Donning Of Personal Protective Equipment Research Articles

Effectiveness of Virtual Reality Training in Teaching Personal Protective Equipment Skills

Training on the proper use of personal protective equipment (PPE) is critical for infection prevention among health care workers. Traditional methods, such as face-to-face and video-based training, can strain resources and present challenges. To determine the effectiveness of 360° virtual reality (VR) training for PPE donning and doffing compared with face-to-face and video training in enhancing the PPE use skills of prospective health care practitioners. A blinded, prospective, and randomized noninferiority clinical trial was conducted from August to December 2021 at Teikyo University School of Medicine in Tokyo, Japan, with a mixed population of medical students. Participants were second- to fourth-year medicine, medical technology, or pharmacy students aged 20 years or older with no prior PPE training. Participants were randomized into 1 of 3 training groups (VR, face-to-face, or video) based on their enrollment order. An intention-to-treat analysis was conducted. A 30-minute lecture on PPE procedures was delivered to all participants before the training. After the lecture, the VR group trained with an immersive 360° VR tool, the face-to-face group trained with actual PPE, and the video group trained by watching video footage on a computer and a projector. After 3 days, a standardized practical skills test was administered. The primary outcome was the mean score on a 20-point practical skills test, and the secondary outcome was the percentage of correct execution. A total of 91 participants were recruited and randomized into 3 groups: VR (n = 30), face-to-face (n = 30), and video (n = 31) training. After excluding 1 participant due to illness, 90 participants (mean [SD] age, 24.2 [3.15] years; 54 males [60.0%]) completed the assessment. The mean (SD) scores were 17.70 (2.10) points for the VR group, 17.57 (2.45) points for the face-to-face group, and 15.87 (2.90) points for the video group. The VR group demonstrated no significant difference in performance from the face-to-face group. However, the VR group had significantly higher effectiveness than the video group (17.70 vs 15.87 points; P = .02). Results of this trial indicate that VR training was as effective as face-to-face training in enhancing PPE donning and doffing skills and was superior to video training. The findings suggest that VR training is a viable resource-conserving training option. Japan Registry of Clinical Trials Identifier: jRCT103021029.

Development of an Automated and Scalable Virtual Assistant to Aid in PPE Adherence: A Study with Implications for Applications within Anesthesiology.

Virtual assistants (VAs) are conversational agents that are able to provide cognitive aid. We developed a VA device for donning and doffing personal protective equipment (PPE) procedures and compared it to live human coaching to explore the feasibility of using VAs in the anesthesiology setting. An automated, scalable, voice-enabled VA was built using the Amazon Alexa device and Alexa Skills application. The device utilized voice-recognition technology to allow a touch-free interactive user experience. Audio and video step-by-step instructions for proper donning and doffing of PPE were programmed and displayed on an Echo Show device. The effectiveness of VA in aiding adherence to PPE protocols was compared to traditional human coaching in a randomized, controlled, single-blinded crossover design. 70 anesthesiologists, anesthesia assistants, respiratory therapists, and operating room nurses performed both donning and doffing procedures, once under step-by-step VA instructional guidance and once with human coaching. Performance was assessed using objective performance evaluation donning and doffing checklists. More participants in the VA group correctly performed the step of "Wash hands for 20 seconds" during both donning and doffing tests. Fewer participants in the VA group correctly performed the steps of "Put cap on and ensure covers hair and ears" and "Tie gown on back and around neck". The mean doffing total score was higher in the VA group; however, the donning score was similar in both groups. Our study demonstrates that it is feasible to use commercially available technology to create a voice-enabled VA that provides effective step-by-step instructions to healthcare professionals.

Front-Line Health Care Workers' COVID-19 Infection Contamination Risks: A Human Factors and Risk Analysis Study of Personal Protective Equipment.

