Health Workers Not Removing Protective Garments Correctly

A recent study published in the American Journal of Infection Control finds that only 13 percent of healthcare workers (4/30) followed all CDC recommendations for the removal of personal protective equipment (PPE) after patient care.

In the current era of emerging pathogens such as Ebola virus, removal of PPE is crucial to reduce contamination of healthcare workers (HWC). The Centers for Disease Control and Prevention (CDC) recommends that gloves should be removed first, followed by the gentle removal of the gown from the back while still in the patient’s isolation room.

In this study conducted by researchers from the University of Wisconsin, a trained observer watched HWCs entering and exiting patient rooms specified as following isolation precautions on various units of the hospital. Isolation precautions are used to help stop the spread of germs from one person to another and may require use of gowns, gloves, and face protection. Observations took place on 13-31 October 2014.

Of the 30 HCWs observed removing PPE, 17 removed their gown before removing their gloves, 16 wore their PPE out into the hallway, and 15 removed their gown in a manner that was not gentle, which could cause pathogens from the gown to transfer to their clothes. Previous studies have reported that viruses on PPE transfer to hands in experiments involving model viruses and fluorescent tracers.

These breaches of PPE removal protocol may be due to a lack of awareness of the proper protocol, time constraints, or lack of understanding of the importance of proper PPE removal, according to Nasia Safdar, MD, PhD, Department of Medicine, University of Wisconsin, and colleagues.

“As a result of the current Ebola outbreak, the critical issue of proper PPE removal has come front and centre,” the authors write. “Healthcare facilities should use this opportunity of heightened interest to undertake practice improvement focused on PPE removal protocol, including technique, for all healthcare-associated conditions that require the donning and doffing of PPE.”

Source: Elsevier
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