OBJECTIVE: We assessed the impact of personal protective equipment (PPE) doffing errors on healthcare worker (HCW) contamination with multidrug-resistant organisms (MDROs). DESIGN: Prospective, observational study. SETTING: The study was conducted at 4 adult ICUs at 1 tertiary-care teaching hospital. PARTICIPANTS: HCWs who cared for patients on contact precautions for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci, or multidrug-resistant gram-negative bacilli were enrolled. Samples were collected from standardized areas of patient body, garb sites, and high-touch environmental surfaces in patient rooms. HCW hands, gloves, PPE, and equipment were sampled before and after patient interaction. Research personnel observed PPE doffing and coded errors based on CDC guidelines. RESULTS: We enrolled 125 HCWs; most were nurses (66.4%) or physicians (19.2%). During the study, 95 patients were on contact precautions for MRSA. Among 5,093 cultured sites (HCW, patient, environment), 652 (14.7%) yielded the target MDRO. Moreover, 45 HCWs (36%) were contaminated with the target MDRO after patient interactions, including 4 (3.2%) on hands and 38 (30.4%) on PPE. Overall, 49 HCWs (39.2%) made multiple doffing errors and were more likely to have contaminated clothes following a patient interaction (risk ratio [RR], 4.69; P = .04). All 4 HCWs with hand contamination made doffing errors. The risk of hand contamination was higher when gloves were removed before gowns during PPE doffing (RR, 11.76; P = .025). CONCLUSION: When caring for patients on CP for MDROs, HCWs appear to have differential risk for hand contamination based on their method of doffing PPE. An intervention as simple as reinforcing the preferred order of doffing may reduce HCW contamination with MDROs.
OBJECTIVE: We assessed the impact of personal protective equipment (PPE) doffing errors on healthcare worker (HCW) contamination with multidrug-resistant organisms (MDROs). DESIGN: Prospective, observational study. SETTING: The study was conducted at 4 adult ICUs at 1 tertiary-care teaching hospital. PARTICIPANTS: HCWs who cared for patients on contact precautions for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci, or multidrug-resistant gram-negative bacilli were enrolled. Samples were collected from standardized areas of patient body, garb sites, and high-touch environmental surfaces in patient rooms. HCW hands, gloves, PPE, and equipment were sampled before and after patient interaction. Research personnel observed PPE doffing and coded errors based on CDC guidelines. RESULTS: We enrolled 125 HCWs; most were nurses (66.4%) or physicians (19.2%). During the study, 95 patients were on contact precautions for MRSA. Among 5,093 cultured sites (HCW, patient, environment), 652 (14.7%) yielded the target MDRO. Moreover, 45 HCWs (36%) were contaminated with the target MDRO after patient interactions, including 4 (3.2%) on hands and 38 (30.4%) on PPE. Overall, 49 HCWs (39.2%) made multiple doffing errors and were more likely to have contaminated clothes following a patient interaction (risk ratio [RR], 4.69; P = .04). All 4 HCWs with hand contamination made doffing errors. The risk of hand contamination was higher when gloves were removed before gowns during PPE doffing (RR, 11.76; P = .025). CONCLUSION: When caring for patients on CP for MDROs, HCWs appear to have differential risk for hand contamination based on their method of doffing PPE. An intervention as simple as reinforcing the preferred order of doffing may reduce HCW contamination with MDROs.
Authors: Gita Nadimpalli; Lyndsay M O'Hara; Lisa Pineles; Karly Lebherz; J Kristie Johnson; David P Calfee; Loren G Miller; Daniel J Morgan; Anthony D Harris Journal: Infect Control Hosp Epidemiol Date: 2020-02-10 Impact factor: 3.254
Authors: Tan Seng Beng; Carol Lai Cheng Kim; Chai Chee Shee; Diana Ng Leh Ching; Tan Jiunn Liang; Mehul Kumar Narendra Kumar; Ng Chong Guan; Lim Poh Khuen; Lam Chee Loong; Loh Ee Chin; Sheriza Izwa Zainuddin; David Paul Capelle; Ang Chui Munn; Lim Kah Yen; Nik Nathasha Hani Nik Isahak Journal: Am J Hosp Palliat Care Date: 2021-09-16 Impact factor: 2.090
Authors: Kyle J Popovich; Stefan J Green; Koh Okamoto; Yoona Rhee; Mary K Hayden; Michael Schoeny; Evan S Snitkin; Robert A Weinstein Journal: Clin Infect Dis Date: 2021-06-01 Impact factor: 20.999
Authors: Guy Martin; Louis Koizia; Angad Kooner; John Cafferkey; Clare Ross; Sanjay Purkayastha; Arun Sivananthan; Anisha Tanna; Philip Pratt; James Kinross Journal: J Med Internet Res Date: 2020-08-14 Impact factor: 5.428