Infectious risks escalate with complex donning and doffing personal protective equipment (PPE) protocols. Recent studies suggest that PPE donning and doffing behaviors that deviate from protocol during PPE reuse compounded the risks of health care worker (HCW) self-contamination. This study quantified the occurrence of behaviors associated with known risks in PPE use and reuse. We conducted a prospective study of emergency department HCWs and video-recorded PPE donning and doffing 5 times in simulated patient encounters. Trained coders recorded HCW behaviors according to an evidence-based guide. All 28 participants deviated from the Centers for Disease Control and Prevention (CDC) sanctioned donning and doffing protocol order, and most were documented to have (92.85%) self-contaminated at least once during each simulated clinical encounter. Behaviors that compounded self-contamination due to PPE reuse were also observed. Wide variation in PPE donning and doffing behaviors was found among front-line, experienced HCWs. Future work is needed to determine which deviations put HCWs at increased risk for accidental self-contamination and what changes are needed to the CDC protocol for protecting HCW from infections.

The PATH to PPE Mastery - Programme for Assessment and Training in HCID (High Consequence Infectious Diseases) PPE (Personal Protective Equipment), Mastery

High Consequence Infectious Diseases (HCIDs), have the potential to cause pandemics and require particular focus for preparedness due to their high mortality rates. The application of Personal Protective Equipment (PPE) for HCIDs is complex and carries significant risk of Health Care Worker (HCW) contamination if done incorrectly. Previous reviews have reported a lack of information on the nature of training provided and the ideal timing of repeat training to best retain skills. Simulation Based Mastery Learning (SBML) is a methodology for skill acquisition which encompasses deliberate practice and repeated assessment until the learner achieves a pre-set Mastery standard. SBML has been demonstrated to improve competence, skill retention and patient outcomes in other clinical procedures. SBML has not been previously studied or utilised in HCID PPE training. We aimed to increase the likelihood of safe clinical practice by evidencing that Lothian modified SBML for PPE effectively prepares our priority learners. A quasi-experimental within group post-test design was used. Learners undertook a modified SBML programme which included two-hour asynchronous and two-hour synchronous components. 11 learners (10 infectious diseases registrars and 1 infectious diseases consultant) were enrolled in the programme with 8 completing all stages, all of whom achieved the Mastery passing standard. The resources were highly rated by learners with the exemplar videos of skills highlighted as particularly useful. Self-assessed preparedness for each skill increased following pre-learning and synchronous sessions. Modified SBML can be used as an effective methodology for the training and assessment of HCWs in the donning and doffing of HCID PPE.

Contamination of SARS-CoV-2 RNA on personal protective equipment and environmental surfaces in nonpatient entry area of a Fangcang shelter hospital.

To determine the extent of contamination of personal protective equipment (PPE) and surfaces by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the nonpatient entry area of a Fangcang shelter hospital, the medical staff accommodation area, and the staff transport bus. We collected 816 samples from the nonpatient entry area and floors in a Fangcang shelter hospital, medical staff accommodation area, and scheduled bus, and the five major types of PPE used from April 13 to May 18, 2022. SARS-CoV-2 ribonucleic acid (RNA) was detected by reverse transcription-polymerase chain reaction. Overall, 22.2% of PPE samples were positive for SARS-CoV-2 RNA. Boot covers and gowns were the most contaminated types of PPE. The positive PPE contamination rate of staff collecting respiratory specimens was significantly higher than that of the general-treatment staff group (35.8% vs. 12.2%) and cleaner group (35.8% vs. 26.4%), p < 0.01. In total, 27 of 265 (10.2%) environmental surface samples were positive for SARS-CoV-2 RNA. The contamination-positive rates were 26.8% (22/82), 5.4% (4/74), and 0.9% (1/109) for contaminated, potentially contaminated, and clean zones, respectively. SARS-CoV-2 RNA was frequently detected on objects such as mobile phones, tables, computer keyboards and mice, and door handles. SARS-CoV-2 RNA was widely distributed on high-touch surfaces and on PPE in the contaminated zone of the Fangcang shelter hospital, implying a potentially high infection risk for healthcare workers. Our findings emphasize the need to ensure adequate environmental cleaning, improve hand hygiene, and reduce the risk of infection. Additionally, prevention of self-contamination during PPE donning and doffing is complex and needs more research.

