TY - JOUR
T1 - Assessment of dental health care personnel protocol deviations and self-contamination during personal protective equipment donning and doffing
AU - Reske, Kimberly A.
AU - Park, Daniel
AU - Bach, Tracey Habrock
AU - Stewart, Henry B.
AU - Vogt, Lucy C.
AU - Arter, Olivia G.
AU - Stoeckel, Daniel
AU - Steinkamp, Heidi M.
AU - Liang, Stephen Y.
AU - Durkin, Michael J.
AU - Kwon, Jennie H.
N1 - Publisher Copyright:
© 2022 American Dental Association
PY - 2022/11
Y1 - 2022/11
N2 - Background: Dental health care personnel (DHCP) may be at increased risk of exposure to severe acute respiratory syndrome coronavirus 2, the virus that causes COVID-19, as well as other clinically important pathogens. Proper use of personal protective equipment (PPE) reduces occupational exposure to pathogens. The authors performed an assessment of PPE donning and doffing practices among DHCP, using a fluorescent marker as a surrogate for pathogen transmission. Methods: Participants donned PPE (that is, disposable gown, gloves, face mask, and eye protection) and the fluorescent marker was applied to their palms and abdomen. DHCP then doffed PPE according to their usual practices. The donning and doffing processes were video recorded, areas of fluorescence were noted, and protocol deviations were assessed. Statistical analyses included frequency, type, and descriptions of protocol deviations and factors associated with fluorescence. Results: Seventy DHCP were enrolled. The donning and doffing steps with the highest frequency of protocol deviations were hand hygiene (66% of donning and 78% of doffing observations involved a deviation) and disposable gown use (63% of donning and 60% of doffing observations involved a deviation). Fluorescence was detected on 69% of DHCP after doffing, most frequently on hands. An increasing number of protocol deviations was significantly associated with increased risk of fluorescence. DHCP with a gown doffing deviation, excluding doffing out of order, were more likely to have fluorescence detected. Conclusions: DHCP self-contamination was common with both donning and doffing PPE. Practical Implications: Proper use of PPE is an important component of occupational health.
AB - Background: Dental health care personnel (DHCP) may be at increased risk of exposure to severe acute respiratory syndrome coronavirus 2, the virus that causes COVID-19, as well as other clinically important pathogens. Proper use of personal protective equipment (PPE) reduces occupational exposure to pathogens. The authors performed an assessment of PPE donning and doffing practices among DHCP, using a fluorescent marker as a surrogate for pathogen transmission. Methods: Participants donned PPE (that is, disposable gown, gloves, face mask, and eye protection) and the fluorescent marker was applied to their palms and abdomen. DHCP then doffed PPE according to their usual practices. The donning and doffing processes were video recorded, areas of fluorescence were noted, and protocol deviations were assessed. Statistical analyses included frequency, type, and descriptions of protocol deviations and factors associated with fluorescence. Results: Seventy DHCP were enrolled. The donning and doffing steps with the highest frequency of protocol deviations were hand hygiene (66% of donning and 78% of doffing observations involved a deviation) and disposable gown use (63% of donning and 60% of doffing observations involved a deviation). Fluorescence was detected on 69% of DHCP after doffing, most frequently on hands. An increasing number of protocol deviations was significantly associated with increased risk of fluorescence. DHCP with a gown doffing deviation, excluding doffing out of order, were more likely to have fluorescence detected. Conclusions: DHCP self-contamination was common with both donning and doffing PPE. Practical Implications: Proper use of PPE is an important component of occupational health.
KW - COVID-19
KW - Masks
KW - dental infection control
KW - eye protective devices
KW - gloves, protective
KW - health, occupational
UR - http://www.scopus.com/inward/record.url?scp=85139084293&partnerID=8YFLogxK
U2 - 10.1016/j.adaj.2022.08.004
DO - 10.1016/j.adaj.2022.08.004
M3 - Article
C2 - 36175202
AN - SCOPUS:85139084293
SN - 0002-8177
VL - 153
SP - 1070-1077.e1
JO - Journal of the American Dental Association
JF - Journal of the American Dental Association
IS - 11
ER -