Abstract
Background: More than 28 000 people were infected with Ebola virus during the 2014-2015 West African outbreak, resulting in more than 11 000 deaths. Better methods are needed to reduce the risk of self-contamination while doffing personal protective equipment (PPE) to prevent pathogen transmission. Methods: A set of interventions based on previously identified failure modes was designed to mitigate the risk of self-contamination during PPE doffing. These interventions were tested in a randomized controlled trial of 48 participants with no prior experience doffing enhanced PPE. Contamination was simulated using a fluorescent tracer slurry and fluorescent polystyrene latex spheres (PLSs). Self-contamination of scrubs and skin was measured using ultraviolet light visualization and swabbing followed by microscopy, respectively. Doffing sessions were videotaped and reviewed to score standardized teamwork behaviors. Results: Participants in the intervention group contaminated significantly fewer body sites than those in the control group (median [interquartile range], 6 [3-8] vs 11 [6-13], P =. 002). The median contamination score was lower for the intervention group than the control group when measured by ultraviolet light visualization (23.15 vs 64.45, P =. 004) and PLS swabbing (72.4 vs 144.8, P =. 001). The mean teamwork score was greater in the intervention group (42.2 vs 27.5, P <. 001). Conclusions: An intervention package addressing the PPE doffing task, tools, environment, and teamwork skills significantly reduced the amount of self-contamination by study participants. These elements can be incorporated into PPE guidance and training to reduce the risk of pathogen transmission.
| Original language | English (US) |
|---|---|
| Pages (from-to) | S248-S255 |
| Journal | Clinical Infectious Diseases |
| Volume | 69 |
| DOIs | |
| State | Published - Sep 13 2019 |
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Keywords
- biocontainment
- inhalational exposure
- personal protective equipment doffing
- self-contamination
- viral hemorrhagic fever
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases
Cite this
Effect of an Intervention Package and Teamwork Training to Prevent Healthcare Personnel Self-contamination during Personal Protective Equipment Doffing. / Andonian, Jennifer; Kazi, Sadaf; Therkorn, Jennifer; Benishek, Lauren; Billman, Carrie; Schiffhauer, Margaret; Nowakowski, Elaine; Osei, Patience; Gurses, Ayse; Hsu, Yea-Jen; Drewry, David; Forsyth, Ellen R.; Vignesh, Arjun; Oresanwo, Ifeoluwa; Garibaldi, Brian Thomas; Rainwater-Lovett, Kaitlin; Trexler, Polly; Maragakis, Lisa.
In: Clinical Infectious Diseases, Vol. 69, 13.09.2019, p. S248-S255.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effect of an Intervention Package and Teamwork Training to Prevent Healthcare Personnel Self-contamination during Personal Protective Equipment Doffing
AU - Andonian, Jennifer
AU - Kazi, Sadaf
AU - Therkorn, Jennifer
AU - Benishek, Lauren
AU - Billman, Carrie
AU - Schiffhauer, Margaret
AU - Nowakowski, Elaine
AU - Osei, Patience
AU - Gurses, Ayse
AU - Hsu, Yea-Jen
AU - Drewry, David
AU - Forsyth, Ellen R.
AU - Vignesh, Arjun
AU - Oresanwo, Ifeoluwa
AU - Garibaldi, Brian Thomas
AU - Rainwater-Lovett, Kaitlin
AU - Trexler, Polly
AU - Maragakis, Lisa
PY - 2019/9/13
Y1 - 2019/9/13
N2 - Background: More than 28 000 people were infected with Ebola virus during the 2014-2015 West African outbreak, resulting in more than 11 000 deaths. Better methods are needed to reduce the risk of self-contamination while doffing personal protective equipment (PPE) to prevent pathogen transmission. Methods: A set of interventions based on previously identified failure modes was designed to mitigate the risk of self-contamination during PPE doffing. These interventions were tested in a randomized controlled trial of 48 participants with no prior experience doffing enhanced PPE. Contamination was simulated using a fluorescent tracer slurry and fluorescent polystyrene latex spheres (PLSs). Self-contamination of scrubs and skin was measured using ultraviolet light visualization and swabbing followed by microscopy, respectively. Doffing sessions were videotaped and reviewed to score standardized teamwork behaviors. Results: Participants in the intervention group contaminated significantly fewer body sites than those in the control group (median [interquartile range], 6 [3-8] vs 11 [6-13], P =. 002). The median contamination score was lower for the intervention group than the control group when measured by ultraviolet light visualization (23.15 vs 64.45, P =. 004) and PLS swabbing (72.4 vs 144.8, P =. 001). The mean teamwork score was greater in the intervention group (42.2 vs 27.5, P <. 001). Conclusions: An intervention package addressing the PPE doffing task, tools, environment, and teamwork skills significantly reduced the amount of self-contamination by study participants. These elements can be incorporated into PPE guidance and training to reduce the risk of pathogen transmission.
AB - Background: More than 28 000 people were infected with Ebola virus during the 2014-2015 West African outbreak, resulting in more than 11 000 deaths. Better methods are needed to reduce the risk of self-contamination while doffing personal protective equipment (PPE) to prevent pathogen transmission. Methods: A set of interventions based on previously identified failure modes was designed to mitigate the risk of self-contamination during PPE doffing. These interventions were tested in a randomized controlled trial of 48 participants with no prior experience doffing enhanced PPE. Contamination was simulated using a fluorescent tracer slurry and fluorescent polystyrene latex spheres (PLSs). Self-contamination of scrubs and skin was measured using ultraviolet light visualization and swabbing followed by microscopy, respectively. Doffing sessions were videotaped and reviewed to score standardized teamwork behaviors. Results: Participants in the intervention group contaminated significantly fewer body sites than those in the control group (median [interquartile range], 6 [3-8] vs 11 [6-13], P =. 002). The median contamination score was lower for the intervention group than the control group when measured by ultraviolet light visualization (23.15 vs 64.45, P =. 004) and PLS swabbing (72.4 vs 144.8, P =. 001). The mean teamwork score was greater in the intervention group (42.2 vs 27.5, P <. 001). Conclusions: An intervention package addressing the PPE doffing task, tools, environment, and teamwork skills significantly reduced the amount of self-contamination by study participants. These elements can be incorporated into PPE guidance and training to reduce the risk of pathogen transmission.
KW - biocontainment
KW - inhalational exposure
KW - personal protective equipment doffing
KW - self-contamination
KW - viral hemorrhagic fever
UR - http://www.scopus.com/inward/record.url?scp=85072145866&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85072145866&partnerID=8YFLogxK
U2 - 10.1093/cid/ciz618
DO - 10.1093/cid/ciz618
M3 - Article
C2 - 31517976
AN - SCOPUS:85072145866
VL - 69
SP - S248-S255
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
ER -