Assessing personal protective equipment compliance in a polish healthcare setting during the COVID-19 pandemic – A pilot case study

Objective: The purpose of this study is to identify failures in proper Personal Protective Equipment (PPE) usage in a healthcare hospital environment to enhance PPE compliance through proper donning and doffing procedures.Methods: We used naturalistic observation (shadowing) of PPE donning and doffing by healthcare medical staff in their hospital work setting to identify non-conformities to compliant donning and doffing of PPE.Results: We found an average of 1.84 non-conformances per healthcare worker across the donning procedures and 2.06 non-conformances in the doffing procedures per healthcare provider. Nurses experienced 1.94 average non-conformances in the donning procedures, while physicians average 1.75 non-conformances. Nurses experienced 2.29 average doffing nonconformances, while physicians averaged 1.85 average doffing non-conformances during the study. PPE compliance is critical to protect both healthcare workers and patients in the healthcare setting, as well as building a culture of safety.Research implications: Appropriate training and compliance should be performed to ensure appropriate PPE donning and doffing protocols are adhered to, so that it reduces the transmission of disease and infections. Future studies will explore the environmental, cultural and operational factors that contribute to PPE compliance in healthcare.Conclusions: This is the first study to quantify donning and doffing errors of personal protective compliance within the realm of environmental and cultural impacts.

Personal Protective Equipment Protocols Lead to a Delayed Initiation of Patient Assessment in Mountain Rescue Operations.

van Veelen, Michiel J., Giulia Roveri, Ivo B. Regli, Tomas Dal Cappello, Anna Vögele, Michela Masè, Marika Falla, and Giacomo Strapazzon. Personal protective equipment protocols lead to a delayed initiation of patient assessment in mountain rescue operations. High Alt Med Biol. 24:127-131, 2023. Introduction: Mountain rescue operations can be challenging in austere environmental conditions and remote settings. Airborne infection prevention measures include donning of personal protective equipment (PPE), potentially delaying the approach to a patient. We aimed to investigate the time delay caused by these prevention measures. Methods: This randomized crossover trial consisted of 24 rescue simulation trials intended to be as realistic as possible, performed by mountain rescue teams in difficult terrain. We analyzed the time needed to perform an airborne infection prevention protocol during the approach to a patient. Time delays in scenarios involving patients already wearing versus not wearing face masks and gloves were compared using a linear mixed model Results: The airborne infection prevention measures (i.e., screening questionnaire, hand antisepsis, and donning of PPE) resulted in a time delay of 98 ± 48 (26-214) seconds on initiation of patient assessment. There was a trend to a shorter time to perform infection prevention measures if the simulated patient was already wearing PPE consisting of face mask and gloves (p = 0.052). Conclusion: Airborne infection prevention measures may delay initiation of patient assessment in mountain rescue operations and could impair clinical outcomes in time-sensitive conditions. Trial registration number 0105095-BZ Ethics Committee review board of Bolzano.

Reinventing Medical Hazardous Materials Response for Radiological Emergencies: Building Resiliency in Emergency Medical Response Systems Through a Novel Approach to Education and Training

Introduction:The past three years have included multiple Public Health Emergencies of International Concern (PHEIC) and dramatically impacted all facets of Emergency Medical Response. During this time, simultaneous crises have demonstrated the value of the non-traditional responder in mitigating complex incidents. Current geopolitical climate has proliferated nuclear power and increases the necessity for readiness and awareness for radiological incidents. These are complex incidents a responder may face and requires even the lowest skilled practitioner to be fully engaged before special operations intervention.Limited research exists to determine whether current emergency medical services (EMS) training supplies the competency necessary to ensure safety of the prehospital provider during a radiological incident. Forthcoming research will investigate the effectiveness of this current training within the United States.Method:Survey data will be collected from multiple providers across the United States to evaluate their confidence level on two primary objectives during a radiological incident: competency of personal protective equipment donning and doffing, and management of contaminated patients.Data analyses of survey responses help drive future proposed educational activities that will be compliant with best practices set forth by organizations such as the United States Department of Health and Human Services Radiation Emergency Medical Management (REMM), the National Fire Protection Agency (NFPA), and Radiation Emergency Assistance Center/ Training Site (REAC/TS).Results:Data will be collected by survey responses to evaluate a diverse range of EMS services. Details such as skill level, type of EMS service, catchment of communities served, and their impressions upon the training will be analyzed.Conclusion:This is an ongoing project that will embrace the perspectives of the diverse group of delegates of WADEM throughout and become enriched through the organization's wealth of knowledge. Gaps highlighted during roll-out of this research can also be used to address logistics, doctrine, and policy shortfalls.

