Effect of an Intervention Package and Teamwork Training to Prevent Healthcare Personnel Self-contamination during Personal Protective Equipment Doffing

Clinical Infectious Diseases

Volumn 69, Issue , 2019, Pages S248-S255

  Andonian, Jennifer ^a   Kazi, Sadaf ^b,c   Therkorn, Jennifer ^d   Benishek, Lauren ^b,c   Billman, Carrie ^a,e   Schiffhauer, Margaret ^a   Nowakowski, Elaine ^a   Osei, Patience ^b,c   Gurses, Ayse P ^b,c   Hsu, Yea Jen ^c,e   Drewry, David ^d   Forsyth, Ellen R ^d   Vignesh, Arjun ^b   Oresanwo, Ifeoluwa ^b   Garibaldi, Brian T ^c   Rainwater Lovett, Kaitlin ^d   Trexler, Polly ^a   Maragakis, Lisa L ^a,b,c,e  

^a JOHNS HOPKINS HOSPITAL   (United States)

^b JOHNS HOPKINS UNIVERSITY   (United States)

^c JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE   (United States)

^d JOHNS HOPKINS UNIVERSITY APPLIED PHYSICS LABORATORY   (United States)

^e JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH   (United States)

Author keywords

biocontainment; inhalational exposure; personal protective equipment doffing; self contamination; viral hemorrhagic fever

Indexed keywords

ARTICLE; ATTITUDE TO HEALTH; CLINICAL ARTICLE; CLINICAL EFFECTIVENESS; CONTAMINATION; CONTROLLED STUDY; FEMALE; HAND WASHING; HEALTH CARE PERSONNEL; HEALTH PERSONNEL ATTITUDE; HUMAN; INFECTION CONTROL; INFECTION PREVENTION; MALE; MEDICAL EDUCATION; PERSONAL PROTECTIVE EQUIPMENT DOFFING INTERVENTION PACKAGE; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; RISK REDUCTION; SAFETY PROCEDURE; SELF CONCEPT; SIMULATION TRAINING; TEAMWORK; ULTRAVIOLET RADIATION; EBOLA HEMORRHAGIC FEVER; EDUCATION; EPIDEMIC; FLUORESCENCE; GAS MASK; PATIENT CARE; PROCEDURES; PROTECTIVE EQUIPMENT; PROTECTIVE GLOVE; SKIN;

POLYSTYRENE; POLYSTYRENE DERIVATIVE;

DISEASE OUTBREAKS; FLUORESCENCE; GLOVES, PROTECTIVE; HEALTH PERSONNEL; HEMORRHAGIC FEVER, EBOLA; HUMANS; INFECTION CONTROL; PATIENT CARE TEAM; PERSONAL PROTECTIVE EQUIPMENT; POLYSTYRENES; RESPIRATORY PROTECTIVE DEVICES; SIMULATION TRAINING; SKIN;

EID: 85072145866     PISSN: 10584838     EISSN: 15376591     Source Type: Journal    
DOI: 10.1093/cid/ciz618     Document Type: Article

References (23)

