Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-28T11:47:28.110Z Has data issue: false hasContentIssue false
  • English
  • Français

Personal Protective Equipment for Infectious Disease Preparedness: A Human Factors Evaluation

Published online by Cambridge University Press:  13 June 2016

Tracey A. Herlihey ,
Stefano Gelmi ,
Christopher J. Flewwelling ,
Trevor N. T. Hall ,
Carleene Bañez ,
Plinio P. Morita ,
Paul Beverley ,
Joseph A. Cafazzo  and
Susy Hota
Tracey A. Herlihey*
Affiliation:
Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Canada
Stefano Gelmi
Affiliation:
Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Canada
Christopher J. Flewwelling
Affiliation:
Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Canada
Trevor N. T. Hall
Affiliation:
Emergency Preparedness & Ontario’s Emergency Medical Assistance Team, Sunnybrook Health Sciences Centre, Toronto, Canada
Carleene Bañez
Affiliation:
Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Canada
Plinio P. Morita
Affiliation:
Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Canada
Paul Beverley
Affiliation:
Emergency Preparedness, University Health Network, Toronto, Canada
Joseph A. Cafazzo
Affiliation:
Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada Institute of Biomaterials and Biomedical Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, Canada
Susy Hota
Affiliation:
Infection Prevention and Control Unit, University Health Network, Toronto, Canada University of Toronto, Department of Medicine, Division of Infectious Diseases, Toronto, Canada
*
Address correspondence to Tracey A. Herlihey, PhD, Healthcare Human Factors, Techna Institute, University Health Network, R. Fraser Elliott Bldg, 4th Fl, Toronto, Canada, M5G 2C4 ([email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

OBJECTIVE

To identify issues during donning and doffing of personal protective equipment (PPE) for infectious diseases and to inform PPE procurement criteria and design.

DESIGN

A mixed methods approach was used. Usability testing assessed the appropriateness, potential for errors, and ease of use of various combinations of PPE. A qualitative constructivist approach was used to analyze participant feedback.

SETTING

Four academic health sciences centers: 2 adult hospitals, 1 trauma center, and 1 pediatric hospital, in Toronto, Canada.

PARTICIPANTS

Participants (n=82) were representative of the potential users of PPE within Western healthcare institutions.

RESULTS

None of the tested combinations provided a complete solution for PPE. Environmental factors, such as anteroom layout, and the design of protocols and instructional material were also found to impact safety. The study identified the need to design PPE as a complete system, rather than mixing and matching components.

CONCLUSIONS

Healthcare institutions are encouraged to use human factors methods to identify risk and failure points with the usage of their selected PPE, and to modify on the basis of iterative evaluations with representative end users. Manufacturers of PPE should consider usability when designing the next generation of PPE.