Assessment of knowledge, accessibility, and adherence to the use of personal protective equipment and standard preventive practices among healthcare workers during the COVID-19 pandemic.

Healthcare workers are at risk of acquiring infectious agents while providing services to patients. Thus, the need for evaluating and closely monitoring healthcare worker knowledge, perception, and adherence levels is critical. This study evaluates the knowledge, accessibility, and adherence regarding personal protective equipment (PPE) and preventive protocols among healthcare workers during the COVID-19 pandemic. A web-based cross-sectional survey was conducted from March to September 2021. The study participants were 187 healthcare workers who replied to a 31-item questionnaire using an online tool. A total of 187 participants responded to the questionnaire. Most of the participants 102 (54.5%) were in the age group of 25-34 years. Of the 187 participants, 98 (52.4%) were medical doctors, and 92 (49.2%) had correct knowledge regarding donning and doffing of PPE. The vast majority (93.7%) had access to essential PPE. The average adherence level was 82.1%. Accessibility (p = 0.003) and adherence (p < 0.01) were found to be significantly high in older age participants. The study showed most of the healthcare workers had appropriate knowledge and, they also adhered to the proper use of PPE and infection control protocols. However, few of them identified with poor knowledge about COVID-19, inappropriate doffing of PPE, non-adherence to the protocol, and unacceptable practices. We recommend the provision of adequate training that will lead to minimizing the risk of exposure to and transmission of COVID-19 among healthcare providers.

Assessing efficacy of instructor based orientation to donning doffing protocols and modifications to doffing area infrastructure in reducing SARS-CoV-2 infection among Doctors assigned to COVID-19 patient care

We assess the efficacy of orientation programmes for doctors of proper donning, doffing techniques for personal protective equipment (PPE) and safe practices inside the COVID-19 hospital in reducing the COVID-19 infection rate among doctors. A total of 767 resident doctors and 197 faculty visits on weekly rotation were recorded over a six month period. Doctors were guided through orientation sessions before their entry into the COVID-19 hospital from 1 August 2020. The infection rate among doctors was used to study the efficacy of the programme. McNemars Chi-square test was used to compare the infection rate in the two groups before and after orientation sessions were commenced. A statistically significant reduction in SARS-CoV-2 infection was seen among resident doctors after orientation programmes and infrastructure modification (3% vs 7.4%, P=0.03). Twenty-eight of 32 (87.5%) doctors who tested positive developed asymptomatic to mild infection. The infection rate was 3.65% and 2.1% among residents and faculty respectively. There was no mortality recorded. Orientation programme for healthcare workers for PPE donning and doffing protocols with practical demonstration and trial of PPE usage can significantly reduce COVID-19 infection. Such sessions should be mandatory for all workers on deputation in designated area for Infectious Diseases and in pandemic situations.

Staying proper with your personal protective equipment: How to don and doff

IntroductionThe global COVID-19 pandemic highlighted the importance of protecting frontline healthcare workers from novel respiratory infections while also exposing the limited instruction that medical students receive on proper donning of personal protective equipment (PPE) and more importantly the safe doffing of contaminated PPE to minimize their risk of nosocomial infection. The best methods of providing this kind of instruction have not yet been determined. MethodsAnesthesiology interns and CA-1 residents were trained on proper PPE donning and doffing for AGPs using a methodology based on Miller's pyramid and following a “knows-knows how-shows-does” progression. Participants donned PPE without instruction and were sprayed with Glo Germ® to identify areas of contamination, after which they received both video and in-person instruction on best practices for donning and doffing PPE for AGPs. Following instruction, they again donned PPE and were sprayed with Glo Germ® to identify areas of contamination. Results54 participants completed the study. Before training, overall donning compliance was 60% and overall doffing compliance was 48%. Overall, 70% were contaminated after PPE doffing, with 46% having multiple sites of contamination. After training, donning compliance increased by nearly 30% (P < 0.001), doffing compliance increased by over 20% (P < 0.001), and overall contamination decreased by nearly 30% (P = 0.029), with multiple-site contamination decreasing to only 6% (P = 0.013). DiscussionWhile best methods for providing instruction regarding topics such as PPE donning and doffing have not yet been determined, we have demonstrated that the underlying knowledge base from medical school regarding proper donning and doffing for respiratory isolation is insufficient for preventing self-contamination, and that Miller's pyramid-based training using both video and in-person instruction combined with task execution by learners can improve compliance with PPE donning and doffing protocols and more importantly decrease skin contamination among a group of early training anesthesiology residents.

The Impact of COVID-19 on Pediatric Cardiac Arrest Outcomes: A Systematic Review and Meta-Analysis.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic, required the donning of personal protective equipment during clinical contact, and continues to be a significant worldwide public health concern. Pediatric cardiac arrest is a rare but critical condition with a high mortality rate, the outcomes of which may be negatively affected by donning personal protective equipment. The aim of this study is to perform a systematic review and meta-analysis of the impact of the COVID-19 pandemic on pediatric cardiac arrest outcomes. We conducted a systematic review with meta-analysis in the following databases: PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library from their inception to 1 October 2022. We included studies published in English on pediatric patients with cardiac arrest, dichotomized by the pre- and during-COVID-19 periods and then stratified by COVID-19 positive or negative status, to evaluate clinical outcomes associated with cardiac arrest. Six studies were included in the meta-analysis. In witnessed out-of-hospital cardiac arrest patients, there were no differences between the pandemic and pre-pandemic periods for witnessed cardiac arrest (28.5% vs. 28.7%; odds ratio (OR) = 0.99; 95% confidence interval (CI): 0.87 to 1.14; p = 0.93), administration of bystander cardiopulmonary resuscitation (61.5 vs. 63.6%; OR = 1.11; 95%CI: 0.98 to 1.26; p = 0.11), bystander automated external defibrillator use (both 2.8%; OR = 1.00; 95%CI: 0.69 to 1.45; p = 0.99), return of spontaneous circulation(8.4 vs. 8.9%; OR = 0.93; 95%CI: 0.47 to 1.88; p = 0.85), survival to hospital admission (9.0 vs. 10.2%, OR = 0.81; 95%CI: 0.45 to 1.44; p = 0.47), or survival to hospital discharge (13.4 vs. 12.4%; OR = 0.62; 95%CI: 0.22 to 1.72; p = 0.35). COVID-19 did not change pediatric cardiac arrest bystander interventions or outcomes.

A cross-sectional study on knowledge, attitude, and practices of donning and doffing of personal protective equipment: an institutional survey on interns during the COVID-19 pandemic

Background: Personal protective equipment (PPE) is a physical barrier that healthcare workers (HCW) wear to stop the transmission of a pathogen from a pathologic specimen or a confirmed or suspected case. It prevents the spread of disease from patient to HCWs as well as the other way around. Eyewear, face shield, surgical mask, particulate respirators, glove, disposable gowns and boots, and head coverings are some examples of these physical barriers. The primary objective of the study is to assess the knowledge, attitude and practices (KAP) of interns towards appropriate use of PPE and secondary objective is to find the role of training on donning and doffing of PPE of interns towards appropriate use of PPE.Methods: This is an institutional based, analytical cross-sectional study. Data was collected from interns (n=130) posted in COVID-19 ward using a universal sampling method. A predesigned questionnaire was used for study. The data was analyzed using SPSS 26 trial versionResults: Interns were aware of the importance and criticality of donning and doffing procedure, overall level of KAP of donning and doffing of PPE were 96.90%, 73.10% and 86.20% respectively. We found that there was statistically significant mean difference between the KAP scores with respect to training of PPE.Conclusions: There were some gaps in KAP at institutional level among the interns with regards to donning and doffing of PPE during the beginning of this pandemic.

