A Review of Isolation Gowns in Healthcare: Fabric and Gown Properties

2015 ◽  
Vol 10 (3) ◽  
pp. 155892501501000 ◽  
Author(s):  
F. Selcen Kilinc
Keyword(s):  
Healthcare Workers ◽  
Emerging Infectious Diseases ◽  
Hemorrhagic Fever ◽  
Healthcare Setting ◽  
Critical Parameters ◽  
Protective Equipment ◽  
Bodily Fluids ◽  
Healthcare Settings ◽  
Ebola Hemorrhagic Fever ◽  
Wear And Tear

The threat of emerging infectious diseases including Ebola hemorrhagic fever, pandemic influenza, avian influenza, Hepatitis B, Hepatitis C, and SARS has highlighted the need for effective personal protective equipment (PPE) to protect healthcare workers (HCWs), patients, and visitors. PPE is a critical component in the hierarchy of controls used to protect HCWs from infectious hazards. HCW PPE may include gowns, respirators, face masks, gloves, eye protection, face shields, and head and shoe coverings. Important research has been conducted in certain areas, such as respirators and protective masks, but studies in other areas, particularly gowns, are scarce. Gowns are identified as the second-most-used piece of PPE, following gloves, in the healthcare setting. According to the Centers for Disease Control and Prevention's Guideline for Isolation Precautions, isolation gowns should be worn to protect HCWs’ arms and exposed body areas during procedures and patient-care activities when anticipating contact with clothing, blood, bodily fluids, secretions and excretions. Isolation gowns currently available on the marketplace offer varying resistance to blood and other bodily fluids depending on the type of the material, its impermeability, and wear and tear. While some studies show no benefit of the routine use of isolation gowns, others demonstrate that its use is associated with a reduced infection rate. This paper reviews isolation gowns in healthcare settings, including the fabrics used, gown design and interfaces, as well as critical parameters that affect microorganism and liquid transmission through fabrics.

scholarly journals Evaluating the contributions of strategies to prevent SARS-CoV-2 transmission in the healthcare setting: a modelling study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044644
Author(s):  
Xueting Qiu ◽  
Joel C Miller ◽  
Derek R MacFadden ◽  
William P Hanage
Keyword(s):  
Healthcare Workers ◽  
Healthcare Setting ◽  
Stochastic Simulations ◽  
Limited Resources ◽  
Base Case ◽  
Protective Equipment ◽  
Random Testing ◽  
Weekly Basis ◽  
Force Of Infection ◽  
Effective Use

IntroductionSince its onset, the COVID-19 pandemic has caused significant morbidity and mortality worldwide, with particularly severe outcomes in healthcare institutions and congregate settings. To mitigate spread, healthcare systems have been cohorting patients to limit contacts between uninfected patients and potentially infected patients or healthcare workers (HCWs). A major challenge in managing the pandemic is the presence of currently asymptomatic/presymptomatic individuals capable of transmitting the virus, who could introduce COVID-19 into uninfected cohorts. The optimal combination of personal protective equipment (PPE), testing and other approaches to prevent these events is unclear, especially in light of ongoing limited resources.MethodsUsing stochastic simulations with a susceptible-exposed-infected-recovered dynamic model, we quantified and compared the impacts of PPE use, patient and HCWs surveillance testing and subcohorting strategies.ResultsIn the base case without testing or PPE, the healthcare system was rapidly overwhelmed, and became a net contributor to the force of infection. We found that effective use of PPE by both HCWs and patients could prevent this scenario, while random testing of apparently asymptomatic/presymptomatic individuals on a weekly basis was less effective. We also found that even imperfect use of PPE could provide substantial protection by decreasing the force of infection. Importantly, we found that creating smaller patient/HCW-interaction subcohorts can provide additional resilience to outbreak development with limited resources.ConclusionThese findings reinforce the importance of ensuring adequate PPE supplies even in the absence of testing and provide support for strict subcohorting regimens to reduce outbreak potential in healthcare institutions.

