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US health workers ‘not removing protective gear correctly’

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Fewer than one in six healthcare workers followed all US recommendations for the removal of personal protective equipment (PPE) after patient care, according to a small study.

The researchers who carried out the study noted that removal of personal protective equipment was “crucial” to reduce contamination of healthcare workers, especially in the current era of emerging pathogens such as ebola.

In their study, a trained observer watched healthcare personnel entering and exiting patient rooms specified as following isolation precautions on various units of the hospital.

“Only about half of health care workers correctly remove their PPE, and very few remove their PPE in the correct order and dispose of it in the proper location”

Study authors

Isolation precautions are used to help stop the spread of germs from one person to another and may require use of gowns, gloves, and face protection. Observations took place during October 2014.

The study authors highlighted that the US Centers for Disease Control and Prevention recommended that gloves should be removed first, followed by the gentle removal of the gown from the back while still in the patient’s isolation room.

But they found only about half of healthcare workers observed correctly removed their PPE, and very few removed it in the correct order and disposed of it in the proper location.

Of the 30 healthcare workers observed removing equipment, 17 removed the gown out of order, 16 wore their equipment out into the hallway, and 15 removed their gown in a manner that was not gentle, which could cause pathogens from the gown to transfer to their clothes.

“As a result of the current Ebola outbreak, the critical issue of proper PPE removal has come front and centre,” said the researchers from the University of Wisconsin.

“Healthcare facilities should use this opportunity of heightened interest to undertake practice improvement focused on PPE removal protocol, including technique, for all healthcare-associated conditions that require the donning and doffing of PPE,” they added.

The study was published as a brief report in the American Journal of Infection Control.

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