman kullanımı, Covid-19 pozitifliği/negatifliği ve semptomları iki farklı zaman aralığında analiz edildi. Kadınların erkeklere göre anestezistlerin de diğer gruplara göre daha fazla korunduğu bulundu. Ameliyathane personelinde hastaneye yatışlar çok nadirdi ve ciddi semptomlar yoktu. Son olarak, aşılamadan sonra semptomlarda ve şiddetinde önemli bir azalma oldu. Sonuç: Bu çalışma, pandemi döneminde önlem alınması gereken önemli yerlerin başında ameliyathanelerin de olduğunu ortaya koymuştur. Bu çalışma olası salgınlar sırasında ameliyathanede çalışan personelin korunmasına yönelik fikir verebilir.

Anahtar Kelimeler

• Covid-19
• ameliyathanelerde korunma
• kişisel korunma ekipmanları

How we protected ourselves as workers in operating rooms during the Covid-19 pandemic: operating room experience for 2 years

Öz

Purpose: Covid-19 virus is a viral disease that is transmitted quickly between people through close contact and droplets. It spread from China to the rest of the world easily and within a few months. The limited information about Covid-19 and the fact that it has changed the life routine has inevitably affected hospitals and many operating room settings, as in all parts of the countries. The aim of this article is to discuss the use of personal protection methods in our hospital, to examine the virus exposure of our personnel working in the operating room with the current protection methods in the operating room during the pandemic period lasting more than two years, and to examine and evaluate the effects of vaccination on the severity of the disease. Materials and methods: This study was based on prospective data obtained from Pamukkale University Faculty of Medicine operating room staff between March 2020 and 2022 after receiving the approval from the Ethics Committee. The use of personal protection equipment against Covid-19 virus, exposure to the virus, vaccination status, and hospitalization status of healthcare workers in operating rooms, which is an isolated part of the hospital, were evaluated from the first period of the Covid-19 pandemic. At the same time, the groups were divided into 2 different time periods: before and after vaccination. The use of personal protective equipment, status of having Covid-19 infection, hospitalizations due to the virus, symptoms in case of illness, vaccination status and the number of vaccine doses were examined. During this time, people who were dismissed from the hospital were excluded from the study. Results: Data were collected at 2 different time points as before and after the vaccination of healthcare workers. Demographic data, personal protective equipment use, Covid-19 positivity and negativity and symptoms of 144 participants were analyzed at two different time points. It has been found in many different analyses that women are better protected than men, but also that the protection of anesthesiologists is higher than other groups. Hospitalizations were very rare in operating room staff and they did not have severe symptoms. Finally, there was a significant decrease in symptoms and their severity after vaccination. Conclusion: In conclusion this study revealed the fact that operating rooms are the most important places where precautions should be taken during pandemics. This study aims to shed light on the protection of operating room staff during possible future outbreaks.

Anahtar Kelimeler

• Covid-19
• operating room
• personal protective equipment

Kaynakça

1. 1. Tang LY, Wang J. Anesthesia and Covid-19: what we should know and what we should do. Semin Cardiothorac Vasc Anesth 2020;24:127-137. https://doi.org/10.1177/1089253220921590
2. 2. Coccolini F, Perrone G, Chiarugi M, et al. Surgery in Covid-19 patients: operational directives. World J Emerg Surg 2020;15:25. https://doi.org/10.1186/s13017-020-00307-2
3. 3. Wong J, Goh QY, Tan Z, et al. Preparing for a Covid-19 pandemic: a review of operating room outbreak response measures in a large tertiary hospital in Singapore. Can J Anesth 2020;67:732-745. https://doi.org/10.1007/s12630-020-01620-9
4. 4. World Health Organization. Infection prevention and control of epidemic- and pandemic-prone acute respiratory diseases in health care. WHO guidelines 2007.
5. 5. Chen X, Liu Y, Gong Y, et. al. Perioperative management of patients infected with the Novel Coronavirus. Anesthesiology 2020;132:1307-1316. https://doi.org/10.1097/ALN.0000000000003301
6. 6. Ortega R, Gonzalez M, Nozari A, Cannelli R. Personal protective equipment and Covid-19. N Engl J Med 2020;382:105. https://doi.org/10.1056/NEJMvcm2014809
7. 7. Li XH, Chen L, Pan QN, et al. Vaccination status, acceptance, and knowledge toward a Covid-19 vaccine among healthcare workers: a cross-sectional survey in China. Hum Vaccin Immunother 2021;17:4065-4073 https://doi.org/10.1080/21645515.2021.1957415
8. 8. Forrester JD, Nassar AK, Maggio MP, Hawn MT. Precautions for operating room team members during the Covid-19 pandemic. J Am Coll Surg 2020;230:1098-1101. https://doi.org/10.1016/j.jamcollsurg.2020.03.030