1922. Outbreak and Management of COVID-19 and Infection Prevention Control Practices at a Community Living Center in Veterans Administration Hospital, North Texas

Abstract Background The increase in SARS-CoV-2 cases due to the omicron wave led to significant utilization of healthcare resources and reduced acute care hospital beds at the Veterans Administration Hospital, North Texas Health Care System (VANTHCS). As a result, veterans with non-severe disease were managed at a VANTHCS community living center (CLC) during a COVID-19 outbreak. Methods Veterans residing at the CLC with laboratory-confirmed cases of SARS-CoV-2 (the virus that causes COVID-19) by polymerase chain reaction diagnosed from January 1 to February 15, 2022, were included in the descriptive analysis. We described resident characteristics and outcomes and infection control practices (IPC) implemented to control the outbreak. Resident data was ascertained from the COVID-19 facility dashboard and medical record system. Results From January 1–February 15, 2022, 33 adults residing at the CLC were diagnosed COVID-19. Most infections (93.9%) occurred between January 12–24 (figure 1). The median age was 76 years [interquartile range, 71–80 years] and 30 (90.9%) were men and 25 (75.8%) were white and 5 (15.2%) African American (table 1). Among the total cases, 9 (27.3%) resided in the dementia unit. Nineteen of 33 (57.6%) were asymptomatic. Overall, 28 (84.8%) were documented to be fully vaccinated against SARS-CoV-2 and 24 (72.7%) were boosted. Obesity, ischemic heart disease, chronic obstructive pulmonary disease, and stroke were the most common comorbidities. Residents were cohorted based on COVID-19 results. A multidisciplinary team was convened, and staff were fit tested for appropriate personal protective equipment (PPE) and received refresher training on hand hygiene, donning and doffing of PPE. Most residents were determined to have mild or moderate COVID-19 and managed at the CLC while 7 (21.2%) were hospitalized in the acute care hospital. For management of COVID-19, 11 (33.3%) received dexamethasone and 25 (75.8%) received remdesivir. Overall, 32 (97%) residents survived while one hospice resident was transferred to acute care and died; only 1 resident required ICU admission. Epidemic curve of laboratory-confirmed coronavirus disease 2019 (COVID-19) disease at a Community Living Center, Veterans Administration Hospital, North Texas Health Care System, January–February 2022. Table 1Epidemiological Characteristics, and Outcomes of Laboratory-confirmed COVID-19 cases (N=33)Abbreviation: BMI, body mass index; COPD, Chronic Obstructive Pulmonary Disease; ESRD, end stage renal disease1Other comorbidity (asthma n=1 and chronic liver disease n=2) Conclusion It is feasible to administer COVID-19 therapies to high-risk residents with mild-moderate disease in a CLC with a multidisciplinary team and IPC strategies. Disclosures All Authors: No reported disclosures.

Assessing knowledge and behavioral pattern of nurses working in wards of four major specialties in Colombo South Teaching Hospital during the COVID-19 outbreak

In the latter part of 2019, a severe respiratory disease was reported in China and was found to be an outbreak of Coronavirus. In March 2020, with the rapid increase of patients in many other countries, World Health Organization (WHO) declared COVID-19 as a pandemic. As one of the frontline workers providing care to patients with COVID-19, nurses are at risk of developing the illness, if not geared up with appropriate Personal Protective Equipment (PPE). The infected number would rise rapidly if no adequate knowledge on basic preventive measures or no appropriate behavior patterns are adopted by the nurses. A descriptive cross-sectional study was conducted from 1st to 31st December 2020, in Colombo South Teaching Hospital to assess knowledge and the impact of the pandemic on the behavioral pattern of nurses using a self-administered questionnaire. The total number of nurses who responded to the study was 155. Study indicates that nurses have sufficient knowledge of COVID-19, its contagiousness, transmission, prevention, and educating patients. The measures taken by the administration along with the relevant authorities in the institution during the initial phase of the pandemic were helpful to acquire such knowledge. Comprehensive training on donning and doffing of PPEs and other infection prevention practices is recommended as a Continuous Professional Development program.

Attitude of the Dental Undergraduate Students and Interns towards Dentistry Post COVID-19