Infection Control Practices Among Correctional Healthcare Workers: Effect of Management Attitudes and Availability of Protective Equipment and Engineering Controls

2001 ◽  
Vol 22 (9) ◽  
pp. 555-559 ◽  
Author(s):  
Judith Green-McKenzie ◽  
Robyn R.M. Gershon ◽  
Christine Karkashian
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Healthcare Workers ◽  
Safety Climate ◽  
Healthcare Setting ◽  
Protective Equipment ◽  
Correctional Health Care ◽  
Engineering Controls ◽  
Correctional Health ◽  
Correctional Healthcare

AbstractObjectives:To determine the relation of the availability of personal protective equipment (PPE) and engineering controls to infection control (IC) practices in a prison healthcare setting, and to explore the effect on IC practices of a perceived organizational commitment to safety.Design:Cross-sectional survey.Setting:The study population was drawn from the 28 regional Correctional Health Care Workers Facilities in Maryland.Participants:All full-time Maryland correctional healthcare workers (HCWs) were surveyed, and 225 (64%) of the 350 responded.Method:A confidential, self-administered questionnaire was mailed to all correctional HCWs employed in the 28 Maryland Correctional Health Care Facilities. The questionnaire was analyzed psychometrically and validated through extensive pilot testing. It included items on three major constructs: IC practices, safety climate (defined as the perception of organizational commitment to safety), and availability of IC equipment and supplies.Results:A strong correlation was found between the availability of PPE and IC practices. Similarly, a strong correlation was found between IC practices and the presence of engineering controls. In addition, an equally strong association was seen between the adoption of IC practices and employee perception of management commitment to safety. Those employees who perceived a high level of management support for safety were more than twice as likely to adhere to recommended IC practices. IC practices were significantly more likely to be followed if PPE was always readily available. Similarly, IC practices were more likely to be followed if engineering controls were provided.Conclusion:These findings suggest that ready availability of PPE and the presence of engineering controls are crucial to help ensure their use in this high-risk environment. This is especially important because correctional HCWs are potentially at risk of exposure to bloodborne pathogens such as human immunodeficiency virus and hepatitis B and C viruses. Commitment to safety was found to be highly associated with the adoption of safe work practices. There is an inherent conflict of “custody versus care” in this setting; hence, it is especially important that we understand and appreciate the relation between safety climate and IC practices. Interventions designed to improve safety climate, as well as availability of necessary IC supplies and equipment, will most likely prove effective in improving employee compliance with IC practices in this healthcare setting.

scholarly journals Hand Hygiene and Personal Protective Equipment in Healthcare Settings During COVID-19 Pandemic in Bangladesh

2020 ◽  
Vol 31 (2) ◽  
pp. 69-75
Author(s):  
Md Rezaul Karim ◽  
Sushil Kumar Sah ◽  
Afsarunnesa Syeda ◽  
Muhammad Tanvir Faysol ◽  
Aminur Rahman ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Healthcare Facility ◽  
Survey Study ◽  
Protective Equipment ◽  
Protective Measures ◽  
Healthcare Settings ◽  
Mandatory Training ◽  
Before And After

Objective: This study conducted to implement protective measures in healthcare settings during theCOVID-19 pandemic in the context of Bangladesh. Methods: It is an observational survey study. A pre-designed open questionnaire electronic linkusing google form was used to collect data from 500 healthcare workers within Bangladesh in whichparticipants were observed, and variables were measured. Results: The study findings revealed that among all participants, 70.9% were working in COVID-19dedicated hospitals, and 1.8% were diagnosed with COVID-19 while working. The study showed that69.1% of participants washed hands before and after consulting/handling each patient, 69.1% hadreadily available rubs/sanitizer in their healthcare facility, and 65.5% adhered principals ofhandwashing. The study also revealed that only 76.4% of participants maintained aseptic precautionsfor donning/doffing. Conclusion: The study findings recommend that mandatory training and maintaining asepticprecautions for PPE putting on (donning), and removal (doffing) is equally important. Bangladesh J Medicine July 2020; 31(2) :69-75

