Dataset Information

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

ABSTRACT:

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

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

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

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.

SUBMITTER: Doos D

PROVIDER: S-EPMC9172254 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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

Doos D D Barach P P Alves N J NJ Falvo L L Bona A A Moore M M Cooper D D DD Lefort R R Ahmed R R

The Journal of hospital infection 20220607

<h4>Background</h4>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.<h4>Methods</h4>In this study, observations were made of 28 experienced clinical participants performing five donning and doffing encounters while performing simulated full evaluation ...[more]

PMID: 35688273

Similar Datasets

Project description:BackgroundHealthcare workers (HCWs) use personal protective equipment (PPE) in Ebola virus disease (EVD) situations. However, preventing the contamination of HCWs and the environment during PPE removal crucially requires improved strategies. This study aimed to compare the efficacy of three PPE ensembles, namely, Hospital Authority (HA) Standard Ebola PPE set (PPE1), Dupont Tyvek Model, style 1422A (PPE2), and HA isolation gown for routine patient care and performing aerosol-generating procedures (PPE3) to prevent EVD transmission by measuring the degree of contamination of HCWs and the environment.MethodsA total of 59 participants randomly performed PPE donning and doffing. The trial consisted of PPE donning, applying fluorescent solution on the PPE surface, PPE doffing of participants, and estimation of the degree of contamination as indicated by the number of fluorescent stains on the working clothes and environment. Protocol deviations during PPE donning and doffing were monitored.ResultsPPE2 and PPE3 presented higher contamination risks than PPE1. Environmental contaminations such as those originating from rubbish bin covers, chairs, faucets, and sinks were detected. Procedure deviations were observed during PPE donning and doffing, with PPE1 presenting the lowest overall deviation rate (%) among the three PPE ensembles (p < 0.05).ConclusionContamination of the subjects' working clothes and surrounding environment occurred frequently during PPE doffing. Procedure deviations were observed during PPE donning and doffing. Although PPE1 presented a lower contamination risk than PPE2 and PPE3 during doffing and protocol deviations, the design of PPE1 can still be further improved. Future directions should focus on designing a high-coverage-area PPE with simple ergonomic features and on evaluating the doffing procedure to minimise the risk of recontamination. Regular training for users should be emphasised to minimise protocol deviations, and in turn, guarantee the best protection to HCWs.

Project description:In this paper, we examine the cost effectiveness of investment in personal protective equipment (PPE) for protecting health care workers (HCWs) against two infectious diseases: Ebola virus and methicillin-resistant Staphylococcus aureus (MRSA). This builds on similar work published for COVID-19 in 2020. We developed two separate decision-analytic models using a payer perspective to compare the costs and effects of multiple PPE use scenarios for protection of HCW against Ebola and MRSA. Bayesian multivariate sensitivity analyses were used to consider the uncertainty surrounding all key parameters for both diseases. We estimate the cost to provide adequate PPE for a HCW encounter with an Ebola patient is $13.04, which is associated with a 97% risk reduction in infections. The mean incremental cost-effectiveness ratio (ICER) is $3.98 per disability-adjusted life year (DALY) averted. Because of lowered infection and disability rates, this investment is estimated to save $132.27 in averted health systems costs, a financial ROI of 1,014%. For MRSA, the cost of adequate PPE for one HCW encounter is $0.88, which is associated with a 53% risk reduction in infections. The mean ICER is $362.14 per DALY averted. This investment is estimated to save $20.18 in averted health systems costs, a financial ROI of 2,294%. In terms of total health savings per death averted, investing in adequate PPE is the dominant strategy for Ebola and MRSA, suggesting that it is both more costly and less clinically optimal to not fully invest in PPE for these diseases. There are many compelling reasons to invest in PPE to protect HCWs. This analysis examines the economic case, building on previous evidence that protecting HCWs with PPE is cost-effective for COVD-19. Ebola and MRSA scenarios were selected to allow assessment of both endemic and epidemic infectious diseases. While PPE is cost-effective for both conditions, compared to our analysis for COVID-19, PPE is relatively more cost-effective for Ebola and relatively less so for MRSA. Further research is needed to assess shortfalls in the PPE supply chain identified during the COVID-19 pandemic to ensure an efficient and resilient supply in the face of future pandemics.

Project description:AbstractThe pandemic of the 2019 novel coronavirus disease (COVID-19) has caused an unprecedented mobilization of the United States' healthcare workforce. In addition to working extended hours under increased duress, healthcare professionals (HCP) of all stations have been making use of various types of personal protective equipment (PPE) with greatly increased frequency and duration. Current data regarding adverse skin reactions as a possible consequence of PPE use are, particularly in the United States, largely insufficient for policy-makers to make informed decisions regarding daily PPE use among HCP.The research vehicle employed by this study is a cross-sectional 25-item survey distributed via email to workers currently employed by a five-hospital system in southcentral Kentucky. This survey was used to collect information from hospital workers of all professional roles about their experiences during the COVID-19 pandemic, focusing on reports of adverse dermatological reactions and associated risk factors.Out of 879 respondents, 54.4% reported some type of skin irritation reaction. Skin irritation was significantly more prevalent among medical and medical support staff than non-medical hospital workers, with the highest prevalence among Certified Nurse Assistant (CNAs). Among clinical workers, those in dedicated COVID-19 units reported the highest prevalence of adverse skin reaction. The most common complaint was dryness/scaling of the skin (306 out of 439, 69.7%), and the most common location was the facial cheeks (305 out of 516, 59.1%). Among those who reported skin irritation, the average self-reported severity of skin reaction (on a scale of 1-5) was 2.00 ± 0.05, and the mean total days of skin reaction per month was 11.70 ± 0.39 days. Total days of irritation per month was found to be significantly related to "total days of PPE use per month," "hours of PPE use per day," "frequency of hand washing," and "use of disinfecting UV irradiation." Severity of skin reaction was found to be significantly related to "hours per day of PPE use," "consecutive days of PPE use," and "female sex."Clinical workers that put in the most face-to-face time with patients, and those in dedicated COVID-19 units, had the highest risk of adverse skin reaction. Overall, skin reactions were found to be mild, even in those hospital workers with the heaviest PPE use. Because the widespread and consistent use of facial masks in public settings has become a key tool in our protracted struggle with SARS-CoV-2, these findings may help to ameliorate concerns that everyday facial mask and/or other PPE usage contributes to significant dermatologic morbidity among both medical professionals and public citizens.

Dataset Information

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

Background

Methods

Results

Conclusion

Publications

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

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets