Frequent and unexpected deviations from personal protective equipment guidelines increase contamination risks

Mulvey, Diane; Mayer, Jeanmarie; Visnovsky, Lindsay; Samore, Matthew H.; Drews, Frank A.

doi:10.1016/j.ajic.2019.03.013

Cited by 34 publications

(34 citation statements)

References 5 publications

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“…The knowledge deficit identified in this study aligns with that of Peres et al [ 28 ], in which surveys of advanced medical students and junior doctors found that 59% of respondents had inadequate knowledge about PPE. Potential self-contamination, due to errors in PPE doffing, has been demonstrated in a number of studies which has implications for pathogen transmission not only to clinicians, themselves, but also to the environment and patients [ 29 , 30 ]. The current COVID-19 outbreak has highlighted the importance of correct PPE use to protect frontline workers [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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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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Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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“…The knowledge de cit identi ed in this study aligns with that of Peres et al (26), in which surveys of advanced medical students and junior doctors found that 59% of respondents had inadequate knowledge about PPE. Potential self-contamination, due to errors in PPE do ng, has been demonstrated in a number of studies which has implications for pathogen transmission not only to clinicians, themselves, but also to the environment and patients (27,28). The current COVID-19 outbreak has highlighted the importance of correct PPE use to protect frontline workers (29).…”

Section: Discussionmentioning

confidence: 99%

“…Consistent with ndings from other studies (5,6), poor access to suitable PPE within clinical areas was an environmental barrier, contributing to lack of opportunity to develop appropriate skills. Unavailability of the correct sizes of gowns or masks increases the risk of selfcontamination (27).…”

Section: Discussionmentioning

confidence: 99%

Are Australian medical interns adequately prepared for the optimal use of personal protective equipment?

Barratt¹

2020

Preprint

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Abstract BackgroundThe 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 new graduates’ experiences of the use of PPE and identify opportunities for improvement in medical student education and training programmes, to improve occupational and patient safety. MethodsThis study was undertaken in 2018 in a large tertiary-care teaching hospital in XXXX, Australia, to explore medical interns’ self-reported experiences of PPE use, at the beginning of their first postgraduate year. Focus 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 interns 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. ConclusionsUndergraduate teaching should be consistent with best practice PPE use, and include practical training that embeds correct and safe practices.

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“…Donning and doffing PPE take practice, time, and care for full effect. When pressed for time, HCPs may don and doff incorrectly (18). Additional staff may be engaged to "spot" breaches and prevent self-contamination during doffing.…”

Section: Personal Protection Equipmentmentioning

confidence: 99%

Effect of COVID-19 Precautions on Neonatal Resuscitation Practice: A Balance Between Healthcare Provider Safety, Infection Control, and Effective Neonatal Care

et al. 2020

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Adaptations have been proposed for resuscitation of infants born to women with COVID-19, to protect health care providers, maintain infection control, and limit post-natal transmission. Changes especially impact respiratory procedures, personal protective equipment (PPE) use, resuscitation environments, teamwork, and family involvement. Adding viral filters to ventilation devices and modifications to intubation procedures might hinder effective ventilation. PPE could delay resuscitation, hinder task performance, and degrade communication. Changes to resuscitation locations and team composition alter workflow and teamwork. Physical distancing measures and PPE impede family-integrated care. These disruptions need to be considered given the uncertainty of vertical transmission of SARS-CoV-2.

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Frequent and unexpected deviations from personal protective equipment guidelines increase contamination risks

Cited by 34 publications

References 5 publications

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

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

Are Australian medical interns adequately prepared for the optimal use of personal protective equipment?

Effect of COVID-19 Precautions on Neonatal Resuscitation Practice: A Balance Between Healthcare Provider Safety, Infection Control, and Effective Neonatal Care

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