Tuberculosis: Infection Control/Exposure Control Issues for Oral Healthcare Workers

2008 ◽  
Vol 9 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Geza T. Terezhalmy ◽  
Nuala B. Porteous
Keyword(s):  
Infection Control ◽  
Healthcare Workers ◽  
Healthcare Setting ◽  
Essential Elements ◽  
Exposure Control ◽  
Standard Precautions ◽  
Control Plan ◽  
Healthcare Settings ◽  
Tuberculosis Infection Control ◽  
Tb Infection Control

Abstract Aim The aim is to present the essential elements of an infection control/exposure control plan for the oral healthcare setting with emphasis on tuberculosis (TB). Methods and Materials A comprehensive review of the literature was conducted with special emphasis on TB infection-control issues in the oral healthcare setting. Results Currently available knowledge related to TB infection-control issues is supported by data derived from well-conducted trials or extensive controlled observations. In the absence of supportive data the information is supported with the best-informed, most authoritative opinion available. Conclusion Essential elements of an effective TB infection-control plan include a three-level hierarchy of administrative, environmental, and respiratory-protection controls. Clinical Significance Standard precautions provide the fabric for strategies to prevent or reduce the risk of exposure to bloodborne pathogens and other potentially infectious material. However, standard precautions are inadequate to prevent the spread of organisms through droplet nuclei 1-5 micron in diameter and additional measures are necessary to prevent the spread of Mycobacterium tuberculosis. Oral healthcare settings have been identified as outpatient settings in which patients with suspected or confirmed infectious TB disease are expected to be encountered. Therefore, oral healthcare settings must have a written TB infection-control program. Citation Porteous NB, Terezhalmy GT. Tuberculosis: Infection Control/Exposure Control Issues for Oral Healthcare Workers. J Contemp Dent Pract 2008 January; (9)1:001-013.

scholarly journals Stability of SARS-CoV-2 on Critical Personal Protective Equipment

2020 ◽  
Author(s):  
Samantha B Kasloff ◽  
James E Strong ◽  
Duane Funk ◽  
Todd Cutts
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Protective Equipment ◽  
Potential Utility ◽  
Rapid Degradation ◽  
Healthcare Settings ◽  
Interesting Insight ◽  
Mode Of Transmission ◽  
Insight Into ◽  
Shed Light

AbstractThe spread of COVID-19 in healthcare settings is concerning, with healthcare workers representing a disproportionately high percentage of confirmed cases. Although SARS-CoV-2 virus has been found to persist on surfaces for a number of days, the extent and duration of fomites as a mode of transmission, particularly in healthcare settings, has not been fully characterized. To shed light on this critical matter, the present study provides the first comprehensive assessment of SARS-CoV-2 stability on experimentally contaminated personal protective equipment (PPE) widely used by healthcare workers and the general public. Persistence of viable virus was monitored over 21 days on eight different materials, including nitrile medical examination gloves, reinforced chemical resistant gloves, N-95 and N-100 particulate respirator masks, Tyvek®, plastic, cotton, and stainless steel. Unlike previous reports, viable SARS-CoV-2 in the presence of a soil load persisted for up to 21 days on experimentally inoculated PPE, including materials from filtering facepiece respirators (N-95 and N-100 masks) and a plastic visor. Conversely, when applied to 100% cotton fabric, the virus underwent rapid degradation and became undetectable in less than 24 hours. These findings underline the importance of appropriate handling of contaminated PPE during and following use in high-risk settings and provide interesting insight into the potential utility of cotton, including cotton masks, in limiting COVID-19 transmission.

