Minimizing Contamination in the Use of Personal Protective Equipment: Simulation Results through Tracking Contamination and Enhanced Protocols.

Abstract Background Due to variations and the inadequate use of personal protective equipment (PPE), this study aimed to evaluate our enhanced PPE protocols for minimizing doffing contamination. Methods Among 3 PPE kits (simple, Level D, and Level C), 30 participants conducted the 1st simulation in their adapted way and the 2nd following enhanced protocols. After donning, participants performed a 1-minute simulation of direct care on a patient simulator covered with fluorescent powder. For tracking contamination routes between doffing processes, fluorescent powder contamination was examined with ultraviolet lamps in the darkened room. Results Participants were mostly registered nurses (N=27, 90%), female (87%), and on average 31.7 years old with 8.5 years of clinical experience. Among 61 total simulations 32 had at least one contamination (52.5%); “Noticeable” level (40%) at the “hands-fingers” and “shirt” body areas were most frequent. For 1st and 2nd simulations with identical PPE kits, compared to the 1st with adapted practice, the 2nd with enhanced protocols showed a significant reduction in doffing contamination rates (72.7% vs. 22.7%, p=0.0009 for both Level C and D; 77.8% vs. 27.8%, p=0.0027 for Level D). Conclusions Our enhanced protocols could significantly reduce contaminations. More studies are necessary to provide safer PPE protocol options.