title: Use of personal protective equipment among health care personnel: Results of clinical observations and simulations.
abstract: Very little is known about how health care personnel (HCP) actually use personal protective equipment (PPE).
  
  
  
  The clinical PPE practices of 50 HCP from selected units at the University of Pittsburgh Medical Center (UPMC) Presbyterian Hospital were videotaped with HCP consent. For 2 PPE simulation sessions (simple and full-body sets), 82 HCP were recruited throughout the UPMC system. Simulation practices were videotaped and examined using fluorescent powder with ultraviolet lighting. All participants completed an electronic survey. For a follow-up evaluation simulation, 12 HCP were recruited among simulation participants.
  
  
  
  Among 130 total sessions from 65 participants, contamination occurred in 79.2% of simulations during the doffing process with various PPE items: simple set (92.3%) and full-body set (66.2%). Among 11 follow-up evaluation participants, contaminations still occurred in 82% after receiving individual feedback, but the overall contamination level was reduced. Using the contamination information gained during the simulation analysis, 66% of potential contamination was estimated for the clinical observation. Concerns and barriers in PPE use from HCP survey responses were as follows: time-consuming, cumbersomeness, and PPE effectiveness.
  
  
  
  Although HCP knew they were being videotaped, contamination occurred in 79.2% of the PPE simulations. Devising better standardized PPE protocols and implementing innovative PPE education are necessary to ensure HCP safety.
authors.affiliation: Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA. Electronic address: jahyunkang@gmail.com.
authors.forename: JaHyun
authors.initials: J
authors.lastname: Kang
authors.affiliation: Department of Nurse Anesthesia, School of Nursing, University of Pittsburgh, Pittsburgh, PA.
authors.forename: John M
authors.initials: JM
authors.lastname: O'Donnell
authors.affiliation: Clinical Improvement Department, Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Colaianne
authors.affiliation: Department of Anesthesiology, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Bircher
authors.affiliation: Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Dianxu
authors.initials: D
authors.lastname: Ren
authors.affiliation: Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Section of Decision Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D000067289:Behavior Observation Techniques; D005260:Female; D005456:Fluorescent Dyes; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D000067393:Personal Protective Equipment / Q000706:statistics & numerical data*; D013194:Staining and Labeling; D014741:Video Recording; D055815:Young Adult
chemical_list: D005456:Fluorescent Dyes
keywords: Contamination; Fluorescent powder; Health care personnel; Personal protective equipment; Simulation; Videotape analysis