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Use of personal protective equipment among health care personnel: Results of clinical observations and simulations

  • Author Footnotes
    1 Current affiliations: College of Nursing, Seoul National University, Seoul, Republic of Korea and Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea.
    JaHyun Kang
    Correspondence
    Address correspondence to JaHyun Kang, PhD, MPH, College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. (J. Kang).
    Footnotes
    1 Current affiliations: College of Nursing, Seoul National University, Seoul, Republic of Korea and Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea.
    Affiliations
    Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA
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  • John M. O'Donnell
    Affiliations
    Department of Nurse Anesthesia, School of Nursing, University of Pittsburgh, Pittsburgh, PA
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  • Bonnie Colaianne
    Affiliations
    Clinical Improvement Department, Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, PA
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  • Nicholas Bircher
    Affiliations
    Department of Anesthesiology, School of Medicine, University of Pittsburgh, Pittsburgh, PA
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  • Dianxu Ren
    Affiliations
    Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA
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  • Kenneth J. Smith
    Affiliations
    Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA

    Section of Decision Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA
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  • Author Footnotes
    1 Current affiliations: College of Nursing, Seoul National University, Seoul, Republic of Korea and Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea.

      Highlights

      • Among 130 simulations, contamination occurred in 79.2% during the doffing process.
      • Despite feedback, contaminations still occurred in 82% of 22 follow-up simulations.
      • Devising better personal protective equipment education and protocols is necessary to ensure health care personnel safety.

      Background

      Very little is known about how health care personnel (HCP) actually use personal protective equipment (PPE).

      Methods

      The clinical PPE practices of 50 HCP from selected units at the University of Pittsburgh Medical Center (UPMC) Presbyterian Hospital were videotaped with HCP consent. For 2 PPE simulation sessions (simple and full-body sets), 82 HCP were recruited throughout the UPMC system. Simulation practices were videotaped and examined using fluorescent powder with ultraviolet lighting. All participants completed an electronic survey. For a follow-up evaluation simulation, 12 HCP were recruited among simulation participants.

      Results

      Among 130 total sessions from 65 participants, contamination occurred in 79.2% of simulations during the doffing process with various PPE items: simple set (92.3%) and full-body set (66.2%). Among 11 follow-up evaluation participants, contaminations still occurred in 82% after receiving individual feedback, but the overall contamination level was reduced. Using the contamination information gained during the simulation analysis, 66% of potential contamination was estimated for the clinical observation. Concerns and barriers in PPE use from HCP survey responses were as follows: time-consuming, cumbersomeness, and PPE effectiveness.

      Conclusions

      Although HCP knew they were being videotaped, contamination occurred in 79.2% of the PPE simulations. Devising better standardized PPE protocols and implementing innovative PPE education are necessary to ensure HCP safety.

      Key Words

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