1. World Health Organization. Health worker Ebola infections in Guinea, Liberia and Sierra Leone. Available at: https://www.who.int/hrh/documents/21may2015-web-final.pdf. Accessed 10 February 2019.
2. Centers for Disease Control and Prevention. Guidance on personal protective equipment (PPE) to be used by healthcare workers during management of patients with confirmed Ebola or persons under investigation (PUIs) for Ebola who are clinically unstable or have bleeding, vomiting, diarrhea in U.S hospitals, including procedures for donning and doffing PPE. Available at: https://www.cdc.gov/vhf/ebola/healthcare-us/ppe/guidance.html. Accessed 10 February 2019.
3. Gurses AP, Dietz AS, Nowakowski E, et al; CDC Prevention Epicenter Program. Human factors-based risk analysis to improve the safety of doffing enhanced personal protective equipment. Infect Control Hosp Epidemiol 2019; 40:178-86.
4. Tomas ME, Kundrapu S, Thota P, et al. Contamination of health care personnel during removal of personal protective equipment. JAMA Intern Med 2015; 175:1904-10.
5. Suen LKP, Guo YP, Tong DWK, et al. Self-contamination during doffing of personal protective equipment by healthcare workers to prevent Ebola transmission. Antimicrob Resist Infect Control 2018; 7:157.
6. Chughtai AA, Chen X, Macintyre CR. Risk of self-contamination during doffing of personal protective equipment. Am J Infect Control 2018; 46:1329-34.
7. Zimring CM, Matić Z, Wong Sala MF, et al; Centers for Disease Control and Prevention-Prevention Epicenters Program. Making the invisible visible: why does design matter for safe doffing of personal protection equipment? Infect Control Hosp Epidemiol 2018; 39:1375-7.
8. Casanova LM, Erukunuakpor K, Kraft CS, et al; Centers for Disease Control and Prevention-Prevention Epicenters Program, Division of Healthcare Quality Promotion. Assessing viral transfer during doffing of Ebola-level personal protective equipment in a biocontainment unit. Clin Infect Dis 2018; 66:945-9.
9. Mumma JM, Durso FT, Ferguson AN, et al; Centers for Disease Control and Prevention-Prevention Epicenters Program, Division of Healthcare Quality Promotion. Human factors risk analyses of a doffing protocol for Ebola-level personal protective equipment: mapping errors to contamination. Clin Infect Dis 2018; 66:950-8.
10. Gurses AP, Seidl KL, Vaidya V, et al. Systems ambiguity and guideline compliance: a qualitative study of how intensive care units follow evidence-based guidelines to reduce healthcare-associated infections. Qual Saf Health Care 2008; 17:351-9.
11. Sax H, Clack L. Mental models: a basic concept for human factors design in infection prevention. J Hosp Infect 2015; 89:335-9.
12. Anderson J, Gosbee LL, Bessesen M, Williams L. Using human factors engineering to improve the effectiveness of infection prevention and control. Crit Care Med 2010; 38:S269-81.
13. Yanke E, Carayon P, Safdar N. Translating evidence into practice using a systems engineering framework for infection prevention. Infect Control Hosp Epidemiol 2014; 35:1176-82.
14. Carayon P, Schoofs Hundt A, Karsh BT, et al. Work system design for patient safety: the SEIPS model. Qual Saf Health Care 2006; 15(Suppl 1):i50-8.
15. Holden RJ, Carayon P, Gurses AP, et al. SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and patients. Ergonomics 2013; 56:1669-86.
16. Therkorn J, Drewry D, Andonian J, et al. Development and comparison of complementary methods to study potential skin and inhalational exposure to pathogens during personal protective equipment doffing. Clin Infect Dis 2019; 69(S3):S231-40.
17. Drewry D, Sauer L, Shaw-Saliba K, et al. A novel approach to identify potential provider and environmental contamination on a clinical biocontainment unit using aerosolized pathogen simulants. Health Secur 2017; 16:83-91.
18. Hart SG, Staveland LE. Development of NASA-TLX (Task Load Index): results of empirical and theoretical research. In: Hancock PA, Meshkati N, eds. Advances in Psychology. Vol. 52. North-Holland: Elsevier B.V., 1988:139-83.
19. Baker D, Krokos K, Amodeo A. TeamSTEPPS teamwork attitudes questionnaire manual. Available at: https://www.ahrq.gov/teamstepps/instructor/reference/teamattitudesmanual.html. Accessed 12 April 2019.
20. Zamora JE, Murdoch J, Simchison B, Day AG. Contamination: a comparison of 2 personal protective systems. CMAJ 2006; 175:249-54.
21. Kwon JH, Burnham CD, Reske K, et al. Healthcare worker self-contamination during standard and Ebola virus disease personal protective equipment doffing. Open Forum Infect Dis 2016; 3(Suppl 1):1387.
22. Tomas ME, Kundrapu S, Thota P, et al. Contamination of health care personnel during removal of personal protective equipment. JAMA Intern Med 2015; 175:1904-10.
23. Mumma JM, Durso FT, Casanova L, et al. Common behaviors and faults when doffing personal protective equipment for patients with serious communicable diseases. Clin Infect Dis 2019: 69(S3):S214-20.