Which type of personal protective equipment (PPE) and which method of donning or doffing PPE carries the least risk of infection for healthcare workers?

Abstract

Data sources CENTRAL, MEDLINE, Embase and CINAHL. Study selection Controlled studies (randomised or non-randomised) that evaluated the effect of full-body PPE on healthcare workers (HCW) exposed to highly infectious diseases, assessed which method of donning and doffing PPE was associated with reduced risk of contamination or infection for HCW, and which training methods increased compliance with PPE protocols. Data extraction and synthesis Two reviewers independently screened the titles and abstracts for inclusion of studies. Full text articles were subsequently assessed for eligibility and disagreements were resolved through consensus. Using criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions, pairs of review authors independently assessed risk of bias for each randomised study and rated each potential source of bias as high, low, or unclear. ROBINS-I tool was used for the assessment of risk of bias in nonrandomised intervention studies. Where appropriate, random effects meta-analyses were conducted. Results A total of 24 studies (randomised controlled trials [RCT] [n = 14]; Quasi-RCT [n = 1] and non-randomised design [n=9]) with 2278 participants were included. Included studies compared types of © EBD 2020:21.2 SUMMARY REVIEW/PPE AND HIGHLY INFECTIOUS DISEASES underpinning evidence and some areas are unlikely to ever have strong (or any) research evidence. 6 Research is urgently required to build evidence on what types of PPE, and which modifications provide most appropriate, manageable protection for members of the dental team to deliver care safely.

Exposure Risks and Preventive Strategies Considered in Dental Care Settings to Combat Coronavirus Disease (COVID-19)

“…The CDC also recommends the doffing methods like single-step removal of kit and separate removal, use of glove in glove, or bird beak method for glove removal. Dental care providers can be trained through educational videos, health education pamphlets, and government-initiated training programs (Using Personal Protective Equipment (PPE) CDC., 2019 ; Hegde, 2020 ). xi.…”

Personal Protective Equipment in COVID-19

“…Non-compliance donning and doffing of PPE may lead to increasing chances of contamination. 5 , 6 Besides individual difficulties, HCPs may also experience enormous challenges in team collaborations. They may need more time to recognize and build up team to each other as everyone is dressed in the same uniform.…”

Making the invisible visible: New perspectives on the intersection of human-environment interactions of clinical teams in intensive care

“…Reducing avoidable touch could contribute to reducing the number of high touch surfaces including peripheral computer interfaces, that may improve patient safety by reducing the hospital acquired infections associated to this 12,22,23 . There are additional efficiency and protective gains for healthcare workers who would be required to don and doff PPE less frequently 24 .…”