Use of ultraviolet-fluorescence-based simulation in evaluation of personal protective equipment worn for first assessment and care of a patient with suspected high-consequence infectious disease

Abstract

All suspected case PPE ensembles either had post-doffing contamination events or other significant disadvantages to their use. This identified the need to design a unified PPE ensemble and doffing procedure, incorporating the most protective PPE considered for each body area. This work has been presented to, and reviewed by, key stakeholders to decide on a proposed unified ensemble, subject to further evaluation.

‘VIOLET’: a fluorescence-based simulation exercise for training healthcare workers in the use of personal protective equipment

“…Some post-doffing contamination events were observed, with mechanisms identified by retrospective review of video footage. Full results of the contamination events and PPE analysis are presented and examined further in separate work by Hall et al [30].…”

“…Instant visual feedback facilitated real-time discussion about contamination routes and reinforced the need for controlled doffing, avoiding excessive movements such as kicking boots or shaking gowns. Filming each exercise allowed the footage to be reviewed retrospectively to identify mechanisms of contamination events, providing vital information to enable PPE evaluation, as discussed further in separate work by Hall et al [30].…”

“…The inclusion of respiratory transmission, alongside bodily fluid exposures of vomit, diarrhoea and sweat, enables adaptation for any recognized or emerging HCID pathogen. VIOLET has already provided an objective evidence-based assessment of HCID PPE in use, identifying various strengths and limitations, as discussed in Hall et al [30].…”

“…Volunteers had to demonstrate competency in PPE to a staff trainer prior to the simulation. Descriptions of the PPE used can be found in separate work by Hall et al [30].…”

Washing our hands of the problem

“…Gloved hand disinfection (for a single patient encounter) has been shown to increase compliance with hand hygiene [14]. Where glove use is appropriate, careful removal and disposal of gloves is important as environmental contamination is known to occur with doffing of PPE and gloves [15][16][17].…”