Personal Protection Equipment: Preliminary Evidence of Effectiveness from a Three-phase Simulation Program

Overview

Journal J Infect Prev

Publisher Sage Publications

Date 2023 Nov 16

PMID 37969467

Authors

Ghazwan Altabbaa

Corrinne Pidhorney

Tanya Beran

Joseph Kim

Donna Ledgerwood

Michele Cowan

Elizabeth Oddone Paolucci

Affiliations

Soon will be listed here.

Abstract

Background: Healthcare providers carry the occupational risk of being exposed to pathogens. Personal Protection Equipment (PPE) requires proficiency whenever used. Yet, evidence shows significant errors and variation in competency when applying PPE.

Objective: In this study, we developed a three-phase intervention to promote PPE proficiency.

Methods: Education and assessment of participants' PPE knowledge and skills occurred at a large academic university in Western Canada. Participants first completed an online module; second, they experienced one-on-one coaching and deliberate practice with infection control professionals; and third, participants managed a COVID-19 clinical simulation scenario. The measured outcomes include a 15-item pre- and post-knowledge test and a pre- and post-skills assessment of donning and doffing behaviors. These behaviors were observed from video recordings and were assessed using two standardized checklists.

Results: Knowledge and donning/doffing post-test scores (11.73, 0.95, and 0.96, respectively) were significantly higher after completing all three phases of the educational intervention, < .001.

Conclusions: An online module alone is insufficient for PPE knowledge and skill development. Rather, a module followed by practice and simulation allows learners to gain proficiency.

Citing Articles

Effectiveness of donning and doffing personal protective equipment education using video debriefing among Korean undergraduate nursing students.

Yeom G, Park J BMC Nurs. 2024; 23(1):712.

PMID: 39363171 PMC: 11451162. DOI: 10.1186/s12912-024-02370-5.

References

Huttunen R, Syrjanen J . Healthcare workers as vectors of infectious diseases. Eur J Clin Microbiol Infect Dis. 2014; 33(9):1477-88. DOI: 10.1007/s10096-014-2119-6. View

Chou R, Dana T, Buckley D, Selph S, Fu R, Totten A . Update Alert 10: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers. Ann Intern Med. 2021; 175(1):W8-W9. PMC: 8593888. DOI: 10.7326/M21-4294. View

Au K, Lam D, Garg N, Chau A, Dzwonek A, Walker B . Improving skills retention after advanced structured resuscitation training: A systematic review of randomized controlled trials. Resuscitation. 2019; 138:284-296. DOI: 10.1016/j.resuscitation.2019.03.031. View

Tomas M, Kundrapu S, Thota P, Sunkesula V, Cadnum J, Mana T . Contamination of Health Care Personnel During Removal of Personal Protective Equipment. JAMA Intern Med. 2015; 175(12):1904-10. DOI: 10.1001/jamainternmed.2015.4535. View

Ferrer R, Klein W, Avishai A, Jones K, Villegas M, Sheeran P . When does risk perception predict protection motivation for health threats? A person-by-situation analysis. PLoS One. 2018; 13(3):e0191994. PMC: 5832213. DOI: 10.1371/journal.pone.0191994. View

Curtis H, Trang K, Chason K, Biddinger P . Video-Based Learning vs Traditional Lecture for Instructing Emergency Medicine Residents in Disaster Medicine Principles of Mass Triage, Decontamination, and Personal Protective Equipment. Prehosp Disaster Med. 2018; 33(1):7-12. DOI: 10.1017/S1049023X1700718X. View

Casanova L, Rutala W, Weber D, Sobsey M . Effect of single- versus double-gloving on virus transfer to health care workers' skin and clothing during removal of personal protective equipment. Am J Infect Control. 2011; 40(4):369-74. PMC: 7115263. DOI: 10.1016/j.ajic.2011.04.324. View

Patel L, Kozikott S, Ilboudo R, Kamateeka M, Lamorde M, Subah M . Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative. BMJ Glob Health. 2021; 6(6). PMC: 8182752. DOI: 10.1136/bmjgh-2021-005833. View

Ward D . The role of education in the prevention and control of infection: a review of the literature. Nurse Educ Today. 2010; 31(1):9-17. DOI: 10.1016/j.nedt.2010.03.007. View

10.

Faul F, Erdfelder E, Buchner A, Lang A . Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009; 41(4):1149-60. DOI: 10.3758/BRM.41.4.1149. View

11.

Bourgeault I, Maier C, Dieleman M, Ball J, MacKenzie A, Nancarrow S . The COVID-19 pandemic presents an opportunity to develop more sustainable health workforces. Hum Resour Health. 2020; 18(1):83. PMC: 7602762. DOI: 10.1186/s12960-020-00529-0. View

12.

Kang H . Sample size determination and power analysis using the G*Power software. J Educ Eval Health Prof. 2021; 18:17. PMC: 8441096. DOI: 10.3352/jeehp.2021.18.17. View

13.

Knapp T . Why Is the One-Group Pretest-Posttest Design Still Used?. Clin Nurs Res. 2016; 25(5):467-72. DOI: 10.1177/1054773816666280. View

14.

Koo T, Li M . A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016; 15(2):155-63. PMC: 4913118. DOI: 10.1016/j.jcm.2016.02.012. View

15.

Kilmarx P, Clarke K, Dietz P, Hamel M, Husain F, McFadden J . Ebola virus disease in health care workers--Sierra Leone, 2014. MMWR Morb Mortal Wkly Rep. 2014; 63(49):1168-71. PMC: 4584541. View

16.

Kwon J, Burnham C, Reske K, Liang S, Hink T, Wallace M . Assessment of Healthcare Worker Protocol Deviations and Self-Contamination During Personal Protective Equipment Donning and Doffing. Infect Control Hosp Epidemiol. 2017; 38(9):1077-1083. PMC: 6263164. DOI: 10.1017/ice.2017.121. View

17.

Hung P, Choi K, Chiang V . Using interactive computer simulation for teaching the proper use of personal protective equipment. Comput Inform Nurs. 2014; 33(2):49-57. DOI: 10.1097/CIN.0000000000000125. View

18.

Hajar Z, Mana T, Tomas M, Alhmidi H, Wilson B, Donskey C . A crossover trial comparing contamination of healthcare personnel during removal of a standard gown versus a modified gown with increased skin coverage at the hands and wrists. Infect Control Hosp Epidemiol. 2019; 40(11):1278-1280. DOI: 10.1017/ice.2019.211. View

19.

Pokrajac N, Schertzer K, Poffenberger C, Alvarez A, Marin-Nevarez P, Winstead-Derlega C . Mastery Learning Ensures Correct Personal Protective Equipment Use in Simulated Clinical Encounters of COVID-19. West J Emerg Med. 2020; 21(5):1089-1094. PMC: 7514383. DOI: 10.5811/westjem.2020.6.48132. View

20.

Poller B, Hall S, Bailey C, Gregory S, Clark R, Roberts P . 'VIOLET': a fluorescence-based simulation exercise for training healthcare workers in the use of personal protective equipment. J Hosp Infect. 2018; 99(2):229-235. PMC: 7133760. DOI: 10.1016/j.jhin.2018.01.021. View