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Donning and Doffing PPE

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1. Donning and Doffing PPE

Donning and Doffing PPE Donning and Doffing PPE Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Donning and Doffing PPE Donning (...) and Doffing PPE Aka: Donning and Doffing PPE , Donning and Doffing Personal Protection Equipment II. Precautions Method described here is for basic donning and doffing of PPE High level protection for Ebola is described on CDC website III. Technique: Donning (putting on) PPE Step 1: Gown Surgical gowns are rated on a 4 level scale (level 4 for the smallest infectious particles such as Ebola) Cover the torso and extremities (neck to knees, arms to wrists, wrapped to back) Fasten gown at neck and waist Step

2018 FP Notebook

2. Donning and Doffing PPE

Donning and Doffing PPE Donning and Doffing PPE Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Donning and Doffing PPE Donning (...) and Doffing PPE Aka: Donning and Doffing PPE , Donning and Doffing Personal Protection Equipment II. Precautions Method described here is for basic donning and doffing of PPE High level protection for Ebola is described on CDC website III. Technique: Donning (putting on) PPE Step 1: Gown Surgical gowns are rated on a 4 level scale (level 4 for the smallest infectious particles such as Ebola) Cover the torso and extremities (neck to knees, arms to wrists, wrapped to back) Fasten gown at neck and waist Step

2016 FP Notebook

3. Alternative Doffing Strategies to Prevent Healthcare Worker Self-Contamination When Using Personal Protective Equipment (PPE)

), and the one-step roll off of gown and gloves (one-step procedure), with the CDC procedure as the control. Participants will be assigned to a doffing protocol chronologically starting with the double glove and ending with the control until 100 volunteers have participated. Additional PPE such as masks and goggles will be removed as part of each of the four protocols. Healthcare workers will receive a demonstration of the donning/doffing from the study coordinator, and perform a practice donn/doff prior (...) Alternative Doffing Strategies to Prevent Healthcare Worker Self-Contamination When Using Personal Protective Equipment (PPE) Alternative Doffing Strategies to Prevent Healthcare Worker Self-Contamination When Using Personal Protective Equipment (PPE) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached

2017 Clinical Trials

4. Assessment of Healthcare Worker Protocol Deviations and Self-Contamination During Personal Protective Equipment Donning and Doffing. (PubMed)

Assessment of Healthcare Worker Protocol Deviations and Self-Contamination During Personal Protective Equipment Donning and Doffing. OBJECTIVE To evaluate healthcare worker (HCW) risk of self-contamination when donning and doffing personal protective equipment (PPE) using fluorescence and MS2 bacteriophage. DESIGN Prospective pilot study. SETTING Tertiary-care hospital. PARTICIPANTS A total of 36 HCWs were included in this study: 18 donned/doffed contact precaution (CP) PPE and 18 donned/doffed (...) Ebola virus disease (EVD) PPE. INTERVENTIONS HCWs donned PPE according to standard protocols. Fluorescent liquid and MS2 bacteriophage were applied to HCWs. HCWs then doffed their PPE. After doffing, HCWs were scanned for fluorescence and swabbed for MS2. MS2 detection was performed using reverse transcriptase PCR. The donning and doffing processes were videotaped, and protocol deviations were recorded. RESULTS Overall, 27% of EVD PPE HCWs and 50% of CP PPE HCWs made ≥1 protocol deviation while

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2017 Infection control and hospital epidemiology

5. Risk of self-contamination during doffing of personal protective equipment. (PubMed)

Risk of self-contamination during doffing of personal protective equipment. The aim of this study was to describe the risk of self-contamination associated with doffing of personal protective equipment (PPE) and to compare self-contamination with various PPE protocols.We tested 10 different PPE donning and doffing protocols, recommended by various health organizations for Ebola. Ten participants were recruited for this study and randomly assigned to use 3 different PPE protocols. After donning (...) difficulty, suffocation, heat stress, and fogging-up glasses. Most participants rated PPE high (18/30) or medium (11/30) for ease of donning/doffing and comfort. PPE sequences with powered air-purifying respirators (PAPRs) and assisted doffing were generally associated with fewer problems and were rated the highest.This study confirmed the risk of self-contamination associated with the doffing of PPE. PAPR-containing protocols and assisted doffing should be preferred whenever possible during the outbreak

2018 American journal of infection control

6. Human Factors Risk Analyses of a Doffing Protocol for Ebola-Level Personal Protective Equipment: Mapping Errors to Contamination. (PubMed)

