Health care workers, PPE and infection control: Study finds failures to follow protocol

Ann Arbor, MI — Health care workers may be contaminating themselves and their work environments by neglecting to use personal protective equipment and follow preventive protocol, according to a study from researchers at the University of Michigan and the University of Utah.

Researchers conducted 325 observations of health care workers over a nine-month period, charting behaviors inside and outside patient rooms. The observations showed 283 offenses that were capable of triggering self-contamination or transmission of infectious agents. The breakdown:

• 102 violations were categorized as neglecting to follow standard interaction protocol. Many were related to failure to use PPE such as gowns, gloves and masks. Violations were observed when workers interacted with patients’ families, checked devices or delivered supplies to patient rooms.
• 144 violations were categorized as errors in process or procedure. Examples included removing gowns in an improper sequence, touching gloved hands to ID badges to access in-room computers and using gloved hands to gather medications or supplies from coat pockets.
• 37 violations were categorized as inadvertent responsive behaviors. Examples included using a gloved hand to touch one’s face or using a personal device.

“The factors that contributed to these failures varied widely, suggesting the need for a range of strategies to reduce potential transmission risk during routine hospital care,” the researchers wrote.

They recommended reconsidering technology and strategies such as the parameters within a patient’s room in which PPE is required. The researchers also found some violations linked to poorly designed clothing, room configuration and computer access.

“At the core of our work is the idea that we need to be even more thoughtful about the type of equipment that we introduce in health care,” Frank Drews, senior author and University of Utah psychology professor, said in a June 11 press release. “More usable equipment will make it easier for health care workers to do their tasks.”

The study was published online June 11 in JAMA Internal Medicine.