Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-23T16:45:42.283Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparing Training Techniques in Personal Protective Equipment Use

Published online by Cambridge University Press:  11 May 2020

Richard J. Salway Open the ORCID record for Richard J. Salway [Opens in a new window] ,
Trenika Williams Open the ORCID record for Trenika Williams [Opens in a new window] ,
Camilo Londono ,
Patricia Roblin ,
Kristi Koenig  and
Bonnie Arquilla
Richard J. Salway*
Affiliation:
New York Health and Hospitals, Office of Quality and Safety, New York, New York, USA Kings County Hospital Center, Department of Emergency Medicine, Brooklyn, New YorkUSA
Trenika Williams
Affiliation:
Geisel School of Medicine at Dartmouth, Hanover, New HampshireUSA
Camilo Londono
Affiliation:
SUNY Downstate College of Medicine, Brooklyn, New YorkUSA
Patricia Roblin
Affiliation:
SUNY Downstate College of Medicine, Brooklyn, New YorkUSA
Kristi Koenig
Affiliation:
Center for Disaster Medical Sciences, University of California – Irvine School of Medicine, Irvine, CaliforniaUSA
Bonnie Arquilla
Affiliation:
SUNY Downstate College of Medicine, Brooklyn, New YorkUSA
*
Correspondence: Richard James (RJ) Salway 451 Clarkson Avenue Kings County Hospital Center Department of Emergency Medicine Brooklyn, New York11203USA E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Physicians’ management of hazardous material (HAZMAT) incidents requires personal protective equipment (PPE) utilization to ensure the safety of victims, facilities, and providers; therefore, providing effective and accessible training in its use is crucial. While an emphasis has been placed on the importance of PPE, there is debate about the most effective training methods. Circumstances may not allow for a traditional in-person demonstration; an accessible video training may provide a useful alternative.

Hypothesis:

Video training of Emergency Medicine (EM) residents in the donning and doffing of Level C PPE is more effective than in-person training.

Null Hypothesis:

Video training of EM residents in the donning and doffing of Level C PPE is equally effective compared with in-person training.

Methods:

A randomized, controlled pilot trial was performed with 20 EM residents as part of their annual Emergency Preparedness training. Residents were divided into four groups, with Group 1 and Group 2 viewing a demonstration video developed by the Emergency Preparedness Team (EPT) and Group 3 and Group 4 receiving the standard in-person demonstration training by an EPT member. The groups then separately performed a donning and doffing simulation while blinded evaluators assessed critical tasks utilizing a prepared evaluation tool. At the drill’s conclusion, all participants also completed a self-evaluation survey about their subjective interpretations of their respective trainings.

Results:

Both video and in-person training modalities showed significant overall improvement in participants’ confidence in doffing and donning PPE equipment (P <.05). However, no statistically significant difference was found in the number of failed critical tasks in donning or doffing between the training modalities (P >.05). Based on these results, the null hypothesis cannot be rejected. However, these results were limited by the small sample size and the study was not sufficiently powered to show a difference between training modalities.

Conclusion:

In this pilot study, video and in-person training were equally effective in training for donning and doffing Level C PPE, with similar error rates in both modalities. Further research into this subject with an appropriately powered study is warranted to determine whether this equivalence persists using a larger sample size.

Keywords

disastersemergenciesemergency medicinepersonal protective equipmentpreparednesstraining
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 4 , August 2020 , pp. 364 - 371
Copyright
© World Association for Disaster and Emergency Medicine 2020