Human Factors Risk Analyses of a Doffing Protocol for Ebola-Level Personal Protective Equipment: Mapping Errors to Contamination. Doffing protocols for personal protective equipment (PPE) are critical for keeping healthcare workers (HCWs) safe during care of patients with Ebola virus disease. We assessed the relationship between errors and self-contamination during doffing.Eleven HCWs experienced with doffing Ebola-level PPE participated in simulations in which HCWs donned PPE marked (...) with surrogate viruses (ɸ6 and MS2), completed a clinical task, and were assessed for contamination after doffing. Simulations were video recorded, and a failure modes and effects analysis and fault tree analyses were performed to identify errors during doffing, quantify their risk (risk index), and predict contamination data.Fifty-one types of errors were identified, many having the potential to spread contamination. Hand hygiene and removing the powered air purifying respirator (PAPR) hood had the highest

2018 Clinical Infectious Diseases

7. Assessing Viral Transfer During Doffing of Ebola-Level Personal Protective Equipment in a Biocontainment Unit. (PubMed)

= 10) experienced in EVD care donned and doffed PPE following unit protocols that incorporate trained observer guidance and alcohol-based hand rub (ABHR). A mixture of Φ6 (enveloped), MS2 (nonenveloped), and fluorescent marker was applied to 4 PPE sites, approximating body fluid viral load (Φ6, 105; MS2, 106). They performed a patient care task, then doffed. Inner gloves, face, hands, and scrubs were sampled for virus, as were environmental sites with visible fluorescent marker.Among 10 HCWs (...) Assessing Viral Transfer During Doffing of Ebola-Level Personal Protective Equipment in a Biocontainment Unit. Personal protective equipment (PPE) protects healthcare workers (HCWs) caring for patients with Ebola virus disease (EVD), and PPE doffing is a critical point for preventing viral self-contamination. We assessed contamination of skin, gloves, and scrubs after doffing Ebola-level PPE contaminated with surrogate viruses: bacteriophages MS2 and Φ6.In a medical biocontainment unit, HCWs (n

2018 Clinical Infectious Diseases

8. Infection Control for Haemodialysis Units

-borne virus screening, hepatitis B immune status and hepatitis B vaccination history should be recorded and noted in the patient medical record. ? If screening for colonisation with particular MROs is conducted, we suggest monitoring the prevalence of colonisation in haemodialysis patients every 12 months minimum to identify potential failures of infection control procedures. ? Protocols for the use of personal protective equipment (PPE) and environmental cleaning in haemodialysis units should

2019 KHA-CARI Guidelines

9. Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff. (PubMed)

protects best, what is the best way to remove PPE, and how to make sure HCWs use PPE as instructed.To evaluate which type or component of full-body PPE and which method of donning or removing (doffing) PPE have the least risk of self-contamination or infection for HCWs, and which training methods most increase compliance with PPE protocols.We searched MEDLINE (PubMed up to 8 January 2016), Cochrane Central Register of Trials (CENTRAL up to 20 January 2016), EMBASE (embase.com up to 8 January 2016 (...) ten interventions. Of these, eight trials simulated the exposure with a fluorescent marker or virus or bacteria containing fluids. Five studies evaluated different types of PPE against each other but two did not report sufficient data. Another two studies compared different types of donning and doffing and three studies evaluated the effect of different types of training.None of the included studies reported a standardised classification of the protective properties against viral penetration

2016 Cochrane

10. Design Strategies to Improve Healthcare Worker Safety in Biocontainment Units: Learning from Ebola Preparedness. (PubMed)

Design Strategies to Improve Healthcare Worker Safety in Biocontainment Units: Learning from Ebola Preparedness. To identify ways that the built environment may support or disrupt safe doffing of personal protective equipment (PPE) in biocontainment units (BCU).We observed interactions between healthcare workers (HCWs) and the built environment during 41 simulated PPE donning and doffing exercises.The BCUs of 4 Ebola treatment facilities and 1 high-fidelity BCU mockup.ParticipantsA total of 64 (...) inadvertently leaving the doffing area and stepping back into the contaminated areas. Lack of standard location for items resulted in equipment and supplies frequently shifting positions. Finally, different solutions for maintaining balance while removing shoe covers (ie, chair, hand grips, and step stool) had variable success. We identified the 5 key requirements that doffing areas must achieve to support safe doffing of PPE, and we developed a matrix of proposed design strategies that can be implemented

