The dangers of reused personal protective equipment: healthcare workers and workstation contamination.

Contamination Healthcare workers Human factors Occupational hazards Personal protective equipment Worker safety

Journal

The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166

Informations de publication

Date de publication:
Sep 2022
Historique:
received: 06 04 2022
revised: 07 05 2022
accepted: 24 05 2022
pubmed: 11 6 2022
medline: 14 9 2022
entrez: 10 6 2022
Statut: ppublish

Résumé

Personal protective equipment (PPE) is essential to protect healthcare workers (HCWs). The practice of reusing PPE poses high levels of risk for accidental contamination by HCWs. Scarce medical literature compares practical means or methods for safe reuse of PPE while actively caring for patients. In this study, observations were made of 28 experienced clinical participants performing five donning and doffing encounters while performing simulated full evaluations of patients with coronavirus disease 2019. Participants' N95 respirators were coated with a fluorescent dye to evaluate any accidental fomite transfer that occurred during PPE donning and doffing. Participants were evaluated using blacklight after each doffing encounter to evaluate new contamination sites, and were assessed for the cumulative surface area that occurred due to PPE doffing. Additionally, participants' workstations were evaluated for contamination. All participants experienced some contamination on their upper extremities, neck and face. The highest cumulative area of fomite transfer risk was associated with the hook and paper bag storage methods, and the least contamination occurred with the tabletop storage method. Storing a reused N95 respirator on a tabletop was found to be a safer alternative than the current recommendation of the US Centers for Disease Control and Prevention to use a paper bag for storage. All participants donning and doffing PPE were contaminated. PPE reusage practices pose an unacceptably high level of risk of accidental cross-infection contamination to healthcare workers. The current design of PPE requires complete redesign with improved engineering and usability to protect healthcare workers.

Sections du résumé

BACKGROUND BACKGROUND
Personal protective equipment (PPE) is essential to protect healthcare workers (HCWs). The practice of reusing PPE poses high levels of risk for accidental contamination by HCWs. Scarce medical literature compares practical means or methods for safe reuse of PPE while actively caring for patients.
METHODS METHODS
In this study, observations were made of 28 experienced clinical participants performing five donning and doffing encounters while performing simulated full evaluations of patients with coronavirus disease 2019. Participants' N95 respirators were coated with a fluorescent dye to evaluate any accidental fomite transfer that occurred during PPE donning and doffing. Participants were evaluated using blacklight after each doffing encounter to evaluate new contamination sites, and were assessed for the cumulative surface area that occurred due to PPE doffing. Additionally, participants' workstations were evaluated for contamination.
RESULTS RESULTS
All participants experienced some contamination on their upper extremities, neck and face. The highest cumulative area of fomite transfer risk was associated with the hook and paper bag storage methods, and the least contamination occurred with the tabletop storage method. Storing a reused N95 respirator on a tabletop was found to be a safer alternative than the current recommendation of the US Centers for Disease Control and Prevention to use a paper bag for storage. All participants donning and doffing PPE were contaminated.
CONCLUSION CONCLUSIONS
PPE reusage practices pose an unacceptably high level of risk of accidental cross-infection contamination to healthcare workers. The current design of PPE requires complete redesign with improved engineering and usability to protect healthcare workers.

Identifiants

pubmed: 35688273
pii: S0195-6701(22)00170-0
doi: 10.1016/j.jhin.2022.05.016
pmc: PMC9172254
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

59-68

Informations de copyright

Copyright © 2022 The Healthcare Infection Society. All rights reserved.

Auteurs

D Doos (D)

Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. Electronic address: devindoos@gmail.com.

P Barach (P)

Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA; University of Queensland, Brisbane, Queensland, Australia.

N J Alves (NJ)

Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

L Falvo (L)

Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

A Bona (A)

Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

M Moore (M)

Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

D D Cooper (DD)

Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

R Lefort (R)

Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

R Ahmed (R)

Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

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Classifications MeSH