9. 9. Au Yong PA, Peh WM, Koh FH, et al. Perceptions of healthcare workers in high-risk areas of a Singapore hospital during Covid-19: a cross-sectional study. Singapore Med J 2022;63:514-519. https://doi.org/10.11622/smedj.2021046
10. 10. Kantarevic J, Chami N, Vinden C, et al. Covid-19 and the duration of operating room procedures in Ontario: a population-based retrospective study. Can J Surg 2022;65:675-682. https://doi.org/10.1503/cjs.011521
11. 11. Mohammadi F, Tehranineshat B, Bijani M, Oshvandi K, Badiyepeymaiejahromi Z. Exploring the experiences of operating room health care professionals’ from the challenges of the Covid-19 pandemic. BMC Surg 2021;21:434 https://doi.org/10.1186/s12893-021-01437-3
12. 12. Solmaz AF, Ozcan MS, Ozden ES, Balık O, Kırdemir P. Covid-19 pandemi sürecinde ameliyathane yönetimi ve anestezik yaklaşım. SDÜ Tıp Fak Derg 2021;özelsayı-1:125-131. https://doi.org/10.17343/sdutfd.909051
13. 13. Kessel SAM, Hartman OTC, Lucassen PLBJ, Jaarsveld CHM. Post-acute and long Covid-19 symptoms in patients with mild diseases: a systematic review. Fam Pract 2022;39:159-167. https://doi.org/10.1093/fampra/cmab076
14. 14. Levi ML, McMillian D, Dhandha V, Allan J, D’ercole F. Covid-19 mRNA vaccination, reactogenicity, work-related absences and the impact on operating room staffing: a cross-sectional study. Perioper Care Oper Room Manag 2021; 25:100220. https://doi.org/10.1016/j.pcorm.2021.100220
15. 15. Baş YF. Pandemide aşılamanın önemi ve Covid 19 aşılama çalışmaları. SDÜ Tıp Fak Derg 2021; özelsayı-1:245-248. https://doi.org/10.17343/sdutfd.902436
16. 16. Quintão VC, Simões CM, Lima LHNE, et al. The anesthesiologist and Covid-19. Braz J Anesthesiol 2020;70:77-81. https://doi.org/10.1016/j.bjane.2020.03.002
17. 17. Hippisley Cox J, Coupland CA, Mehta N, et al. Risk prediction of Covid-19 related death and hospital admission in adults after Covid-19 vaccination: national prospective cohort study. BMJ 2021;374:2244. https://doi.org/10.1136/bmj.n2244
18. 18. Chenchula S, Karunakaran P, Sharma S, Chavan M. Current evidence on efficacy of Covid‐19 booster dose vaccination against the Omicron variant: a systematic review. J Med Virol 2022;94:2969-2976. https://doi.org/10.1002/jmv.27697
19. 19. Prakash L, Dhar SA, Mushtaq M. Covid-19 in the operating room: a review of evolving safety protocols. Patient Saf Surg 2020;14:30. https://doi.org/10.1186/s13037-020-00254-6