Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases Personal Protective Equipment for Healthcare Personnel: Update 2010 (2011) / Chapter Skim
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4 Using PPE: Individual and Organizational Issues
4 Using PPE: Individual and Organizational Issues
Pages 113-132
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From page 113... ...
As noted in Chapter 3, researchers, designers, and manufacturers continue to look for improvements to the equipment that can reduce the physiological burdens, improve communication, and be more comfortable and less of an encumbrance to wear. For healthcare personnel, the trade-offs of hazardous exposures with the challenges of donning, wearing, and doffing PPE often end up with healthcare personnel not fully adhering to PPE and infection control protocols.
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From page 114... ...
organizational factors, such as management's expectations and performance feedback, workplace policies, and training and edu cation programs. Discussion in the 2008 report focused on the concerted efforts needed by individual healthcare personnel, managers, and institutions to improve the safety culture in healthcare facilities.
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From page 115... ...
Healthcare facilities need to foster and promote a strong culture of safety that includes a commitment to worker safety, adequate access to safety equip ment, and extensive training efforts that utilize protocols requiring specific safety actions and detailing consequences for noncom pliance.
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From page 116... ...
A concerted effort to identify best practices in infection control and to disseminate this information to other healthcare facilities could increase worker and patient safety and have positive rami fications well beyond preparedness for an influenza pandemic. As noted throughout the prior report, the use of PPE is only one component of promoting a strong safety culture in healthcare settings.
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From page 117... ...
An in-depth review of Canada's experience with severe acute respiratory syndrome (SARS) by the SARS Commission emphasized the importance of a robust safety culture in healthcare facilities and pointed to the need for close cooperation between infection control and occupational safety and health programs and personnel (Possamai, 2007)
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From page 118... ...
Only 5 percent routinely used PPE when in contact with potentially infectious material. Compliance was higher among nurses who had received training in infection control.
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From page 119... ...
Turnberg and investigators (2008) conducted a survey of 653 hospital staff in 5 medical centers in Washington state and found lack of knowledge by healthcare personnel about, and limited training on, recommended infection control practices and PPE usage, as well as limited resource support.
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From page 120... ...
First, studies continue to show knowledge gaps and training deficiencies among healthcare personnel with respect to proper PPE usage, modes of transmission, and other infection control topics. Research by Bryce and colleagues (2008)
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In week 2, only 3 of the 54 participants wore the respirator "on most shifts." During weeks 3 and 4, only 1 healthcare worker wore the respirator "on most shifts." By week 4, 70.4 percent of the healthcare personnel reported that they never wore the respirator. Their reasons were that it was hot, was difficult to breathe through, interfered with patient communication, and had to be stored somewhere between uses.
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From page 122... ...
Hon and colleagues (2008) reported that an online infection control course adequately transferred knowledge regarding PPE selection and use.
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From page 123... ...
The authors note that most research has been done in hospitals, which has only limited applicability to other community settings. SUMMARY OF PROGRESS Research during the past several years reveals modest gains in understanding that self-protective behavior in the healthcare settings involves a constellation of interacting and independent components.
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From page 124... ...
FINDINGS AND RESEARCH NEEDS This is an opportune time for research on promoting and enhancing healthcare worker safety and the use of PPE. As noted throughout the chapter, extensive work has been done in recent years on improving patient safety.
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From page 125... ...
• Personal protective equipment usage presents varied challenges across different types of healthcare settings. • Existing knowledge is sufficient to begin to incorporate the following practices into PPE usage in health care: deliberate planning and preparation at the leadership and organizational levels; compre hensive training, including supervisors and managers; widespread and convenient availability of appropriate PPE devices; and ac countability at all levels of the organization.
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From page 126... ...
• Metrics: Similar to measures of the patient safety culture, met rics are needed to measure worker and organizational safety cul ture and use of PPE. • Varying healthcare settings: In order to determine practice needs in different work settings, research is needed to examine and differentiate PPE policy and implementation strategies in large and small healthcare delivery settings.
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From page 127... ...
These efforts should include • conducting human factors and ergonomics research relevant to the design and organization of healthcare work tasks to improve worker safety by reducing hazardous exposures and effectively using PPE (e.g., reduce unnecessary PPE donning and doffing) , • exploring the links between patient safety and healthcare worker safety and health that are relevant to the use of PPE, and • identifying and evaluating strategies to mitigate or ganizational barriers that limit the use of PPE by healthcare personnel.
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From page 128... ...
2009. Effects of safety climate on safety norm violations: Exploring the mediating role of attitudinal ambivalence toward personal protective equipment.
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2007. Surgical nurses and compliance with personal protective equipment.
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2008. Personal protective equipment in health care: Can online infection control courses transfer knowledge and improve proper selection and use?
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From page 131... ...
2008. Appraisal of recommended respiratory infection control practices in primary care and emergency department settings.
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From page 132... ...
2009. Use of personal protective equipment during infectious disease outbreak and nonoutbreak conditions: A survey of emergency medical technicians.
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