Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-25T06:15:45.263Z Has data issue: false hasContentIssue false

The Impact of Environmental Design on Doffing Personal Protective Equipment in a Healthcare Environment: A Formative Human Factors Trial

Published online by Cambridge University Press:  02 May 2017

Tracey A. Herlihey*
Affiliation:
Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Canada
Stefano Gelmi
Affiliation:
Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Canada
Joseph A. Cafazzo
Affiliation:
Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Canada
Trevor N. T. Hall
Affiliation:
Emergency Preparedness & Ontario’s Emergency Medical Assistance Team, Sunnybrook Health Sciences Centre, Toronto, Canada
*
Address correspondence to Tracey A. Herlihey, PhD, CPsychol, Healthcare Human Factors, Techna Institute, University Health Network, R. Fraser Elliott Building, 4th Floor, Toronto, Canada, M5G 2C4 ([email protected]).

Abstract

OBJECTIVE

To explore the impact of environmental design on doffing personal protective equipment in a simulated healthcare environment.

METHODS

A mixed-methods approach was used that included human-factors usability testing and qualitative questionnaire responses. A patient room and connecting anteroom were constructed for testing purposes. This experimental doffing area was designed to overcome the environmental failures identified in a previous study and was not constructed based on any generalizable hospital standard.

RESULTS

In total, 72 healthcare workers from Ontario, Canada, took part in the study and tested the simulated doffing area. The following environmental design changes were tested and were deemed effective: increasing prominence of color-coded zones; securing disinfectant wipes and hand sanitizer; outlining disposal bins locations; providing mirrors to detect possible contamination; providing hand rails to assist with doffing; and restricting the space to doff. Further experimentation and iterative design are required with regard to several important features: positioning the disposal bins for safety, decreasing the risk of contamination and user accessibility; optimal positioning of mirrors for safety; communication within the team; and positioning the secondary team member for optimal awareness. Additional design suggestions also emerged during this study, and they require future investigation.

CONCLUSIONS

This study highlights the importance of the environment on doffing personal protective equipment in a healthcare setting. Iterative testing and modification of the design of the environment (doffing area) are important to enhancing healthcare worker safety.

Infect Control Hosp Epidemiol 2017;38:712–717

Type
Original Articles
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Herlihey, T, et al. Personal protective equipment for infectious disease preparedness: a human factors evaluation. Infect Control Hosp Epidemiol 2016;37:10221028.CrossRefGoogle ScholarPubMed
2. Ulrich, R, et al. A review of the research literature on evidence-based healthcare design. Health Environments Research and Design. Health Environ Res Des 2008;1:61125.Google Scholar
3. Jiang, S, et al. Ventilation of wards and nosocomial outbreak of severe acute respiratory syndrome among healthcare workers. Chin Med J (Engl) 2003;116:12931297.Google ScholarPubMed
4. Oren, I, Haddad, N, Finkelstein, R, Rowe, J. Invasive pulmonary aspergillosis in neutropenic patients during hospital construction: before and after chemoprophylaxis and institution of HEPA filters. Am J Hematol 2001;66:257262.CrossRefGoogle ScholarPubMed
5. Drinka, P, Krause, P, Nest, L, Goodman, B, Gravenstein, S. Risk of acquiring influenza A in a nursing home from a culture-positive roommate. Infect Control Hosp Epidemiol 2003;24:872874.CrossRefGoogle Scholar
6. McManus, A, Mason, A, McManus, W, Pruit, B. A decade of reduced gram-negative infections and mortality associated with improved isolation of burned patients. Arch Surg 1994;129:13061309.CrossRefGoogle ScholarPubMed
7. Passweg, J, Rowlings, PA, Atkinson, KA, et al. Influence of protective isolation on outcome of allogeneic bone marrow transplantation for leukemia. Bone Marrow Transpl 1998;21:12311238.CrossRefGoogle ScholarPubMed
8. Bischoff, W, Reynolds, T, Sessler, C, Edmond, M, Wenzel, R. Handwashing compliance by health care workers: the impact of introducing an accessible, alcohol-based hand antiseptic. Arch Intern Med 2000;160:10171021.CrossRefGoogle ScholarPubMed
9. Creedon, S. Healthcare workers’ hand decontamination practices: compliance with recommended guidelines. J Adv Nurs 1005;51:208216.CrossRefGoogle Scholar
10. Interim infection prevention and control guidance for care of patients with suspected or confirmed filovirus haemorrhagic fever in healthcare settings, with focus on Ebola. World Health Organization website. http://www.who.int/csr/resources/publications/who-ipc-guidance-ebolafinal-09082014.pdf. Published 2014. Accessed March 24, 2017.Google Scholar
11. Guidance for donning and doffing personal protective equipment (PPE) during management of patients with Ebola virus disease in US hospitals. Centers for Disease Control and Prevention website. https://www.cdc.gov/vhf/ebola/healthcare-us/ppe/guidance.html. Updated 2015. Accessed March 24, 2017.Google Scholar
12. Salvendy, G. Handbook of Human Factors and Ergonomics. New York: Wiley; 2012.CrossRefGoogle Scholar
Supplementary material: File

Herlihey supplementary material

Herlihey supplementary material 1

Download Herlihey supplementary material(File)
File 143.6 KB