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Doos D, Hughes AM, Pham T, Barach P, Bona A, Falvo L, Moore M, Cooper DD, Ahmed R. Front-Line Health Care Workers' COVID-19 Infection Contamination Risks: A Human Factors and Risk Analysis Study of Personal Protective Equipment. Am J Med Qual 2024; 39:4-13. [PMID: 38127677 DOI: 10.1097/jmq.0000000000000159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Infectious risks escalate with complex donning and doffing personal protective equipment (PPE) protocols. Recent studies suggest that PPE donning and doffing behaviors that deviate from protocol during PPE reuse compounded the risks of health care worker (HCW) self-contamination. This study quantified the occurrence of behaviors associated with known risks in PPE use and reuse. We conducted a prospective study of emergency department HCWs and video-recorded PPE donning and doffing 5 times in simulated patient encounters. Trained coders recorded HCW behaviors according to an evidence-based guide. All 28 participants deviated from the Centers for Disease Control and Prevention (CDC) sanctioned donning and doffing protocol order, and most were documented to have (92.85%) self-contaminated at least once during each simulated clinical encounter. Behaviors that compounded self-contamination due to PPE reuse were also observed. Wide variation in PPE donning and doffing behaviors was found among front-line, experienced HCWs. Future work is needed to determine which deviations put HCWs at increased risk for accidental self-contamination and what changes are needed to the CDC protocol for protecting HCW from infections.
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Affiliation(s)
- Devin Doos
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Ashley M Hughes
- Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, IL
- Center of Innovation for Chronic Complex Health (CINCCH), Edward Hines Jr. VA Hospital, Hines, IL
| | - Trang Pham
- Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, IL
- Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL
| | - Paul Barach
- Department of Anesthesiology and City of Philadelphia, Jefferson College of Population Health, Thomas Jefferson School of Medicine, PA
- Department of Anesthesiology, Brisbane Queensland, University of Queensland, Australia
| | - Anna Bona
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Lauren Falvo
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Malia Moore
- Simulation Medicine, Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Dylan D Cooper
- Clinical Emergency Medicine, Simulation Education, Department of Emergency Medicine, Simulation Center at Fairbanks Hall, Indiana University School of Medicine, Indianapolis, IN
| | - Rami Ahmed
- Division of Simulation, Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
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