Infect Control Hosp Epidemiol 2016;37:1022–1028

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 9 , September 2016 , pp. 1022 - 1028
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. WHO Ebola Response Team. Ebola virus disease in West Africa: the first 9 months of the epidemic and forward projections. N Engl J Med 2014;317:1481–1495.Google Scholar
2. World Health Organization (WHO). Statement on the 1st meeting of the IHR Emergency Committee on the 2014 Ebola outbreak in West Africa. WHO website. http://www.who.int/mediacentre/news/statements/2014/ebola-20140808/en/. Published 2014. Accessed December 2, 2015.Google Scholar
3. Public Health Agency of Canada (PHAC). Middle East respiratory syndrome coronavirus (MERS-CoV). Travel notice. PHAC website. http://www.phac-aspc.gc.ca/tmp-pmv/notices-avis/notices-avis-eng.php?id=108. Published February 24, 2016. Accessed April 7, 2016.Google Scholar
4. Decker, BK, Sevransky, JE, Barrett, K, Davey, RT, Chertow, DS. Preparing for critical care services to patients with Ebola. Ann Intern Med 2014;161:831–832.Google Scholar
5. Ki, M. What do we really fear? The epidemiological characteristics of Ebola and our preparedness. Epidemiol Health 2014;36:1–4.Google Scholar
6. Gostin, LO, Hodge, JG, Burris, S. Is the United States prepared for Ebola? JAMA 2014;312:2497–2498.Google Scholar
7. WHO. Interim infection prevention and control guidance for care of patients with suspected or confirmed filovirus haemorrhagic fever in health-care settings, with focus on Ebola. WHO website. http://www.who.int/csr/resources/publications/ebola/filovirus_infection_control/en/. Published 2014. Accessed December 2, 2015.Google Scholar
8. Centers for Disease Control and Prevention (CDC). Interim infection prevention and control recommendations for hospitalized patients with Middle East respiratory syndrome coronavirus (MERS-CoV). CDC website. http://www.cdc.gov/coronavirus/mers/infection-prevention-control.html. Updated June 2015. Accessed April 7, 2016.Google Scholar
9. Edmond, MB, Diekema, DJ, Perencevich, EN. Ebola virus disease and the need for new personal protective equipment. JAMA 2015;312:2495–2496.CrossRefGoogle Scholar
10. Morgan, DJ, Braun, B, Milstone, AM, et al. Lessons learned from hospital Ebola preparation. Infect Control Hosp Epidemiol 2015;36:627–631.Google Scholar
11. CDC. Guidance on personal protective equipment (PPE) to be used by healthcare workers during management of patients with confirmed Ebola or persons under investigation (PUIs) for Ebola who are clinically unstable or have bleeding, vomiting, or diarrhea in U.S. CDC website. http://www.cdc.gov/vhf/ebola/healthcare-us/ppe/guidance.html. Updated August 27, 2015. Accessed December 2, 2015.Google Scholar
12. WHO. Guidance for donning and doffing personal protective equipment (PPE) during management of patients with Ebola virus disease in U.S. hospitals. WHO website. http://www.cdc.gov/vhf/ebola/hcp/ppe-training/. Published 2014. Accessed December 2, 2015.Google Scholar
13. Larson, EL, Liverman, CT. Preventing transmission of pandemic influenza and other viral respiratory diseases: personal protective equipment for healthcare workers: update 2010. National Academies Press website. http://www.nap.edu/catalog/13027/preventing-transmission-of-pandemic-influenza-and-other-viral-respiratory-diseases. Published 2010. Accessed December 2, 2015.Google Scholar
14. Valdez, AM. Are you covered? Safe practices for the use of personal protective equipment. J Emerg Nurs 2015;41:154–157.Google Scholar
15. Fischer, WA, Hynes, NA, Perl, TM. Protecting health care workers from Ebola: personal protective equipment is critical but is not enough. Ann Intern Med 2014;161:753–754.Google Scholar
16. Tomas, ME, Kundrapu, S, Thota, P, et al. Contamination of health care personnel during removal of personal protective equipment. JAMA Intern Med 2015;175:1904–1910.Google Scholar
17. Salvendy, G. Handbook of Human Factors and Ergonomics. Hoboken, NJ: Wiley; 2012.Google Scholar
18. Creswell, JW. Qualitative Inquiry and Research Design. 3rd ed. Los Angeles: Sage; 2012.Google Scholar
19. Fetterman, DM. Ethnography: Step-by-Step. 3rd ed. Thousand Oaks, CA: Sage; 2010.Google Scholar
20. Mills, J, Bonner, A, Francis, K. Adopting a constructivist approach to grounded theory: implications for research design. Int J Nurs Pract 2006;12:8–13.Google Scholar
21. Vicente, KJ. Cognitive work analysis: toward safe, productive, and healthy computer-based work. Mahwah, NJ: Lawrence Erlbaum; 1999.Google Scholar
22. Beyer, H, Holtzblatt, K. Contextual Design: Defining Customer-Centered Systems. Burlington, MA: Morgan Kaufmann; 1997.Google Scholar
23. Guo, Y-P, Li, Y, Wong, TG, et al. Evaluation of different PPE ensembles in terms of sensation, usability, satisfaction and preference. J Fiber Bioeng Informatics 2009;2:126–136.Google Scholar
24. Barratt, R. Infection prevention and control lessons learned from the management of the first suspected Ebola virus disease case admitted to a New Zealand hospital. Healthc Infect 2015;20:78–80.Google Scholar
25. Casanova, L, Alfano-Sobsey, E, Rutala, WA, Weber, DJ, Sobsey, M. Virus transfer from personal protective equipment to healthcare employees’ skin and clothing. Emerg Infect Dis 2008;14:1291–1293.Google Scholar