International Journal of Community Medicine and Public Health

Singh G et al. Int J Community Med Public Health. 2024 Jan;11(1):177-181

http://www.ijcmph.com

pISSN 2394-6032 | eISSN 2394-6040

Original Research Article

DOI: https://dx.doi.org/10.18203/2394-6040.ijcmph20234122

Understanding among dialysis therapist and technologist about prevention protocols of COVID-19 in north-west zone of India: a questionnaire-based survey

Gajram Singh1, Dheeraj Kumar2, Manoj Kumar3*, Milind Chunkhare4

1Department of Dialysis Technology, 2Department of Cardiology Technology, Faculty of Paramedical Sciences,

3Department of General Medicine, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, India

4Department of Computer Science, Symbiosis International University, Pune, Maharashtra, India

Received: 11 October 2023

Revised: 07 December 2023

Accepted: 08 December 2023

*Correspondence:

Dr. Manoj Kumar,

E-mail: dheeraj00002@gmail.com

Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background: All over the world human community fighting with COVID-19. It affected a large number of population. Our immune system helps fighting with COVID-19, CKD patients which are on MHD are more prone to COVID-19 infection. MHD patient required twice or thrice a week dialysis. During dialysis, a therapist plays a major role in COVID-19 HD procedure of CKD patients. Dialysis therapist works like a frontline warrior. Aim was to observe the understanding of dialysis therapist/technologist about COVID-19 protocols for prevention of COVID-19 infection.

Methods: A total 122 responder from northwest zone of India attended question-based survey form on the understanding of the infection prevention procedure of COVID-19 maintenance hemodialysis patients. Question set was based on union health ministry of Indian government guideline for dialysis unit set up for COVID-19 patients, Dialysis therapist and patents care taker. Data collection was done by online sampling method.

Results: Study observed dialysis therapist of northwest India about understanding of COVID-19 prevention protocols. Approximate- 122 participants include in this study. But major case of COVID-19 treating in government sector hospitals. This study observed that mostly participants have good understanding about COVID-19 infection prevention protocols.

Conclusions: Required a regular education training program for all government and private sector health workers for infection control practices of COVID-19. Dialysis therapist and other health workers are doing work like a frontline warrior, their safety is a major concern so we can avoid the risk of transmission of disease to dialysis therapist.

Keywords: COVID-19, COVID-19 infection prevention protocols, Dialysis awareness, Dialysis therapists

INTRODUCTION

COVID-19 is an extremely infectious disease first case reported in Wuhanchina.1 COVID-19 virus is a member of corona virus (CoV) family. It host is humans, other mammals, and birds. It is asymptomatic in some people and other show severe symptoms in respiratory and digestive organ.1-3 The common symptoms of COVID-19 is cough and cold, fever, fatigue, dyspnea, muscular pain, runny nose, sore throat, head and chest pain, loss of smell, etc.4-6 So it called severe acute respiratory syndrome corona virus 2 or (SARS-CoV-2) according to ICTV.7 When A healthy person come in contact with a COVID-19 patient, symptom may be seen after 2-14 days.8 India is a hub of traditional medicine so for controlling for COVID-19 AYUSH department of government of India give an advisory for use some herbal medicine as immunity booster of any individual, Indian Council for Medical Research (ICMR) advised to Indian doctors hydroxychloroquine use as prophylaxis and antiviral drugs (lopinavir and ritonavir) use in combination in serious COVID-19 cases.9-12 Basically SARS-CoV emerged from bats in China and then first time infected to human in China after that spread all over the world by community transmission and now challenging for health care providers in all over the world.13,14 SARS-CoV-2 infection is increasing rapidly it is a challenge for health professional and government due to absence of any vaccine and specific therapies.15 In UK approximate 10% people on maintenance hemodialysis and approximately 25% of them died and 4% mortality rate on maintenance hemodialysis patients in USA.16,17 The world fighting against COVID-19. Health workers play a major role in fighting with COVID19, approximate 130000 CKD patient in India on MHD it will increase 232/million population.18,19 CKD patient immunity is very low due to ESRD. So, the chance of COVID-19 infection is very high in maintenance hemodialysis CKD patient.20 For controlling the infection of COVID-19 in these ESRD patients WHO and department of health ministry of India issued some guideline. These are for dialysis technologist and patients both follow these guidelines for controlling COVID-19 infection and reducing CKD patient mortality by COVID19 infection.21 A dialysis therapists/technologist must be trained in prevention protocols of COVID-19 which issue by MOHFW. A definite in dialysis therapist/ technologist data is not available in India. But a large number of dialysis therapists/technologists work in private sector, few numbers dialysis technologists/ therapists in government sector. A dialysis therapist is the key person in a dialysis unit so proper training of a dialysis therapist is must about COVID-19 protocol of dialysis procedure. Because if a dialysis technologist is not trained properly how he saves the patient and himself also. CDC recommends hand wash more than 20 second with soap and water use alcohol based (above 70% alcohol) sanitizer avoid unnecessary touch to your eyes, nose, and mouth without washing your hand. If you touch any surface frequently then disinfect that surface. If you have flu like symptom then stay at your home and avoid unnecessary outer visit.22

METHODS

It was an observation study it conducted on dialysis therapist/technologist of northern and west India. A small number of dialysis therapists approximately 122 joined this study by Google questionnaire, mostly working in private sector hospital. The study was conducted at Saifai, Etawah, UP and Pune, Maharashtra, India from July 2020 to August 2020. Questionnaire consisted of different type of 34 questions distributed in demographic condition, education qualification, and the understanding of a dialysis therapist regarding COVID-19 infection prevention protocols. We created a Google form and it distributed by WhatsApp massage to all participants after that observed the response of the candidates. The study population was dialysis therapists/technologist who working in government and private sector. The sample size was 122 participants of north and west India. Data was collected by online google form which was circulated through social media. The inclusion criteria was dialysis therapists, exclusion criteria was allied health professional except dialysis therapist. Ethical approval was not required.

