Acceptability and Necessity of Training for Optimal Personal Protective Equipment Use

Doll, Michelle; Feldman, Moshe; Hartigan, Sarah; Sanogo, Kakotan; Stevens, Michael P.; McReynolds, Myriah; Masroor, Nadia; Cooper, Kaila; Bearman, Gonzalo

doi:10.1017/ice.2016.252

Cited by 39 publications

(32 citation statements)

References 4 publications

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“…Others have found that workers desire hands-on training about PPE donning and doffing, and this type of training is consistent with principles of adult education because it actively engages the worker in a realistic, relevant activity. [32][33][34] Hands-on training also offers opportunity for evaluation, which is particularly important when self-perceived proficiency is not correlated with performance, such as has been observed for doffing of PPE ensembles. [35] Hands-on training can provide real-time feedback to correct behaviors in the moment with observer interventions or surrogates for contamination.…”

Section: Discussionmentioning

confidence: 99%

Experience of Chicagoland acute care hospitals in preparing for Ebola virus disease, 2014–2015

Bleasdale

Sikka

Moritz

et al. 2019

Journal of Occupational and Environmental Hygiene

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During the 2014-2015 Ebola virus disease (EVD) outbreak, hospitals in the United States selected personal protective equipment (PPE) and trained healthcare personnel (HCP) in anticipation of receiving EVD patients. To improve future preparations for high-consequence infectious diseases, it was important to understand factors that affected PPE selection and training in the context of the EVD outbreak. Semistructured interviews were conducted with HCP involved with decision-making during EVD preparations at acute care hospitals in the Chicago, IL area to gather information about the PPE selection and training process. HCP who received training were surveyed about elements of training and their perceived impact and overall experience by email invitation. A total of 28 HCP from 15 hospitals were interviewed, and 55 HCP completed the survey. Factors affecting PPE selection included: changing guidance, vendor supply, performance evaluations, and perceived risk and comfort for HCP. Cost did not affect selection. PPE acquisition challenges were mitigated by: sharing within hospital networks, reusing PPE during training, and improvising with existing PPE stock. Selected PPE ensembles were similar across sites. Training included hands-on activities with trained observers, instructional videos, and simulations/drills, which were felt to increase HCP confidence. Many felt refresher training would be helpful. Hands-on training was perceived to be effective, but there is a need to establish the appropriate frequency of refresher training frequency to maintain competence. Lacking confidence in the CDC guidance, interviewed trainers described turning to other sources of information and developing independent PPE evaluation and selection. Response to emerging and/or high consequence infectious diseases would be enhanced by transparent, risk-based guidance for PPE selection and training that addresses protection level, ease of use, ensembles, and availability. KEYWORDSEbola virus disease; healthcare personnel training; high-consequence infections; occupational health; personal protective equipment; qualitative research; standard precautions

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Section: Discussionmentioning

confidence: 99%

Experience of Chicagoland acute care hospitals in preparing for Ebola virus disease, 2014–2015

Bleasdale

Sikka

Moritz

et al. 2019

Journal of Occupational and Environmental Hygiene

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“…Personal protective equipment (PPE) is clothing and equipment worn to protect employees, used in jobs that involve exposure to hazards, including infectious materials (Lau et al, 2004). PPE for infection control includes gloves, masks, respirators, face and eye protection, gowns, and shoe and head covers (Doll et al, 2017). For example, a physician might wear a mask, eye protection, and a gown when examining a patient to protect their face and clothing from exposure to infection.…”

Section: Wearing Protective Equipmentmentioning

confidence: 99%

“…Specific standards exist for correctly wearing, removing, and cleaning various types of PPE used for infection control, and small errors can lead to a dramatic increase in the spread of infectious diseases (Lau et al, 2004). Even in healthcare, a business sector familiar with the use of infection-control PPE, compliance with PPE use and procedures is often lacking (Doll et al, 2017;Mumma et al, 2018;Schumacher et al, 2015;Tomas et al, 2015). Phan et al (2019) observed that 90% of observed PPE doffing was completed incorrectly by healthcare workers.…”

Section: Wearing Protective Equipmentmentioning

confidence: 99%

Behavioral strategies for reducing disease transmission in the workplace

Gravina

Nastasi

Sleiman

et al. 2020

J of App Behav Analysis

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The coronavirus pandemic highlighted that workplaces may serve as a hub of disease transmission if proper precautions are not enacted. The Centers for Disease Control recommends several strategies for decreasing the spread of illnesses in the workplace, including a) promoting proper hand hygiene, b) cleaning and sanitizing the work area, c) encouraging sick employees to stay home, d) personal protective equipment, and, e) social distancing. Research suggests that instructions are often not sufficient to change work behaviors, and behavioral interventions may be needed. Thus, the present paper reviews existing research that informs the implementation of behavioral strategies to reduce the spread of disease in the workplace, and makes recommendations for organizations to protect employees, clients, and customers. Intervention components such as training, prompts, the reduction of response effort, clear workplace policies, feedback, and consequences are discussed, and practical recommendations and suggestions for future research are provided.

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“…PPE protects the wearer and contributes to preventing further transmission, yet is often inappropriately used, especially by doctors (6,7). Many doctors feel that they have inadequate knowledge and practical skills, in IPC, generally, and PPE use, speci cally (8), suggesting an unmet need for teaching undergraduates about its importance (9). Mann and Wood found that around 50% of medical students thought their course should have had a greater emphasis on IPC (10), while John et al reported that 92.5% of medical students made procedural errors when removing PPE during training (11).…”

Section: Introductionmentioning

confidence: 99%

Medical interns’ reflections on their training in use of personal protective equipment.

Barratt

Wyer

Hor

et al. 2020

Preprint

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Background The current COVID-19 pandemic has demonstrated that personal protective equipment (PPE) is essential, to prevent the acquisition and transmission of infectious diseases, yet its use is often sub-optimal in the clinical setting. Training and education are important to ensure and sustain the safe and effective use of PPE by medical interns, but current methods are often inadequate in providing the relevant knowledge and skills. The purpose of this study was to explore medical graduates’ experiences of the use of PPE and identify opportunities for improvement in education and training programmes, to improve occupational and patient safety.Methods This study was undertaken in 2018 in a large tertiary-care teaching hospital in Sydney, Australia, to explore medical interns’ self-reported experiences of PPE use, at the beginning of their internship. Reflexive groups were conducted immediately after theoretical and practical PPE training, during hospital orientation. Transcripts of recorded discussions were analysed, using a thematic approach that drew on the COM-B (capability, opportunity, motivation - behaviour) framework for behaviour. Results 80% of 90 eligible graduates participated. Many interns had not previously received formal training in the specific skills required for optimal PPE use and had developed potentially unsafe habits. Their experiences as medical students in clinical areas contrasted sharply with recommended practice taught at hospital orientation and impacted on their ability to cultivate correct PPE use. Conclusions Undergraduate teaching should be consistent with best practice PPE use, and include practical training that embeds correct and safe practices.

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Acceptability and Necessity of Training for Optimal Personal Protective Equipment Use

Cited by 39 publications

References 4 publications

Experience of Chicagoland acute care hospitals in preparing for Ebola virus disease, 2014–2015

Experience of Chicagoland acute care hospitals in preparing for Ebola virus disease, 2014–2015

Behavioral strategies for reducing disease transmission in the workplace

Medical interns’ reflections on their training in use of personal protective equipment.

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