Abstract Introduction The period of coronavirus disease 19 (COVID-19) is a significant period from various aspects such as world health and socioeconomic considerations. The majority of the hospitals involved in dental education had previously limited their clinical practices to dental emergencies, but now are geared up for nonemergent conditions. As teaching modalities shifted to online platforms, students have reported to be anxious with regard to accomplishment of required clinical skills, patient care, and forthcoming graduation. Fresh graduates have reported a delay in the drive, which they would have been able to achieve in the initial stages of their profession. Objectives To assess the attitude of the dental undergraduate students and interns toward dentistry post-COVID-19. Results The majority (80.2%) were prepared for the challenges lying ahead before beginning to work on patients. Also, 16% were willing to treat patients, 28% did not want to treat patients, while 44% were willing to handle emergency cases. Next, 67.8% were scared of infecting themselves while administering dental treatment and 78.9% were concerned that there could be more such pandemics. In total, 21.6% of the respondents who wished that they chose an alternate profession whereas 70.5% of participants felt that the scope of dentistry has not diminished. Also, 90.7% were interested to pursue postgraduation, and 86.3% felt that this was a passing phase and things would be normalized soon. Conclusion With second and third waves being rampant, novel coronavirus has become a public health crisis. Because dental services cannot be stopped for a long time, it is essential for dental students to be well trained to limit the spread of the disease. Owing to the present scenario, appropriate donning and doffing of PPE (personal protective equipment) is a pivotal step in direct patient care, and simulation-based training may help ensure that these skills are acquired by them.

Assessment of dental health care personnel protocol deviations and self-contamination during personal protective equipment donning and doffing

BackgroundDental health care personnel (DHCP) may be at increased risk of exposure to severe acute respiratory syndrome coronavirus 2, the virus that causes COVID-19, as well as other clinically important pathogens. Proper use of personal protective equipment (PPE) reduces occupational exposure to pathogens. The authors performed an assessment of PPE donning and doffing practices among DHCP, using a fluorescent marker as a surrogate for pathogen transmission. MethodsParticipants donned PPE (that is, disposable gown, gloves, face mask, and eye protection) and the fluorescent marker was applied to their palms and abdomen. DHCP then doffed PPE according to their usual practices. The donning and doffing processes were video recorded, areas of fluorescence were noted, and protocol deviations were assessed. Statistical analyses included frequency, type, and descriptions of protocol deviations and factors associated with fluorescence. ResultsSeventy DHCP were enrolled. The donning and doffing steps with the highest frequency of protocol deviations were hand hygiene (66% of donning and 78% of doffing observations involved a deviation) and disposable gown use (63% of donning and 60% of doffing observations involved a deviation). Fluorescence was detected on 69% of DHCP after doffing, most frequently on hands. An increasing number of protocol deviations was significantly associated with increased risk of fluorescence. DHCP with a gown doffing deviation, excluding doffing out of order, were more likely to have fluorescence detected. ConclusionsDHCP self-contamination was common with both donning and doffing PPE. Practical ImplicationsProper use of PPE is an important component of occupational health.

How Can Personal Protective Equipment Be Best Used and Reused: A Closer Look at Donning and Doffing Procedures.

The aim of this study was to examine safety-related contamination threats and risks to health-care workers (HCWs) due to the reuse of personal protective equipment (PPE) among emergency department (ED) personnel. We used a Participatory Design (PD) approach to conduct task analysis (TA) of PPE use and reuse. TA identified the steps, risks, and protective behaviors involved in PPE reuse. We used the Centers for Disease Control and Prevention (CDC) guidance for PPE donning and doffing specifying the recommended task order. Then, we convened subject matter experts (SMEs) with relevant backgrounds in Patient Safety, Human Factors and Emergency Medicine to iteratively identify and map the tasks, risks, and protective behaviors involved in the PPE use and reuse. Two emerging threats were associated with behaviors in donning, doffing, and re-using PPE: (i) direct exposure to contaminant, and (ii) transmission/spread of contaminant. Protective behaviors included: hand hygiene, not touching the patient-facing surface of PPE, and ensuring a proper fit and closure of all PPE ties and materials. TA was helpful revealed that the procedure for donning and doffing of re-used PPE does not protect ED personnel from contaminant spread and risk of exposure, even with protective behaviors present (e.g., hand hygiene, respirator use, etc.). Future work should make more apparent the underlying risks associated with PPE use and reuse.

Corona virus pandemic response among health workers in selected health facilities in Meru County

Corona virus pandemic response among health workers in selected health facilities in Meru County

Compliance to donning and doffing of personal protective equipment among dental healthcare practitioners during the coronavirus pandemic: a quality improvement plan, do, study and act (PDSA) Initiative

IntroductionWith the emergence of SARS-Cov-2, the Centers for Disease Control and Prevention (CDC) defined mandatory guidelines for donning and doffing personal protective equipment (PPE) among dental healthcare professionals. The study’s...