a College of Medicine , University of Illinois at Chicago , Chicago , Illinois.
b School of Public Health , University of Illinois at Chicago , Chicago , Illinois.
J Occup Environ Hyg. 2019 Aug;16(8):582-591. doi: 10.1080/15459624.2019.1628966. Epub 2019 Jul 8.
During the 2014-2015 Ebola Virus Disease (EVD) outbreak, hospitals in the United States selected personal protective equipment (PPE) and trained healthcare personnel (HCP) in anticipation of receiving EVD patients. To improve future preparations for high-consequence infectious diseases, it was important to understand factors that affected PPE selection and training in the context of the EVD outbreak. Semistructured interviews were conducted with HCP involved with decision-making during EVD preparations at acute care hospitals in the Chicago, IL area to gather information about the PPE selection and training process. HCP who received training were surveyed about elements of training and their perceived impact and overall experience by email invitation. A total of 28 HCP from 15 hospitals were interviewed, and 55 HCP completed the survey. Factors affecting PPE selection included: changing guidance, vendor supply, performance evaluations, and perceived risk and comfort for HCP. Cost did not affect selection. PPE acquisition challenges were mitigated by: sharing within hospital networks, reusing PPE during training, and improvising with existing PPE stock. Selected PPE ensembles were similar across sites. Training included hands-on activities with trained observers, instructional videos, and simulations/drills, which were felt to increase HCP confidence. Many felt refresher training would be helpful. Hands-on training was perceived to be effective, but there is a need to establish the appropriate frequency of refresher training frequency to maintain competence. Lacking confidence in the CDC guidance, interviewed trainers described turning to other sources of information and developing independent PPE evaluation and selection. Response to emerging and/or high consequence infectious diseases would be enhanced by transparent, risk-based guidance for PPE selection and training that addresses protection level, ease of use, ensembles, and availability.
在 2014-2015 年埃博拉病毒病（EVD）疫情期间，美国的医院选择个人防护设备（PPE）并培训医疗保健人员（HCP），以准备接收 EVD 患者。为了提高未来对高后果传染病的准备，了解影响 PPE 选择和培训的因素在 EVD 疫情期间是很重要的。在伊利诺伊州芝加哥地区的急症护理医院参与 EVD 准备决策的 HCP 进行了半结构化访谈，以收集有关 PPE 选择和培训过程的信息。通过电子邮件邀请接受培训的 HCP 对培训内容及其感知影响和总体体验进行了调查。共有来自 15 家医院的 28 名 HCP 接受了采访，55 名 HCP 完成了调查。影响 PPE 选择的因素包括：不断变化的指导意见、供应商供应、绩效评估以及 HCP 的感知风险和舒适度。成本不会影响选择。通过以下方式减轻了 PPE 获取方面的挑战：在医院网络内共享、在培训期间重复使用 PPE 以及用现有 PPE 库存进行即兴创作。选定的 PPE 套件在各个站点之间相似。培训包括有训练有素的观察员的实践活动、教学视频和模拟/演练，这些都被认为可以增强 HCP 的信心。许多人认为需要进行复习培训。实践培训被认为是有效的，但需要确定适当的复习培训频率，以保持能力。由于对疾病预防控制中心指导意见缺乏信心，接受采访的培训师描述了转向其他信息来源，并对 PPE 评估和选择进行独立评估。通过透明、基于风险的 PPE 选择和培训指南来应对新出现的和/或高后果传染病，该指南涵盖保护级别、易用性、套件和可用性，将增强对传染病的应对能力。
