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Using HoloLens™ to reduce staff exposure to aerosol generating procedures during a global pandemic
medRxiv - Respiratory Medicine Pub Date : 2020-05-26 , DOI: 10.1101/2020.05.24.20107193
John J Cafferkey , Dominic O P Hampson , Clare Ross , Angad S Kooner , Guy FJ Martin , James M Kinross

RATIONALE: COVID-19 poses a unique challenge; caring for patients with a novel, infectious disease whilst protecting staff. Some interventions used to give oxygen therapy are aerosol generating procedures. Staff delivering such interventions require PPE and are exposed to a significant viral load resulting in sick days and even death. We aim to reduce this risk using an augmented-reality communication device: The HoloLens by Microsoft. OBJECTIVES: In a tertiary centre in London we aim to implement HoloLens technology, allowing other medical staff to remotely join the consulting clinician when in a high-risk patient area delivering oxygen therapy. The study primary outcome was to reduce the exposure to staff and demonstrate non-inferiority staff satisfaction when compared to not using the device. Our secondary outcome was to reduce extrapolated PPE costs when using the device. METHODS: Our study was conducted in March and April 2020, within a respiratory unit delivering aerosolising oxygen therapies (High flow nasal oxygen, Continuous positive airway pressure and non-invasive ventilation) to patients with suspected or confirmed COVID-19 infection. MEASUREMENTS: Self-reported questionnaires to assess satisfaction in key areas of patient care. An infrared people counting device was also used to assess staff in and out of the unit. MAIN RESULTS: Mean self-reported time in the high-risk zone was less when using HoloLens (2.69 hours) compared to usual practice (3.96 hours) although this difference was not statistically significant (p = 0.3657). HoloLens showed non-inferiority when compared to usual practice in staff satisfaction score for all domains. Furthermore, mean staff satisfaction score encouragingly improved when using HoloLens. Self-reported PPE counts from this study showed 12 staff members changing PPE 25.8 times per shift, almost double the 13.5 times in the HoloLens count. CONCLUSIONS: We have demonstrated HoloLens can reduce the number of staff exposed to aerosol generating areas in a novel infectious disease. Our results show it did not impair communication, medical staff availability or end of life care. HoloLens technology may also reduce the use of PPE, which has equipment availability and cost benefits. This study provides grounding for further use of the HoloLens device by bringing a bedside experience to experts remote to the situation.

中文翻译:

在全球大流行期间使用HoloLens™减少员工接触气雾生成程序的时间

理由:COVID-19提出了一个独特的挑战。在保护员工的同时,照顾患有新型传染病的患者。用于进行氧气治疗的一些干预措施是气雾生成程序。提供此类干预措施的工作人员需要个人防护装备,并且需要承受大量病毒负荷,从而导致患病甚至死亡。我们旨在使用增强现实通信设备:Microsoft的HoloLens来降低这种风险。目标:在伦敦的第三中心,我们旨在实施HoloLens技术,使其他医务人员可以在高风险患者区域进行氧气治疗时远程加入咨询临床医生。研究的主要结果是与不使用设备相比,减少了员工的接触并证明了员工的自卑感。我们的次要结果是减少使用该设备时推断出的PPE成本。方法:我们的研究在2020年3月和4月进行,在一个呼吸单元内向怀疑或确诊COVID-19感染的患者提供雾化氧气疗法(高流量鼻氧,持续气道正压通气和无创通气)。测量:自我报告的问卷,以评估患者护理关键领域的满意度。红外人员计数设备也用于评估人员进出单位的情况。主要结果:使用HoloLens的平均自我报告时间(2.69小时)比常规实践(3.96小时)要短,尽管该差异在统计学上并不显着(p = 0.3657)。与所有领域的员工满意度得分相比,HoloLens表现出的自卑感。此外,使用HoloLens时,平均员工满意度得分令人鼓舞地提高。这项研究的自我报告的PPE计数显示,12名工作人员每班换PPE 25.8次,几乎是HoloLens计数的13.5倍的两倍。结论:我们已经证明,HoloLens可以减少一种新型传染病中暴露于气溶胶​​产生区域的人员数量。我们的结果表明,这不会影响沟通,医务人员的可用性或生命周期的终止。HoloLens技术还可以减少PPE的使用,因为PPE具有设备可用性和成本优势。这项研究通过为远离现场情况的专家带来床边经验,为进一步使用HoloLens设备奠定了基础。使用HoloLens时,平均员工满意度得分令人鼓舞地提高。这项研究的自我报告的PPE计数显示,12名工作人员每班换PPE 25.8次,几乎是HoloLens计数的13.5倍的两倍。结论:我们已经证明,HoloLens可以减少一种新型传染病中暴露于气溶胶​​产生区域的人员数量。我们的结果表明,这不会影响沟通,医务人员的可用性或生命周期的终止。HoloLens技术还可以减少PPE的使用,因为PPE具有设备可用性和成本优势。这项研究通过为远离现场情况的专家带来床边经验,为进一步使用HoloLens设备奠定了基础。使用HoloLens时,平均员工满意度得分令人鼓舞地提高。这项研究的自我报告的PPE计数显示,12名工作人员每班换PPE 25.8次,几乎是HoloLens计数的13.5倍的两倍。结论:我们已经证明,HoloLens可以减少一种新型传染病中暴露于气溶胶​​产生区域的人员数量。我们的结果表明,这不会影响沟通,医务人员的可用性或生命周期的终止。HoloLens技术还可以减少PPE的使用,因为PPE具有设备可用性和成本优势。这项研究为远离现场的专家带来了床边经验,为进一步使用HoloLens设备打下了基础。每班8次,几乎是HoloLens计数13.5倍的两倍。结论:我们已经证明,HoloLens可以减少一种新型传染病中暴露于气溶胶​​产生区域的人员数量。我们的结果表明,这不会影响沟通,医务人员的可用性或生命周期的终止。HoloLens技术还可以减少PPE的使用,因为PPE具有设备可用性和成本优势。这项研究为远离现场的专家带来了床边经验,为进一步使用HoloLens设备打下了基础。每班8次,几乎是HoloLens计数13.5倍的两倍。结论:我们已经证明,HoloLens可以减少一种新型传染病中暴露于气溶胶​​产生区域的人员数量。我们的结果表明,这不会影响沟通,医务人员的可用性或生命周期的终止。HoloLens技术还可以减少PPE的使用,因为PPE具有设备可用性和成本优势。这项研究通过为远离现场情况的专家带来床边经验,为进一步使用HoloLens设备奠定了基础。HoloLens技术还可以减少PPE的使用,因为PPE具有设备可用性和成本优势。这项研究通过为远离现场情况的专家带来床边经验,为进一步使用HoloLens设备奠定了基础。HoloLens技术还可以减少PPE的使用,因为PPE具有设备可用性和成本优势。这项研究通过为远离现场情况的专家带来床边经验,为进一步使用HoloLens设备奠定了基础。
更新日期:2020-05-26
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