Evidence map›Paper›PMID 31517976›Full record

Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019

Effect of an Intervention Package and Teamwork Training to Prevent Healthcare Personnel Self-contamination During Personal Protective Equipment Doffing.

Jennifer Andonian, Sadaf Kazi, Jennifer Therkorn, Lauren Benishek, Carrie Billman, Margaret Schiffhauer, Elaine Nowakowski, Patience Osei, Ayse P Gurses, Yea-Jen Hsu and 8 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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  15. Precautions for Operating Room Team Members During the COVID-19 Pandemic.Journal of the American College of Surgeons · 2020
    Article
  16. Procare : das forbildungsmagazin fur pflegeberufe · 2020
    Article
  17. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Jennifer AndonianDepartment of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital.
Sadaf KaziJohns Hopkins Armstrong Institute for Patient Safety and Quality.
Jennifer TherkornDepartment of Applied Biological Sciences, Johns Hopkins Applied Physics Laboratory.
Lauren BenishekJohns Hopkins Armstrong Institute for Patient Safety and Quality.
Carrie BillmanDepartment of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital.
Margaret SchiffhauerDepartment of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital.
Elaine NowakowskiDepartment of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital.
Patience OseiJohns Hopkins Armstrong Institute for Patient Safety and Quality.
Ayse P GursesJohns Hopkins Armstrong Institute for Patient Safety and Quality.
Yea-Jen HsuDepartment of Anesthesia and Critical Care Medicine, Johns Hopkins University School of Medicine.
David DrewryDepartment of Applied Biological Sciences, Johns Hopkins Applied Physics Laboratory.
Ellen R ForsythDepartment of Applied Biological Sciences, Johns Hopkins Applied Physics Laboratory.
Arjun VigneshJohns Hopkins Armstrong Institute for Patient Safety and Quality.
Ifeoluwa OresanwoJohns Hopkins Armstrong Institute for Patient Safety and Quality.
Brian T GaribaldiDepartment of Medicine, Johns Hopkins University School of Medicine.
Kaitlin Rainwater-LovettDepartment of Applied Biological Sciences, Johns Hopkins Applied Physics Laboratory.
Polly TrexlerDepartment of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital.
Lisa L MaragakisDepartment of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital.

Funding

ACL HHS U54CK000447NCEZID CDC HHS U54 CK000447
6 · The paper itself

Abstract

backgroundMore than 28 000 people were infected with Ebola virus during the 2014-2015 West African outbreak, resulting in more than 11 000 deaths. Better methods are needed to reduce the risk of self-contamination while doffing personal protective equipment (PPE) to prevent pathogen transmission.

methodsA set of interventions based on previously identified failure modes was designed to mitigate the risk of self- contamination during PPE doffing. These interventions were tested in a randomized controlled trial of 48 participants with no prior experience doffing enhanced PPE. Contamination was simulated using a fluorescent tracer slurry and fluorescent polystyrene latex spheres (PLSs). Self-contamination of scrubs and skin was measured using ultraviolet light visualization and swabbing followed by microscopy, respectively. Doffing sessions were videotaped and reviewed to score standardized teamwork behaviors.

resultsParticipants in the intervention group contaminated significantly fewer body sites than those in the control group (median [interquartile range], 6 [3-8] vs 11 [6-13], P = .002). The median contamination score was lower for the intervention group than the control group when measured by ultraviolet light visualization (23.15 vs 64.45, P = .004) and PLS swabbing (72.4 vs 144.8, P = .001). The mean teamwork score was greater in the intervention group (42.2 vs 27.5, P < .001).

conclusionsAn intervention package addressing the PPE doffing task, tools, environment, and teamwork skills significantly reduced the amount of self-contamination by study participants. These elements can be incorporated into PPE guidance and training to reduce the risk of pathogen transmission.

Indexed as

Patient Care TeamPersonal Protective EquipmentSkinDisease OutbreaksFluorescenceGloves, ProtectiveHealth PersonnelHemorrhagic Fever, EbolaHumansInfection ControlPolystyrenesRespiratory Protective DevicesSimulation TrainingPolystyrenesstyrofoambiocontainmentinhalational exposurepersonal protective equipment doffingself-contaminationviral hemorrhagic fever

Identifiers

PMID31517976
PMCPMC6761361

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.