2018 Infection control and hospital epidemiology

11. A unified personal protective equipment ensemble for clinical response to possible high consequence infectious diseases: A consensus document on behalf of the HCID programme. (PubMed)

contamination was seen after doffing. Following further review by the working group, a consensus agreement has been reached and a unified 'HCID assessment PPE' ensemble, with accompanying donning and doffing protocols, is presented here.Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved. (...) to assess the safety of PPE ensembles in use in the UK during first assessment of a patient with a possible HCID. A mannequin was adapted to expose volunteer HCWs to synthetic bodily fluids (vomit, sweat, diarrhoea and cough), each with a different coloured fluorescent tracer, invisible other than under ultraviolet (UV) light. After exposure, HCWs were examined under UV lights to locate fluorescent contamination, and were screened again after removing PPE (doffing) to detect any personal contamination

2018 Journal of Infection

12. Addressing Infection Prevention and Control in the First U.S. Community Hospital to Care for Patients With Ebola Virus Disease: Context for National Recommendations and Future Strategies. (PubMed)

strengthened. The personal protective equipment (PPE) ensemble was standardized, HCP were trained on donning and doffing PPE, and a system of trained observers supervising PPE donning and doffing was implemented. Caring for patients with EVD placed substantial demands on a community hospital. The experiences of the authors and others informed national policies for the care of patients with EVD and protection of HCP, including new guidance for PPE, a rapid system for deploying CDC staff to assist hospitals

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2016 Annals of Internal Medicine

13. Personal protective equipment solution for UK military medical personnel working in an Ebola virus disease treatment unit in Sierra Leone. (PubMed)

Personal protective equipment solution for UK military medical personnel working in an Ebola virus disease treatment unit in Sierra Leone. The combination of personal protective equipment (PPE) together with donning and doffing protocols was designed to protect British and Canadian military medical personnel in the Kerry Town Ebola Treatment Unit (ETU) in Sierra Leone. The PPE solution was selected to protect medical staff from infectious risks, notably Ebola virus, and chemical (hypochlorite (...) provided: (i) an evidence base underpinning the PPE solution chosen; (ii) skills in donning and doffing of PPE; (iii) personnel confidence in the selected PPE; and (iv) quantifiable testing of each individual's capability to don PPE, perform tasks and doff PPE safely.Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

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2017 Journal of Hospital Infection

14. Do medical students receive training in correct use of personal protective equipment? (PubMed)

Do medical students receive training in correct use of personal protective equipment? Healthcare personnel often use incorrect technique for donning and doffing of personal protective equipment (PPE).We tested the hypothesis that medical students receive insufficient training on correct methods for donning and doffing PPE.We conducted a cross-sectional survey of medical students on clinical rotations at two teaching hospitals to determine the type of training they received in PPE technique (...) , only 11 (41%) reported receiving PPE training, and none had received training requiring demonstration of proficiency. During simulations, 25 of 27 (92.5%) students had one or more lapses in technique and 12 (44%) contaminated their skin with fluorescent lotion. For 100 residents, fellows and attending physicians representing 67 different medical schools, only 53% reported receiving training in use of PPE and only 39% selected correct donning and doffing sequence.Our findings suggest

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2017 Medical education online

15. Ebola virus disease: The use of fluorescents as markers of contamination for personal protective equipment. (PubMed)

splash. Each participant was assisted in PPE donning and doffing by an experienced trainer. A training mannequin was contaminated with fluorescent agents to simulate bodily fluids. Participants were then given clinical tasks to care for the EVD "patient." De-gowned participants were examined under "black light" for fluorescence indicative of contamination. One participant in each PPE arm had evidence of contamination. One of the contamination events was suspected during the patient care exercise (...) Ebola virus disease: The use of fluorescents as markers of contamination for personal protective equipment. The recent Ebola virus disease (EVD) outbreak has created interest in personal protective equipment (PPE) content and usage. PPE testing has historically been done by individual component, rather than as a bundle for contact isolation. Fluorescent agents are commonly used in training for infection control techniques. The purpose of our study was to compare 2 PPE bundles and to evaluate

