Infection Risk on Removing PPE
Curtis J. Donskey, MD, of the Cleveland Veterans Affairs Medical Center, and colleagues conducted the study of healthcare workers at four northeast Ohio hospitals who participated in personal protective equipment (PPE) removal simulations. Other healthcare personnel at one medical centre participated in an intervention that included education and practice in removal of contaminated PPE.
The research team observed that of 435 glove and gown removal simulations, contamination of skin or clothing with fluorescent lotion happened in 200 (46 percent). Contamination occurred more frequently during removal of contaminated gloves than gowns (52.9 percent vs. 37.8 percent, P = .002) and when lapses in technique were observed vs. not observed (70.3 percent vs. 30.0 percent, P < .001). Notably, the intervention reduced skin and clothing contamination during glove and gown removal (60 percent before the intervention vs. 18.9 percent after) that was sustained after one and three months.
“These findings highlight the urgent need for additional studies to determine effective strategies to minimise the risk of contamination during PPE removal, to improve PPE design and to identify optimal methods for training of personnel in PPE use,” the researchers conclude.
In a related commentary, Michelle Doll, MD, and Gonzalo M. Bearman, MD, MPH, of Virginia Commonwealth University, Richmond, VA, write: "A standardised training procedure for healthcare workers on the recommended techniques for donning and/or doffing gowns and gloves is long overdue. The training should include educational context, proficiency monitoring, and feedback...However, a standard, accepted, and validated training programme has unfortunately not been developed, and debate remains as to what constitutes best practice for donning and doffing. The CDC’s recommendations are widely adopted. However, even the CDC’s procedures have been found by some to be insufficient."
Any standardised procedure and training programme, the authors note, will need to take into account the individual healthcare worker’s comfort, scope of duty, previous training, and typical workload.
Image source: Wikimedia Commons
Doll M, Bearman GM (2015) The Increasing Visibility of the Threat of Health Care Worker Self-contamination. JAMA Intern Med. Published online October 12, 2015. doi: 10.1001/jamainternmed.2015.5457
Published on : Tue, 13 Oct 2015
Print as PDF
The HAMILTON-C1 neo is a versatile neonatal ventilator that combines invasive and noninvasive modes with the additional options of nCPAP and high flow oxygen therapy. The integrated turbine allows it to be operated independently of a compressed air supply....
The fully featured ICU ventilator, HAMILTON-MR1, guarantees uncompromised continuous ventilation care from the ICU to the MRI scanner and back. Its reliability and high performance, with advanced lung-protective strategies and patient-adaptive modes,...
Medos hemofilters pro are used for efficient and gentle hemofiltration during extracorporal circulation.Medos hemofilters pro do not need to be pre-flushed and can be used immediately. This guarantees a safe and quick hemofiltration.
The HAMILTON-C3 ventilator is a modular high-end ventilation solution for all patient groups. Offering a number of unique features, the HAMILTON-C3 is one of the first ventilators featuring the “Ventilation Autopilot” INTELLiVENT-ASV®. The HAMILTON-C3’s...