Validation of personal protective equipment ensembles, incorporating powered air-purifying respirators protected from contamination, for the care of patients with high-consequence infectious diseases.

Fluorescence visualization Infection control Patient health care Personal protective equipment Powered air-purifying respirator

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:
Apr 2023
Historique:
received: 24 10 2022
revised: 03 01 2023
accepted: 06 01 2023
medline: 4 4 2023
pubmed: 31 1 2023
entrez: 30 1 2023
Statut: ppublish

Résumé

The UK High-Consequence Infectious Diseases (HCID) Network of high-level isolation units provides care for patients with contact- or airborne-transmissible highly infectious and highly dangerous diseases. In most HCID units, the healthcare workers (HCWs) wear personal protective equipment (PPE) ensembles incorporating a powered air-purifying respirator (PAPR) for head and respiratory protection. Some PAPRs have components worn outside/over other PPE, necessitating decontamination of re-usable elements. Two alternative PAPRs, with all re-usable elements worn under PPE, were trialled in this study. To undertake scenario-based testing of PAPRs and PPE to determine usability, comfort and ability to remove contaminated PPE without personal cross-contamination. Trained healthcare volunteers (N=20) wearing PAPR/PPE ensembles were sprayed with ultraviolet fluorescent markers. They undertook exercises to mimic patient care, and subsequently, after doffing the contaminated PPE following an established protocol, any personal cross-contamination was visualized under ultraviolet light. Participants also completed a questionnaire to gauge how comfortable they found the PPE. The ensembles were tested under extreme 'worst case scenario' conditions, augmented by physical and manual dexterity tests. Participating volunteers considered the exercise to be beneficial in terms of training and PPE evaluation. Data obtained, including feedback from questionnaires and doffing buddy observations, supported evidence-based decisions on the PAPR/PPE ensemble to be adopted by the HCID Network. One cross-contamination event was recorded in the ensemble chosen; this could be attributed to doffing error, and could therefore be eliminated with further practice.

Sections du résumé

BACKGROUND BACKGROUND
The UK High-Consequence Infectious Diseases (HCID) Network of high-level isolation units provides care for patients with contact- or airborne-transmissible highly infectious and highly dangerous diseases. In most HCID units, the healthcare workers (HCWs) wear personal protective equipment (PPE) ensembles incorporating a powered air-purifying respirator (PAPR) for head and respiratory protection. Some PAPRs have components worn outside/over other PPE, necessitating decontamination of re-usable elements. Two alternative PAPRs, with all re-usable elements worn under PPE, were trialled in this study.
AIM OBJECTIVE
To undertake scenario-based testing of PAPRs and PPE to determine usability, comfort and ability to remove contaminated PPE without personal cross-contamination.
METHODS METHODS
Trained healthcare volunteers (N=20) wearing PAPR/PPE ensembles were sprayed with ultraviolet fluorescent markers. They undertook exercises to mimic patient care, and subsequently, after doffing the contaminated PPE following an established protocol, any personal cross-contamination was visualized under ultraviolet light. Participants also completed a questionnaire to gauge how comfortable they found the PPE.
FINDINGS AND CONCLUSIONS CONCLUSIONS
The ensembles were tested under extreme 'worst case scenario' conditions, augmented by physical and manual dexterity tests. Participating volunteers considered the exercise to be beneficial in terms of training and PPE evaluation. Data obtained, including feedback from questionnaires and doffing buddy observations, supported evidence-based decisions on the PAPR/PPE ensemble to be adopted by the HCID Network. One cross-contamination event was recorded in the ensemble chosen; this could be attributed to doffing error, and could therefore be eliminated with further practice.

Identifiants

pubmed: 36716796
pii: S0195-6701(23)00016-6
doi: 10.1016/j.jhin.2023.01.005
pii:
doi:

Substances chimiques

Coloring Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

71-79

Subventions

Organisme : World Health Organization
ID : 001
Pays : International

Informations de copyright

Copyright © 2023. Published by Elsevier Ltd.

Auteurs

B Crook (B)

Health Capability Group, Science and Research Centre, Health and Safety Executive, Buxton, UK. Electronic address: brian.crook@hse.gov.uk.

C Bailey (C)

Health Capability Group, Science and Research Centre, Health and Safety Executive, Buxton, UK.

A Sykes (A)

Infection Prevention and Control, Royal Victoria Infirmary, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.

M C Hoyle (MC)

ID/HCID Unit, Royal Liverpool Hospital, Royal Liverpool and Broad Green University Hospitals NHS Trust, Liverpool, UK.

C Evans (C)

Department of Virology, Laboratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

B Poller (B)

Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK.

C Makison-Booth (C)

Health Capability Group, Science and Research Centre, Health and Safety Executive, Buxton, UK; World Health Organization, Geneva, Switzerland.

D Pocock (D)

Health Capability Group, Science and Research Centre, Health and Safety Executive, Buxton, UK; Cabinet Office, Kings Court, Sheffield, UK.

C Tuudah (C)

Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK.

B Athan (B)

High-Level Isolation Unit, Royal Free London NHS Foundation Trust, London, UK.

S Hall (S)

Health Capability Group, Science and Research Centre, Health and Safety Executive, Buxton, UK.

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