scholarly journals The ‘haves’ and ‘have-nots’ of personal protective equipment during the COVID-19 pandemic: the ethics of emerging inequalities amongst healthcare workers

2021 ◽  
pp. medethics-2021-107501
Author(s):  
Clifford Shelton ◽  
Kariem El-Boghdadly ◽  
John B Appleby
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Healthcare Setting ◽  
Protective Equipment ◽  
Practical Action ◽  
Ethical Implications ◽  
Healthcare Workforce ◽  
Pandemic Planning ◽  
Operating Theatres

The COVID-19 pandemic has exacerbated inequalities, including among the healthcare workforce. Based on recent literature and drawing on our experiences of working in operating theatres and critical care in the UK’s National Health Service during the pandemic, we review the role of personal protective equipment and consider the ethical implications of its design, availability and provision at a time of unprecedented demand. Several important inequalities have emerged, driven by factors such as individuals purchasing their own personal protective equipment (either out of choice or to address a lack of provision), inconsistencies between guidelines issued by different agencies and organisations, and the standardised design and procurement of equipment required to protect a diverse healthcare workforce. These, we suggest, have resulted largely because of a lack of appropriate pandemic planning and coordination, as well as insufficient appreciation of the significance of equipment design for the healthcare setting. As with many aspects of the pandemic, personal protective equipment has created and revealed inequalities driven by economics, gender, ethnicity and professional influence, creating a division between the ‘haves’ and ‘have-nots’ of personal protective equipment. As the healthcare workforce continues to cope with ongoing waves of COVID-19, and with the prospect of more pandemics in the future, it is vital that these inequalities are urgently addressed, both through academic analysis and practical action.

scholarly journals Recommendations For Metrics For Multidrug-Resistant Organisms In Healthcare Settings: SHEA/HICPAC Position Paper

2008 ◽  
Vol 29 (10) ◽  
pp. 901-913 ◽  
Author(s):  
Adam L. Cohen ◽  
David Calfee ◽  
Scott K. Fridkin ◽  
Susan S. Huang ◽  
John A. Jernigan ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Infection Prevention ◽  
Healthcare Setting ◽  
Multidrug Resistant ◽  
Infection Prevention And Control ◽  
Healthcare Settings ◽  
Multidrug Resistant Organisms ◽  
Vulnerable Patient ◽  
Trends Over Time ◽  
And Control

Monitoring multidrug-resistant organisms (MDROs) and the infections they cause in a healthcare setting is important to detect newly emerging antimicrobial resistance profiles, to identify vulnerable patient populations, and to assess the need for and effectiveness of interventions; however, it is unclear which metrics are the best, because most of the metrics are not standardized. This document describes useful and practical metrics and surveillance considerations for measuring MDROs and the infections they cause in the practice of infection prevention and control in healthcare settings. These metrics are designed to aid healthcare workers in documenting trends over time within their facility and should not be used for interfacility comparison.

scholarly journals Evaluating the potential impact of targeted vaccination strategies against severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) outbreaks in the healthcare setting

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Fatima Abdirizak ◽  
Rayleen Lewis ◽  
Gerardo Chowell
Keyword(s):  
Middle East ◽  
Severe Acute Respiratory Syndrome ◽  
Healthcare Workers ◽  
Healthcare Setting ◽  
Middle East Respiratory Syndrome ◽  
Effective Measure ◽  
Vaccination Strategies ◽  
Healthcare Settings ◽  
Stage Of Development ◽  
Potential Impact

