Personal protective equipment for the Ebola virus disease: A comparison of 2 training programs

Casalino, Enrique; Astocondor, Eugenio; Sanchez, Juan Carlos; Díaz-Santana, David Enrique; Aguila, Carlos del; Carrillo, Juan Pablo

doi:10.1016/j.ajic.2015.07.007

Cited by 51 publications

(58 citation statements)

References 15 publications

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“…This finding is not surprising, given the complexity of EVD PPE, and it is consistent with previous studies. 8,14,22 In a study involving 120 students, Casalino et al 22 found that EVD PPE doffing errors occurred even after a 3-phase training program. While protocol deviations while doffing are a major focus for HCW self-contamination, donning deviations, such as an improperly tied gown (a deviation we observed) may increase the future risk of selfcontamination while doffing.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Healthcare Worker Protocol Deviations and Self-Contamination During Personal Protective Equipment Donning and Doffing

Kwon

Burnham

Reske

et al. 2017

Infect. Control Hosp. Epidemiol.

144

155

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Objective. To evaluate healthcare workers’ (HCWs) risk of self-contamination when donning and doffing personal protective equipment (PPE) using fluorescence and MS2 bacteriophage. Design. Prospective pilot study. Setting. Tertiary care hospital. Participants. 36 HCWs: 18 donned/doffed contact precautions (CP) PPE and 18 donned/doffed Ebola virus disease (EVD) PPE. Interventions. HCWs donned PPE according to standard protocols. Fluorescent liquid and MS2 bacteriophage were applied to HCWs. HCWs then doffed their PPE. After doffing, HCWs were scanned for fluorescence and swabbed for MS2. MS2 detection was performed using reverse transcriptase PCR. The donning and doffing processes were videotaped and protocol deviations were recorded. Results. 27% of EVD PPE HCWs and 50% of CP PPE HCWs made ≥1 protocol deviation while donning. 100% of EVD PPE HCWs and 67% of CP PPE HCWs made ≥1 protocol deviation while doffing (p=0.02). The median number of doffing protocol deviations among EVD PPE HCWs was 4, vs. 1 among CP PPE HCWs. 15 EVD PPE protocol deviations were committed by doffing assistants and/or trained observers. Fluorescence was detected on 8 (44%) of EVD PPE HCWs and 5 (28%) CP PPE HCWs, most commonly on hands. MS2 was recovered from 2 (11%) EVD PPE HCWs and 3 (17%) CP PPE HCWs. Conclusions. Protocol deviations were common during both EVD and CP PPE doffing, and some deviations during EVD PPE doffing were committed by the HCWs’ doffing assistant and/or trained observer. Self-contamination was common. PPE donning/doffing are complex and deserve additional study.

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Section: Discussionmentioning

confidence: 99%

Assessment of Healthcare Worker Protocol Deviations and Self-Contamination During Personal Protective Equipment Donning and Doffing

Kwon

Burnham

Reske

et al. 2017

Infect. Control Hosp. Epidemiol.

144

155

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“…Our study showed that most healthcare workers were not trained on the use of PPE in Pakistan. The risk of infection can be reduced with proper training and availability of policies and standard operating procedures [57]. However, regular monitoring is also required to make sure that healthcare workers are using PPE according to the protocols.…”

Section: Discussionmentioning

confidence: 99%

Use of personal protective equipment to protect against respiratory infections in Pakistan: A systematic review

Chughtai

Khan

2019

Journal of Infection and Public Health

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a b s t r a c tLike other low-income countries, limited data are available on the use of personal protective equipment (PPE) in Pakistan. We conducted a systematic review of studies on PPE use for respiratory infections in healthcare settings in Pakistan. MEDLINE, Embase and Goggle Scholar were searched for clinical, epidemiological and laboratory-based studies in English, and 13 studies were included; all were observational/cross-sectional studies. The studies examined PPE use in hospital (n = 7), dental (n = 4) or laboratory (n = 2) settings. Policies and practices on PPE use were inconsistent. Face masks and gloves were the most commonly used PPE to protect from respiratory and other infections. PPE was not available in many facilities and its use was limited to high-risk situations. Compliance with PPE use was low among healthcare workers, and reuse of PPE was reported. Clear policies on the use of PPE and available PPE are needed to avoid inappropriate practices that could result in the spread of infection. Large, multimethod studies are recommended on PPE use to inform national infection-control guidelines.

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“…Different studies show that improvement in the level of knowledge and training of health care workers is directly related to the repeated practice of donning and doffing PPE correctly (Chan et al, ; Carlos et al, ). Strategies to address the training of health care workers in the treatment of patients potentially infected with the Ebola virus appear to significantly decrease critical errors committed during the doffing of PPE (Casalino et al, ; Clay et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…The use of multi‐professional simulation‐based training in this study effectively provided theoretical and practical skills to help health care workers feel prepared to care for a patient who has been declared to have an infection rated as a Levels 3–4 biohazard. Ongoing and rigorous training are crucial to the containment of future outbreaks, influencing adherence and compliance with measures to control infection and improving learning and skills (Agency for Healthcare Research and Quality AHRQ Issue Brief, ; Carlos et al, ; Casalino et al, ; Oladimeji et al, ). Previous experiences with infectious diseases such as SARS indicate that governments and health care institutions should ensure that appropriate controlling measures are in place to protect health care workers through education, training and support in order both to alleviate fears and to encourage health care workers to comply with policies and procedures (Koh et al, ).…”

Section: Discussionmentioning

confidence: 99%

Multi‐professional simulation and risk perception of health care workers caring for Ebola‐infected patients

Carvalho

Castro

León

et al. 2018

Nursing in Critical Care

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Introduction Treatment of infections that require high‐level isolation can cause anxiety and fear among health care workers. Adequate and complete multi‐professional simulation‐based training could reduce those feelings and improve patient care. Objective The purpose of this study was to assess the impact of multi‐professional simulation‐based training on the risk perception and preparedness of health care workers (registered nurses, doctors and ancillary staff) who care for patients assessed to be at risk or confirmed to have Ebola, level 3–4 biohazard. Methods A prospective before–after study was designed. Health care workers who participated in a multi‐professional simulation training course to improve the care of patients potentially infected with Level 3 and 4 biohazards were evaluated about their risk perception. The training was based on clinical scenarios. The evaluation was conducted using questionnaire based on Likert scale. After the training, a satisfaction survey about the most important aspects of the course was also conducted. Results Fifty‐eight health care workers participated in the training course, 22 of whom were registered nurses. Participants presented positive changes after the training, increasing their sense of security, predisposition and confidence (p < 0.000001 for all). Conclusion Multi‐professional simulation‐based training significantly improves the perception of safety and preparedness of health care workers regarding the care of patients potentially infected with Ebola virus and other Level 3–4 biohazards. Relevance to clinical practice The implementation of educational training strategies – such as simulations – is beneficial in improving the capacity of response and coping, as well as in reducing feelings of fear and insecurity.

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Personal protective equipment for the Ebola virus disease: A comparison of 2 training programs

Cited by 51 publications

References 15 publications

Assessment of Healthcare Worker Protocol Deviations and Self-Contamination During Personal Protective Equipment Donning and Doffing

Assessment of Healthcare Worker Protocol Deviations and Self-Contamination During Personal Protective Equipment Donning and Doffing

Use of personal protective equipment to protect against respiratory infections in Pakistan: A systematic review

Multi‐professional simulation and risk perception of health care workers caring for Ebola‐infected patients

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