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How Can Personal Protective Equipment Be Best Used and Reused: A Closer Look at Donning and Doffing Procedures

Published online by Cambridge University Press:  26 September 2022

Ashley M. Hughes Open the ORCID record for Ashley M. Hughes [Opens in a new window] ,
Devin Doos ,
Rami A. Ahmed ,
Trang N.D. Pham  and
Paul Barach
Ashley M. Hughes*
Affiliation:
Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA Center of Innovation for Complex Chronic Healthcare (CINCCH), Edward Hines Jr VA Medical Center, Hines, IL, USA
Devin Doos
Affiliation:
Department of Emergency Medicine, Division of Simulation, Indiana University School of Medicine, Indianapolis, IN, USA
Rami A. Ahmed
Affiliation:
Department of Emergency Medicine, Division of Simulation, Indiana University School of Medicine, Indianapolis, IN, USA
Trang N.D. Pham
Affiliation:
Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
Paul Barach
Affiliation:
Wayne State School of Medicine, Detroit, MI, USA Jefferson College of Population Health, Philadelphia, PA, USA
*
Corresponding author: Ashley M. Hughes, Email: amhughes@uic.edu.
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Abstract

Objective:

The aim of this study was to examine safety-related contamination threats and risks to health-care workers (HCWs) due to the reuse of personal protective equipment (PPE) among emergency department (ED) personnel.

Methods:

We used a Participatory Design (PD) approach to conduct task analysis (TA) of PPE use and reuse. TA identified the steps, risks, and protective behaviors involved in PPE reuse. We used the Centers for Disease Control and Prevention (CDC) guidance for PPE donning and doffing specifying the recommended task order. Then, we convened subject matter experts (SMEs) with relevant backgrounds in Patient Safety, Human Factors and Emergency Medicine to iteratively identify and map the tasks, risks, and protective behaviors involved in the PPE use and reuse.

Results:

Two emerging threats were associated with behaviors in donning, doffing, and re-using PPE: (i) direct exposure to contaminant, and (ii) transmission/spread of contaminant. Protective behaviors included: hand hygiene, not touching the patient-facing surface of PPE, and ensuring a proper fit and closure of all PPE ties and materials.

Conclusions:

TA was helpful revealed that the procedure for donning and doffing of re-used PPE does not protect ED personnel from contaminant spread and risk of exposure, even with protective behaviors present (e.g., hand hygiene, respirator use, etc.). Future work should make more apparent the underlying risks associated with PPE use and reuse.

Keywords

infection controlemergency medical servicesoccupational healthsanitary engineeringpersonal protective equipmenthuman factorsCOVID-19
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e272
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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