1School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Special Administrative Region of China, China.
2Hospital Authority, Hong Kong, Special Administrative Region of China, China.
Antimicrob Resist Infect Control. 2018 Dec 22;7:157. doi: 10.1186/s13756-018-0433-y. eCollection 2018.
Healthcare workers (HCWs) use personal protective equipment (PPE) in Ebola virus disease (EVD) situations. However, preventing the contamination of HCWs and the environment during PPE removal crucially requires improved strategies. This study aimed to compare the efficacy of three PPE ensembles, namely, Hospital Authority (HA) Standard Ebola PPE set (PPE1), Dupont Tyvek Model, style 1422A (PPE2), and HA isolation gown for routine patient care and performing aerosol-generating procedures (PPE3) to prevent EVD transmission by measuring the degree of contamination of HCWs and the environment.
A total of 59 participants randomly performed PPE donning and doffing. The trial consisted of PPE donning, applying fluorescent solution on the PPE surface, PPE doffing of participants, and estimation of the degree of contamination as indicated by the number of fluorescent stains on the working clothes and environment. Protocol deviations during PPE donning and doffing were monitored.
PPE2 and PPE3 presented higher contamination risks than PPE1. Environmental contaminations such as those originating from rubbish bin covers, chairs, faucets, and sinks were detected. Procedure deviations were observed during PPE donning and doffing, with PPE1 presenting the lowest overall deviation rate (%) among the three PPE ensembles ( 0.05).
Contamination of the subjects' working clothes and surrounding environment occurred frequently during PPE doffing. Procedure deviations were observed during PPE donning and doffing. Although PPE1 presented a lower contamination risk than PPE2 and PPE3 during doffing and protocol deviations, the design of PPE1 can still be further improved. Future directions should focus on designing a high-coverage-area PPE with simple ergonomic features and on evaluating the doffing procedure to minimise the risk of recontamination. Regular training for users should be emphasised to minimise protocol deviations, and in turn, guarantee the best protection to HCWs.
医护人员（HCWs）在埃博拉病毒病（EVD）情况下使用个人防护设备（PPE）。然而，在 PPE 去除过程中防止 HCWs 和环境受到污染至关重要，需要改进策略。本研究旨在比较三种 PPE 套装的功效，即医院管理局（HA）标准埃博拉 PPE 套装（PPE1）、杜邦特卫强型号 1422A（PPE2）和 HA 用于常规患者护理和进行气溶胶生成程序的隔离服（PPE3），以通过测量 HCWs 和环境的污染程度来预防 EVD 传播。
共有 59 名参与者随机进行 PPE 穿戴和脱卸。试验包括 PPE 穿戴、在 PPE 表面涂抹荧光溶液、参与者 PPE 脱卸以及根据工作服和环境上荧光痕迹的数量估计污染程度。监测 PPE 穿戴和脱卸过程中的方案偏差。
PPE2 和 PPE3 比 PPE1 具有更高的污染风险。检测到来自垃圾桶盖、椅子、水龙头和水槽等的环境污染物。在 PPE 穿戴和脱卸过程中观察到程序偏差，PPE1 是三种 PPE 套装中总体偏差率（%）最低的（0.05）。
在 PPE 脱卸过程中，受试者工作服和周围环境经常受到污染。在 PPE 穿戴和脱卸过程中观察到程序偏差。尽管 PPE1 在脱卸和协议偏差方面比 PPE2 和 PPE3 具有较低的污染风险，但 PPE1 的设计仍可以进一步改进。未来的方向应集中在设计具有简单人机工程学特征的高覆盖面积 PPE 上，并评估脱卸程序，以最大限度地降低再污染风险。应强调对使用者进行定期培训，以最大限度地减少协议偏差，并保证 HCWs 的最佳保护。
