Volume 69, Issue Supplement_3, 1 October 2019

Sixteen percent of gloves or gowns were contaminated with MRSA when HCP were caring for intensive care unit patients with methicillin-resistant Staphylococcus aureus (MRSA). Being an occupational, physical, or respiratory therapist or touching patients increases the odds of MRSA contamination. Patient MRSA bacterial burden is associated with increased contamination.

Contact pattern of healthcare workers and patients during care activities for hospitalized patients with viral respiratory infections are described. Healthcare workers regularly contact environmental surfaces that may be contaminated with pathogens and their bodies, putting them at risk for acquiring infection of disseminating pathogens through the contact route.

Workflow and activities vary across healthcare personnel. However, personal protective equipment (PPE) is often thought of as “one size fits all.” This study examines, based on role, the different challenges healthcare personnel encounter when using PPE in their day-to-day activities.

Healthcare workers seek both safety and expediency when doffing personal protective equipment (PPE). While doffing, they track contaminated surfaces, follow design cues, and rely on experience to improvise. They encounter numerous doffing barriers and facilitators, chiefly pertaining to PPE design.

To improve personal protective equipment adherence, a simulator study evaluated a redesigned gown for usability in comparison to a standard gown. The results of this study suggest that the redesigned gown was more usable and reduced cognitive task load.

We mathematically modeled a bundled intervention that successfully reduced carbapenemase-producing Enterobacteriaceae in long-term acute care hospitals. Results show that contact precautions for surveillance-detected carriers plausibly can explain the observed reduction in carriage prevalence without substantial contribution from other intervention components.

Healthcare workers at 4 Ebola treatment centers were observed doffing personal protective equipment for simulated patients with serious communicable diseases. Using human factors methodologies, we identified common points of concern and conclude with potential interventions to alleviate these issues.

Using observations of hand hygiene practices during simulated patient care in biocontainment units, we partitioned variance in the duration and thoroughness of hand hygiene into that attributable to differences between facilities and differences between healthcare workers.

In this laboratory simulation, we investigated the effect of glove decontamination prior to glove removal and found that glove decontamination reduced but did not eliminate bacterial contamination found on hands after glove removal.

In this laboratory simulation to evaluate contamination of nearby environmental surfaces when using wipe vs spray methods of decontaminating personal protective equipment, we did not observe any environmental contamination with bacteriophage MS-2 (Ebola virus surrogate) using bleach spray or wipes.

A new method is pilot tested against the fluorescent liquid tracer method for quantifying skin and inhalational exposure to pathogens during personal protective equipment doffing. The new method uses fluorescent polystyrene latex spheres to simulate pathogen particles.

The physical design of biocontainment units impacts the contamination risk of healthcare workers (HCWs) during doffing of personal protective equipment. Through optimizing the design and layout of the doffing space, HCWs perform fewer risky behaviors and are safer.

An intervention package that addressed components of the task, tools, environment, and teamwork skills during personal protective equipment (PPE) doffing significantly reduced the amount of self-contamination by study participants. These elements can be incorporated into PPE guidance and training to prevent pathogen transmission.