Abstract Background Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) are two coronaviruses with demonstrated potential to generate significant nosocomial outbreaks. In particular, MERS continues to pose a significant threat in the Middle East since 2012. Currently, no licensed vaccine or drug treatment is available to treat patients infected with either coronavirus. However, there are some MERS vaccines in the preclinical stage of development. We sought to evaluate the potential impact of targeted vaccination strategies for mitigating SARS and MERS outbreaks in healthcare settings using simple mathematical models and detailed historic transmission trees describing the progression of past nosocomial outbreaks of SARS and MERS. Results Our findings suggest that vaccination strategies targeting patients and healthcare workers, which have been disproportionately affected during past outbreaks, and assuming two vaccination coverage levels at 50 and 75% have the potential to avert nearly 50% or more of MERS or SARS cases. Conclusion Our modeling results informed by historic outbreak data for SARS and MERS suggest that vaccination strategies targeting patients could be an effective measure to mitigate and prevent outbreaks in the healthcare setting.

scholarly journals Stability of SARS-CoV-2 on critical personal protective equipment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Samantha B. Kasloff ◽  
Anders Leung ◽  
James E. Strong ◽  
Duane Funk ◽  
Todd Cutts
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Protective Equipment ◽  
Potential Utility ◽  
Rapid Degradation ◽  
Healthcare Settings ◽  
Interesting Insight ◽  
Mode Of Transmission ◽  
Insight Into ◽  
Shed Light

AbstractThe spread of COVID-19 in healthcare settings is concerning, with healthcare workers representing a disproportionately high percentage of confirmed cases. Although SARS-CoV-2 virus has been found to persist on surfaces for a number of days, the extent and duration of fomites as a mode of transmission, particularly in healthcare settings, has not been fully characterized. To shed light on this critical matter, the present study provides the first comprehensive assessment of SARS-CoV-2 stability on experimentally contaminated personal protective equipment (PPE) widely used by healthcare workers and the general public. Persistence of viable virus was monitored over 21 days on eight different materials, including nitrile medical examination gloves, reinforced chemical resistant gloves, N-95 and N-100 particulate respirator masks, Tyvek, plastic, cotton, and stainless steel. Unlike previous reports, viable SARS-CoV-2 in the presence of a soil load persisted for up to 21 days on experimentally inoculated PPE, including materials from filtering facepiece respirators (N-95 and N-100 masks) and a plastic visor. Conversely, when applied to 100% cotton fabric, the virus underwent rapid degradation and became undetectable by TCID50 assay within 24 h. These findings underline the importance of appropriate handling of contaminated PPE during and following use in high-risk settings and provide interesting insight into the potential utility of cotton in limiting COVID-19 transmission.

A Review on Methods of Face Masks Sterilization for Reuse Owing To Crisis During COVID-19

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1240-1243
Author(s):  
Pradyuman Singh Rajput ◽  
Asish Kumar Saha ◽  
Insiya Gangardiwala ◽  
Anand Vijayakumar Palur Ramakrishnan
Keyword(s):  
Healthcare Workers ◽  
Health Hazard ◽  
Capital City ◽  
Limited Resources ◽  
Protective Equipment ◽  
First Line ◽  
Republic Of China ◽  
Enormous Amount ◽  
The Face ◽  
The Common

The COVID-19 pandemic initially started from the Wuhan capital city of Hubei Province in the People's Republic of China had now led to a severe public health hazard across the globe, the recorded death is approximately 958 thousand globally and counting. With the enormous amount of spread of the disease, a severe crisis for Personal Protective Equipment (PPE) is being noticed across the globe. Face masks being the first line of defence for all the healthcare workers as well for the common public. It became mandatory to wear face masks before entering the patient care area. The countries who are not manufacturing it locally had to depend on other countries for the procurement. As there is a severe supply chain disruption due to the lockdown measures taken by all the countries to contain the disease, so it had become difficult to procure the face masks from the manufacturing countries. The price for these PPEs is also rising at an alarming rate with the increase in the COVID-19 cases and the huge rate of consumption by the healthcare and other sectors. Therefore, with limited resources, the hospital has to run its services. The CDC, WHO and ICMR have released several guidelines from time to time for sterilization and reuse of face masks. This article will discuss the various methods that can be utilized to sterilize the face masks and reuse of it.

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