Articles: personal-protective-equipment.
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We observed 354 hand hygiene instances across 41 healthcare workers doffing personal protective equipment at 4 hospital-based biocontainment units. We measured the duration and thoroughness of each hand hygiene instance. Both parameters varied substantially, with systematic differences between hospitals and differences between healthcare workers accounting for much of the variance.
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Multicenter Study
Improving healthcare worker adherence to the use of transmission-based precautions through application of human factors design: a prospective multi-centre study.
A key component of transmission-based precautions (TBPs) is the use of personal protective equipment (PPE) but healthcare worker (HCW) adherence remains suboptimal. A human factors-based intervention was implemented to improve adherence to TBPs including (i) improved signage, (ii) standardized placement of signage, (iii) introduction of a mask with integrated face shield, and (iv) improvement in PPE availability. Donning of the correct PPE by HCWs improved significantly (79.7 vs 56.4%; P < 0.001). This approach may be more effective than education alone, but further study is required to determine sustainability and subsequent impact on transmission of healthcare-associated infections.
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Am J Infect Control · Sep 2019
Frequent and unexpected deviations from personal protective equipment guidelines increase contamination risks.
Personal protective equipment (PPE) training aims to reinforce the Centers for Disease Control and Prevention guidelines for donning and doffing; however, many health care and ancillary personnel use non-guideline methods to don and doff their PPE gowns and gloves. We found that hospital personnel commonly deviated from the guidelines, increasing the likelihood of self-contamination. Furthermore, securing the gown ties inappropriately was an especially common problem that consequently increased doffing missteps.
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Ann Work Expo Health · Aug 2019
Environmental and Personal Protective Equipment Contamination during Simulated Healthcare Activities.
Providing care to patients with an infectious disease can result in the exposure of healthcare workers (HCWs) to pathogen-containing bodily fluids. We performed a series of experiments to characterize the magnitude of environmental contamination-in air, on surfaces and on participants-associated with seven common healthcare activities. The seven activities studied were bathing, central venous access, intravenous access, intubation, physical examination, suctioning and vital signs assessment. ⋯ Glove and gown contamination were ubiquitous, affirming the value of wearing these pieces of PPE to protect HCW's clothing and skin. Though intubation and suctioning are considered aerosol-generating procedures, fluorescein was detected less frequently in air and at lower levels on face shields and facemasks than other activities, which suggests that the definition of aerosol-generating procedure may need to be revised. Face shields may protect the face and facemask from splashes and sprays of bodily fluids and should be used for more healthcare activities.
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J Occup Environ Hyg · Aug 2019
Personal protective equipment doffing practices of healthcare workers.
During the doffing of personal protective equipment (PPE), pathogens can be transferred from the PPE to the bodies of healthcare workers (HCWs), putting HCWs and patients at risk of exposure and infection. PPE doffing practices of HCWs who cared for patients with viral respiratory infections were observed at an acute care hospital from March 2017 to April 2018. A trained observer recorded doffing performance of HCWs inside the patient rooms using a pre-defined checklist based on the Centers for Disease Control and Prevention (CDC) guideline. ⋯ Common errors were doffing gown from the front, removing face shield of the mask, and touching potentially contaminated surfaces and PPE during doffing. Deviations from the recommended PPE doffing protocol are common and can increase potential for contamination of the HCW's clothing or skin after providing care. There is a clear need to change the approach used to training HCWs in PPE doffing practices.