The study looked at:
- what type of personal protective equipment (PPE) or combination of PPE gives healthcare workers the best protection.
- whether modifying PPE for easier removal is effective.
- whether following guidance on removing PPE reduced contamination.
- whether training reduced contamination.
The results showed:
Types of PPE
Covering more of the body leads to better protection. However, as this is usually associated with increased difficulty in putting on and removing PPE, and the PPE is less comfortable, it may lead to more contamination. Coveralls are the most difficult PPE to remove but may offer the best protection, followed by long gowns, gowns and aprons. Respirators worn with coveralls may protect better than a mask worn with a gown, but are more difficult to put on. More breathable types of PPE may lead to similar levels of contamination but be more comfortable. Contamination was common in half the studies despite improved PPE.
Gowns that have gloves attached at the cuff, so that gloves and gown are removed together and cover the wrist area, and gowns that are modified to fit tightly at the neck may reduce contamination. Also, adding tabs to gloves and face masks may lead to less contamination. However, one study did not find fewer errors in putting on or removing modified gowns.
Guidance on PPE use
Following Centers for Disease Control and Prevention guidance for apron or gown removal, or any instructions for removing PPE compared to an individual’s own preferences may reduce self‐contamination. Removing gown and gloves in one step, using two pairs of gloves, and cleaning gloves with bleach or disinfectant (but not alcohol) may also reduce contamination.
Face‐to‐face training, computer simulation and video training led to fewer errors in PPE removal than training delivered as written material only or a traditional lecture.
You can read the full study, HERE.