Healthcare workers are not removing protective garments correctly

Washington, DC, July 16, 2015

Fewer than one in six (4/30) healthcare workers (HCW) followed all CDC recommendations for the removal of personal protective equipment (PPE) after patient care, according to a brief report published in the July issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).

In this study undertaken by researchers from the University of Wisconsin, a trained observer watched healthcare personnel entering and exiting patient rooms specified as following isolation precautions on various units of the hospital. Isolation precautions are used to help stop the spread of germs from one person to another and may require use of gowns, gloves, and face protection. Observations took place October 13-31, 2014.

The Centers for Disease Control and Prevention (CDC) recommends that gloves should be removed first, followed by the gentle removal of the gown from the back while still in the patient’s isolation room. Of the thirty HCWs observed removing PPE, seventeen removed the gown out of order, sixteen wore their PPE out into the hallway, and fifteen removed their gown in a manner that was not gentle, which could cause pathogens from the gown to transfer to their clothes.

“As a result of the current Ebola outbreak, the critical issue of proper PPE removal has come front and center,” the authors state. “Healthcare facilities should use this opportunity of heightened interest to undertake practice improvement focused on PPE removal protocol, including technique, for all healthcare-associated conditions that require the donning and doffing of PPE.”

Notes for Editors
“Variation in health care worker removal of personal protective equipment,” by Caroline Zellmer, Sarah Van Hoof, and Nadia Safdar appears in the American Journal of Infection Control, Volume 43, Issue 7 (July 2015).


Caroline Zellmer
William S. Middleton Veterans Hospital and Section of Infectious Diseases, Department of Medicine, University of Wisconsin, Madison, WI

Sarah Van Hoof, BSN, RN
William S. Middleton Veterans Hospital and Section of Infectious Diseases, Department of Medicine, University of Wisconsin, Madison, WI

Nasia Safdar, MD, PhD (Corresponding Author)
William S. Middleton Veterans Hospital and Section of Infectious Diseases, Department of Medicine, University of Wisconsin, Madison, WI


About AJIC: American Journal of Infection ControlAJIC: American Journal of Infection Control covers key topics and issues in infection control and epidemiology. Infection preventionists, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of APIC, AJIC is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. AJIC also publishes infection control guidelines from APIC and the CDC. Published by Elsevier, AJIC is included in MEDLINE and CINAHL.

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