should be redesigned . It ’ s hot in the SPD when you ’ re working with warm or hot water and you ’ re doing vigorous physical activity . When you ’ re suited up like that , it ’ s very uncomfortable . As I think about it , this leads me to believe we ’ re off target by thinking that this is only a PPE issue .”
Ofstead continues . “ This issue takes me back to my lab days where when we worked with a potentially hazardous substance or anything that could be infectious , we performed the task in a hood that was negative pressure ; if there was any hazardous material present , it was sucked out . And for any little splashes , we would wear goggles . We mostly did not wear masks because the hood protected us from exposure . A hood gives you physical protection , and it ’ s a control that doesn ’ t rely on the individual to don PPE correctly .”
“ How much more comfortable would it be in the decontamination area If you didn ’ t have to worry about being exposed ,” Ofstead adds . “ Part of it is when you know you ’ re going to get splashed , you hold your head at an angle , or you tip your head in order to have the splashes land on the face shield and not up under your neck and so , I think the solution we need is re-engineering , re-design .”
Ofstead points to how washer-disinfectors are a good example of automation helping to remove the human factors that can result in errors or adverse events . “ It keeps people from being exposed . In the long run , I think automation is a desirable thing . If we can automate something or have a machine do part of it , but if we ’ re going to have humans do it , we should be thinking about PPE as the last line of defense , not the first and only line of defense .”
The need for barrier protection is clear . As Ofstead , et al . ( 2022 ) explain from their study , “ Despite wearing a mask and a drop-down face shield , droplets were observed on paper affixed to the mask and chin and neck areas . This is concerning because fluid-resistant masks are not required , and personnel are not currently urged to wash their faces and necks after doffing contaminated PPE . Multiple droplets were detected on foot and shin areas , which suggests that tall boot covers are essential for personnel working in decontamination areas . The fronts and arms of gowns were saturated with water within a few seconds of initiating manual cleaning , highlighting the importance of liquid-impermeable gowns .”
“ The improper donning and wearing is what we had seen in facilities , but I ’ ve never audited any institution , any department where I consistently thought people were wearing the right PPE correctly ,” Ofstead says . “ With COVID now , we have a new recognition of droplet transmission along with continuing to be worried about infections caused by superbugs . I ’ m worried about the doffing and the reuse of PPE . I often go into units and see hooks in the break room or in the locker room , or in SPD , and there are gowns on them . You can see colorful droplets on them . SPD personnel tell me they put these gowns back on after their break . I don ’ t know if you can don a contaminated piece of PPE without exposing oneself , but I think that ’ s a very high risk . Reusing PPE and hanging dirty gowns on hooks so they can be re-donned by personnel should never happen . I see no circumstance where that would be ever appropriate .”
The study illuminated risks associated with circumstances that frequently occur in SPDs but also bring new attention to the
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