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316 Personal Protective Equipment Use Among Canadian Healthcare Workers During the Delivery of Care to Patients on Droplet Precautions

Saturday, April 2, 2011: 2:30 PM
Coronado BCD (Hilton Anatole)
Robyn Mitchell, MHSc , Public Health Agency of Canada, Ottawa, ON, Canada
Virginia Roth, MD, FRCPC , The Ottawa Hospital, Ottawa, ON, Canada
George Astrakianakis, PhD , University of British Columbia, Vancouver, BC, Canada
Elizabeth Bryce, MD , Vancouver General Hospital, Vancouver, BC, Canada
Robert Gervais, MD , Public Health Agency of Canada, Ottawa, ON, Canada
Denise Gravel, MSc , Public Health Agency of Canada, Ottawa, ON, Canada
B. Lynn Johnston, MD , Dalhousie University, Halifax, NS, CANADA
Geoffrey Taylor, MD , University of Alberta Hospital, Edmonton, AB, Canada
Mary Vearncombe, MD , SunnyBrook Health Sciences Centre, Toronto, ON, CANADA
Krista D. Wilkinson, MSc , Public Health Agency of Canada, Ottawa, ON, Canada
Background: The proper use of personal protective equipment (PPE) by healthcare workers (HCWs) is vital in preventing the spread of infection and has significant implications for HCW safety.

Objective: The principal objective of this study was to determine the proportion of HCWs appropriately selecting, wearing, and removing PPE for droplet precautions during the second wave of the influenza A H1N1 pandemic in Canadian hospitals.

Methods: An observational study was performed in seven hospitals in Ontario and Manitoba between February 9, 2010 and April 8, 2010.   Using a standardized data collection tool trained observers recorded HCWs selecting, putting on and taking off PPE during the delivery of care to inpatients on droplet precautions. A composite score was derived for correct PPE use as determined by hospital policy.

Results: Observations of 204 HCWs were recorded of which 110 were complete. Only six HCWs (6%) applied all components of proper PPE use.  There were 29% of HCWs who selected appropriate PPE, 76% who put on PPE correctly, 72% who removed PPE using the correct procedure, and 29% who removed PPE in the correct sequence. 

A significantly higher proportion of nurses than other clinical HCWs removed PPE correctly (81% vs. 64%; p=0.04).  As well, significant differences in PPE use between units across all facilities were observed.  For example, HCWs working in the pediatric unit were significantly more likely to remove PPE correctly than those working in the intensive care unit (84% vs. 47%, p=0.002) or emergency department (84% vs. 59%, p=0.01).

Conclusions: HCWs were observed to perform poorly in applying all components of proper PPE use (selection, putting on, and removing).  Reasons for this poor performance should be explored to be better prepared for management of patients on droplet precautions, including during future pandemics.