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

Olivieri, C, Ingrassia, PL, Corte, FD, et al.Hospital preparedness and response in CBRN emergencies. Eur J Emerg Med. 2017;24(5):366–370.CrossRefGoogle ScholarPubMed
Williams, M, Sizemore, DC. “Biologic, Chemical, and Radiation Terrorism Review.” In: StatPearls [Internet]. Treasure Island, Florida USA: StatPearls Publishing; 2018.Google Scholar
Levitin, HW. “Personal Protective Equipment.” In: Koenig, K, & Schultz, C, (eds). Koenig and Schultz’s Disaster Medicine: Comprehensive Principles and Practices. 2nd ed. Cambridge, UK: Cambridge University Press; 2016:219–231.CrossRefGoogle Scholar
Fischer, WA, Weber, DJ, Wohl, DA.Personal protective equipment: protecting health care providers in an Ebola outbreak. Clin Ther. 2015;37(11):2402–2410.CrossRefGoogle Scholar
Keim, M, Pesik, N, Twum-Danso, N.Lack of hospital preparedness for chemical terrorism in a major US city: 1996–2000. Prehosp Disaster Med. 2003;18(3):193–199.CrossRefGoogle Scholar
Gowing, J, Walker, K, Elmer, S, Cummings, E.Disaster preparedness among health professional and support staff: what is effective? An integrative literature review. Prehosp Disaster Med. 2017;32(3):321–328.CrossRefGoogle ScholarPubMed
Mangum, BP, Dacanay, PO, Mangum, TL. Preparedness of hospitals for response to chemical terrorist incidents: review and recommendations. SSRN Electronic Journal. 2017. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3042071. Accessed May 2, 2019Google Scholar
Wetter, DC, Daniell, WE, Treser, CD.Hospital preparedness for victims of chemical or biological terrorism. Am J Public Health. 2001;91(5):710–716.Google ScholarPubMed
National Institute for Occupational Safety and Health (NIOSH). Hierarchy of Control. https://www.cdc.gov/niosh/topics/hierarchy/. Accessed May 5, 2019.Google Scholar
Hazardous Substances Emergency Event Surveillance (HSEES), Agency for Toxic Substances and Disease Registry. Annual Report 2009. https://www.atsdr.cdc.gov/HS/HSEES/annual2009.html/. Accessed May 2, 2019.Google Scholar
Kang, J, Kim, EJ, Choi, JH, et al.Difficulties in using personal protective equipment: training experiences with the 2015 outbreak of Middle East respiratory syndrome in Korea. Am J Infect Control. 2018;46(2):235–237.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention (CDC). Guidance for the Selection and Use of Personal Protective Equipment (PPE) in Healthcare Settings. https://www.cdc.gov/HAI/pdfs/ppe/PPEslides6-29-04.pdf. Accessed May 2, 2019.Google Scholar
Occupational Safety and Health Administration. OSHA Best Practices for Hospital-Based First Receivers of Victims from Mass Casualty Incidents Involving the Release of Hazardous Substances. US Department of Labor, OSHA 3249–08N; 2005. https://www.osha.gov/Publications/osha3249.pdf. Accessed May 2, 2019.Google Scholar
Occupational Safety and Health Administration. Occupational Safety and Health Standards, Personal Protective Equipment. General Requirements. 1910.132. https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.132. Accessed May 2, 2019.Google Scholar
Personal protective equipment guidelines for health care facility staff. Ann Emerg Med. 2016;68(3):406–407.CrossRefGoogle Scholar
Infectious Disease Dashboard. Special Pathogens Program. New York Health and Hospitals. https://www.nychealthandhospitals.org/special-pathogens-program/. Accessed May 3, 2019.Google Scholar
Kang, J, O’Donnell, JM, Colaianne, B, et al.Use of personal protective equipment among health care personnel: results of clinical observations and simulations. Am J Infec Control. 2017;45(1):17–23.CrossRefGoogle ScholarPubMed
Hung, PP, Choi, KS, Chiang, VC.Using interactive computer simulation for teaching the proper use of personal protective equipment. Comput Inform Nurs. 2015;33(2):49–57.CrossRefGoogle ScholarPubMed
Thorne, C, Oliver, M, Al-Ibrahim, M, et al.Terrorism-preparedness training for non-clinical hospital workers: tailoring content and presentation to meet workers’ needs. J Occup Environ Med. 2004;46(7):668–676.CrossRefGoogle ScholarPubMed
Cook, DA, Hamstra, SJ, Brydges, R, et al.Comparative effectiveness of instructional design features in simulation-based education: systematic review and meta-analysis. Med Teach. 2013;35:e867–898.CrossRefGoogle ScholarPubMed
Cook, DA.How much evidence does it take? A cumulative meta-analysis of outcomes of simulation-based education. Med Educ. 2014;48:750–760.CrossRefGoogle Scholar
Doll, M, Feldman, M, Hartigan, S, et al.Acceptability and necessity of training for optimal personal protective equipment use. Infect Control Hosp Epidemiol. 2017;38(2):226–229.CrossRefGoogle ScholarPubMed
Suen, LK, Guo, YP, Tong, DW, et al.Self-contamination during doffing of personal protective equipment by healthcare workers to prevent Ebola transmission. Antimicrob Resist Infect Control. 2018;7:157.CrossRefGoogle ScholarPubMed