Nearly 40% of healthcare workers make errors when removing personal protective equipment

Mistakes in putting on or taking off personal protective equipment open up healthcare workers to risk of contamination with multidrug-resistant organisms, according to a study published in Infection Control & Hospital Epidemiology.

Researchers conducted the study at four adult intensive care units in one tertiary-care teaching hospital. They included 125 healthcare workers in the study, who cared for patients on contact precautions for methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococci or multidrug-resistant gram-negative bacilli. Of the 125 healthcare workers, 66.4 percent were nurses and 19.2 percent were physicians.

Researchers collected 6,000-plus samples from healthcare workers' hands, gloves, personal protective equipment and other equipment, such as stethoscopes and mobile phones. They collected cultures before and after patient interaction.

The researchers also observed the technique each worker used to put on and remove their personal protective equipment. The CDC suggests two personal protective equipment removal methods: a gloves-first approach and an approach that involves removing gown and gloves together. Researchers tracked these two methods as well as a third approach, wherein workers removed their gown first.

The study shows 36 percent of healthcare workers were contaminated with a multidrug-resistant organism, and after removing their personal protective equipment, 10.4 percent of workers were contaminated on their hands, clothes or equipment.

Researchers also found 39.2 percent of workers made multiple doffing errors, and they were more likely to have contaminated clothes following a patient interaction. However, the error rate correlated with personal protective equipment removal method. A majority of healthcare workers (72 percent) who used the glove-first removal approach made multiple errors, such as touching the inside of the gown or glove with a gloved hand.

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