Are health care workers protected? An observational study of selection and removal of personal protective equipment in Canadian acute care hospitals.
BACKGROUND
The proper use of personal protective equipment (PPE) by health care workers (HCWs) is vital in preventing the spread of infection and has implications for HCW safety.


METHODS
An observational study was performed in 11 hospitals participating in the Canadian Nosocomial Infection Surveillance Program between January 7 and March 30, 2011. Using a standardized data collection tool, observers recorded HCWs selecting and removing PPE and performing hand hygiene on entry into the rooms of febrile respiratory illness patients.


RESULTS
The majority of HCWs put on gloves (88%, n = 390), gown (83%, n = 368), and mask (88%, n = 386). Only 37% (n = 163) were observed to have put on eye protection. Working in a pediatric unit was significantly associated with not wearing eye protection (7%), gown (70%), gloves (77%), or mask (79%). Half of the observed HCWs (54%, n = 206) removed their PPE in the correct sequence. Twenty-six percent performed hand hygiene after removing their gloves, 46% after removing their gown, and 57% after removing their mask and/or eye protection.


CONCLUSIONS
Overall adherence with appropriate PPE use in health care settings involving febrile respiratory illness patients was modest, particularly on pediatric units. Interventions to improve PPE use should be targeted toward the use of recommended precautions (eg, eye protection), HCWs working in pediatric units, the correct sequence of PPE removal, and performing hand hygiene.
Public Health Agency of Canada, Ottawa, Ontario, Canada. robyn.mitchell@phac-aspc.gc.ca
Robyn
R
Mitchell
Virginia
V
Roth
Denise
D
Gravel
George
G
Astrakianakis
Elizabeth
E
Bryce
Sarah
S
Forgie
Lynn
L
Johnston
Geoffrey
G
Taylor
Mary
M
Vearncombe
D002170:Canada; D019983:Guideline Adherence; D063373:Hand Hygiene / Q000379:methods; D006282:Health Personnel; D006761:Hospitals; D006801:Humans; D016273:Occupational Exposure / Q000517:prevention & control*; D011482:Protective Devices / Q000706:statistics & numerical data*