ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Design Strategies for Biocontainment Units to Reduce Risk During Doffing of High-level Personal Protective Equipment.
Article 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 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- European consensus recommendations for neonatal and paediatric retrievals of positive or suspected COVID-19 patients.Pediatric research · 2021Guideline
- Unfamiliar personal protective equipment: The role of routine practice and other factors affecting healthcare personnel doffing strategies.Infection control and hospital epidemiology · 2023Article
- A narrative review of high-level isolation unit operational and infrastructure features.BMJ global health · 2023Review
- Article
- Resilience and Protection of Health Care and Research Laboratory Workers During the SARS-CoV-2 Pandemic: Analysis and Case Study From an Austrian High Security Laboratory.Frontiers in psychology · 2022Review
- Lessons learned in infection prevention for Ebola virus disease and the coronavirus disease 2019 (COVID-19) pandemic-Principles underlying prevention.Infection control and hospital epidemiology · 2021Article
- Barriers to using personal protective equipment by healthcare staff during the COVID-19 outbreak in China.Medicine · 2020Article
- How to rapidly design and operationalise PPE donning and doffing areas for a COVID-19 care facility: quality improvement initiative.BMJ open quality · 2020Article
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Authors and funding
13 authors.
Funding
Abstract
backgroundFew data exist to guide the physical design of biocontainment units, particularly the doffing area. This can impact the contamination risk of healthcare workers (HCWs) during doffing of personal protective equipment (PPE).
methodsIn phase I of our study, we analyzed simulations of a standard patient care task with 56 trained HCWs focusing on doffing of high-level PPE. In phase II, using a rapid cycle improvement approach, we tested different balance aids and redesigned doffing area layouts with 38 students. In phase III, we tested 1 redesigned layout with an additional 10 trained HCWs. We assessed the effectiveness of design changes on improving the HCW performance (measured by occurrence and number of risky behaviors) and reducing the physical and cognitive load by comparing the results from phase I and phase III.
resultsThe physical load was highest when participants were removing their shoe covers without any balance aid; the use of a chair required the lowest physical effort, followed by horizontal and vertical grab bars. In the revised design (phase III), the overall performance of participants improved. There was a significant decrease in the number of HCW risky behaviors (P = .004); 5 risky behaviors were eliminated and 2 others increased. There was a significant decrease in physical load when removing disposable shoe covers (P = .04), and participants reported a similar workload in the redesigned doffing layout (P = .43).
conclusionsThrough optimizing the design and layout of the doffing space, we reduced risky behaviors of HCWs during doffing of high-level PPE.
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