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2016 IDCases

16. Behavioural interventions to promote workers' use of respiratory protective equipment. (PubMed)

to 4.96). However, the active group scored significantly higher than the book group (MD 4.20, 95% CI 0.89 to 7.51) and the screen group (MD 7.00, 95% CI 4.06 to 9.94).One RCT compared computer-simulation training with conventional personal protective equipment (PPE) training but reported only results for donning and doffing full-body PPE. Education versus no educationOne RCT found that a multifaceted educational intervention increased the use of RPE (risk ratio (RR) 1.69, 95% CI 1.10 to 2.58) at three (...) traditional lecturesOne CBA study found that participants given motivational group interviewing-based safety education scored higher on a checklist measuring PPE use (MD 2.95, 95% CI 1.93 to 3.97) than control workers given traditional educational sessions.There is very low quality evidence that behavioural interventions, namely education and training, do not have a considerable effect on the frequency or correctness of RPE use in workers. There were no studies on incentives or organisation level

2016 The Cochrane database of systematic reviews

17. Personal Protective Equipment for Infectious Disease Preparedness: A Human Factors Evaluation. (PubMed)

Personal Protective Equipment for Infectious Disease Preparedness: A Human Factors Evaluation. OBJECTIVE To identify issues during donning and doffing of personal protective equipment (PPE) for infectious diseases and to inform PPE procurement criteria and design. DESIGN A mixed methods approach was used. Usability testing assessed the appropriateness, potential for errors, and ease of use of various combinations of PPE. A qualitative constructivist approach was used to analyze participant (...) feedback. SETTING Four academic health sciences centers: 2 adult hospitals, 1 trauma center, and 1 pediatric hospital, in Toronto, Canada. PARTICIPANTS Participants (n=82) were representative of the potential users of PPE within Western healthcare institutions. RESULTS None of the tested combinations provided a complete solution for PPE. Environmental factors, such as anteroom layout, and the design of protocols and instructional material were also found to impact safety. The study identified the need

2016 Infection control and hospital epidemiology

18. Ebola Virus

mortality: 70% Findings suggestive or worse prognosis to coma Refractory shock Persistently high or increasing Ebola Virus RNA titers XI. Prevention Full (PPE) for healthcare workers (donning and doffing) XII. Resources CDC: Ebola WHO: Ebola Pubmed Ebola XIII. References Black, Martin, DeVos (2018) Crit Dec Emerg Med 32(8): 3-12 Bray in Hirsch (2014) Ebola and Marburg Virus Disease, UpToDate, accessed online 11/5/2014 Images: Related links to external sites (from Bing) These images are a random sampling

2018 FP Notebook

19. Assessment of Self-Contamination During Removal of Personal Protective Equipment for Ebola Patient Care. (PubMed)

HCP doffed EVD PPE using a standardized protocol. METHODS A total of 15 HCP donned EVD PPE for this study. Virus was applied to PPE, and a trained monitor guided them through the doffing protocol. Of the 15 participants, 10 used alcohol-based hand rub (ABHR) for glove and hand hygiene and 5 used hypochlorite for glove hygiene and ABHR for hand hygiene. Inner gloves, hands, face, and scrubs were sampled after doffing. RESULTS After doffing, MS2 virus was detected on the inner glove worn (...) Assessment of Self-Contamination During Removal of Personal Protective Equipment for Ebola Patient Care. OBJECTIVE Ebola virus disease (EVD) places healthcare personnel (HCP) at high risk for infection during patient care, and personal protective equipment (PPE) is critical. Protocols for EVD PPE doffing have not been validated for prevention of viral self-contamination. Using surrogate viruses (non-enveloped MS2 and enveloped Φ6), we assessed self-contamination of skin and clothes when trained

2016 Infection control and hospital epidemiology

20. Ebola Virus (Treatment)

(rather than goggles), in addition to either a N95 respirator or powered air-purifying respirator instead of a mask. The CDC now recommends that clinicians train rigorously at donning and doffing PPE in a stepwise manner and demonstrate competency. A trained monitor should oversee each time a clinician puts on and takes off this gear. During patient care, the PPE should not be adjusted, and the worker’s gloved hands should be disinfected frequently using an alcohol-based hand rub (ABHR), especially (...) in U.S. Hospitals, Including Procedures for Putting On (Donning) and Removing (Doffing). Available at . Accessed: October 21, 2014. Kennedy SB, Bolay F, Kieh M, et al. Phase 2 Placebo-Controlled Trial of Two Vaccines to Prevent Ebola in Liberia. N Engl J Med . 2017 Oct 12. 377 (15):1438-1447. . Sullivan NJ, Sanchez A, Rollin PE, Yang ZY, Nabel GJ. Development of a preventive vaccine for Ebola virus infection in primates. Nature . 2000 Nov 30. 408(6812):605-9. . Geisbert TW, Pushko P, Anderson K

2014 eMedicine.com

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