RESULTS

After observation of the questionnaire answer sheet. We found that, 68% working in private sector. In total number of dialysis therapists, male was 55% and female was 45. A large number of candidates approximate 86% working in clinical dialysis unit, 12% working in academic field and only 2% in research work. Approximate 89% were diploma holder after 10+2, 5% graduate, only 6% candidates were post graduate level. 76.2% had less than 3 year working experience (Table 1).

Table 1: Socio-demographic variables (n=122).
Table reproduced from source PDF page 2

Only 76.2% candidate confident about prevention of COVID-19 infection control protocols. Regarding renal failure patients who were more prone to COVID-19 infection, 86.9% were agree on this. 86% was confident about symptom of COVID-19. 93.4% said COVID-19 infection spread person to person. COVID-19 is treated by antiviral drug, 60.7% said yes, but a large number of COVID-19 cases in India cure without antiviral drugs. 82% candidate agreed that mortality is by comorbidity disease. We ask about risk of COVID-19 of dialysis therapist 84.4% said yes. Risk of infection to dialysis therapist is very high for COVID-19 infection. COVID-19 RNA PCR test is must for all ESRD patients who are on maintenance hemodialysis before each hemodialysis process, 86.1% said yes, it is must according to protocols guideline. Mostly participants follow the protocol. 96.7% participant’s use PPE kit during hemodialysis session. 88% participants said both type of patients on hemodialysis should separate, mostly hemodialysis unit provide a separate hemodialysis arrangement for COVID-19 patients. 77.8% participants know about donning and doffing process. 83.6% participants said they have sufficient staff. 89.3% participant’s confident about their working for hemodialysis procedure of COVID-19 patient (Table 2).

Table 2: Questionnaire response rate (n=122).
Table reproduced from source PDF page 3

DISCUSSION

This survey was conducted on dialysis therapist/ technologist. All of these directly concern with hemodialysis patients. So while the majority of participants gave positive responses to the awareness protocol, some participant’s responses were unsatisfactory. Substantial proportion of candidates work in the private sector according to the demographic structure. It also provides information on gender variation, which is quite low, with male accounting for 53% and females accounting for 47%. It provides information about dialysis technologist education; most candidates were accredited diploma, which is beneficial to the health industry. However, a few candidates pursued further education and obtained a postgraduate degree. Participant take information by social and electronic media and updated their knowledge, it shows that a large number of candidate well aware about infection prevention protocol. But only 86% participant have knowledge about symptoms of COVID-19 i.e. fever, coughing, tiredness, dyspnea loss of taste and smell. COVID-19 is an infectious airborne disease.1,3 It spreads from one infected person to another healthy person, 93% participants were aware about this, that shows the awareness of the disease.4 COVID-19 is a viral disease but it is like a flu. Mostly COVID-19 patient recovered in two to three weeks without taking antiviral drug.2 82% participants said that mortality rate of COVID-19 is very less. A dialysis technologist has direct exposure with COVID-19 patient during hemodialysis procedure so the chance of COVID infection is very high. For the prevention of infection, COVID-19 RNAPCR test is must before each hemodialysis, 86% of candidate were following. Because hemodialysis patients spend approximately 4 hours in the hemodialysis unit, wearing a triple layer mask is required for COVID-19 patients, and 98% of participants do so.22

Mostly dialysis technologist follow the prevention of COVID-19 infection protocol and know about PPE kit.3,6 Approximately 90% participants respond that they have separate hemodialysis unit and staff for COVID-19 positive and normal MHD patient. Large number of participants showed positive respons about donning and doffing process. For prevention of COVID-19 infection we use PPE kit, mask, gloves and goggles. 90% of candidates are confidant for COVID-19 patient dialysis, this discussion shows that a large number of dialysis technologists well aware about COVID-19 infection prevention protocols and take of participation fighting against COVID-19 and save life CKD maintenance hemodialysis patient.6

CONCLUSION

After above a healthy discussion, the study shows that a large number of dialysis therapist/technologists are well aware about COVID-19 protocols in maintenance hemodialysis of ESRD (end stage renal disease). Infection prevention protocol of COVID-19 awareness percentage is very high in mostly participant. A large number of candidates working in private sector so there is high requirements to implement continuous training program on infection control practices for COVID-19. All private and government hospitals should conduct regular webinar for improve awareness in dialysis therapist. Webinar should conduct for all healthcare professional and student so it can helpful to fighting with COVID-19 and other communicable disease.

ACKNOWLEDGEMENTS

I would like to express my heartfelt appreciation to everyone engaged in the study, both directly and indirectly.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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