from the editor
Engineering Success Into Clinical Products May Have to be Our New Normal
While the COVID-19 pandemic is still not sufficiently behind us to declare victory , the ongoing supply chain challenges are ensuring that it will be a long time before personal protective equipment ( PPE ) may be in abundance everywhere to everyone who needs it .
The debate over reusing certain , if not all , items of PPE in the face of an outbreak or pandemic , continues , with each side producing evidence to support its case .
Recently , Doos , et al . ( 2022 ) stated that “ the practice of reusing PPE poses high levels of risk for accidental contamination by healthcare workers . Scarce medical literature compares practical means or methods for safe reuse of PPE while actively caring for patients .”
At the height of the pandemic , reuse of PPE was most egregious ( and most forgivable , if that ’ s possible ), and it is hoped that these questionable practices have abated . However , with persistent shortages in some hospitals , this may not be the case , and there are those – outside of disposable PPE manufacturers who stand to gain the most – who say that contamination risks run high . Mid-pandemic , there were numerous studies of varying quality examining methods of disinfection of disposable PPE , with mixed results .
The bigger issue than reuse itself may be the ongoing problem of how healthcare personnel continue to don and doff PPE .
Doos , et al . ( 2022 ) conducted observations of 28 experienced clinical participants performing five donning and doffing encounters while performing simulated full evaluations of COVID patients . Participants ’ N95 respirators were coated with a fluorescent dye to evaluate any accidental fomite transfer that occurred during PPE donning and doffing . Participants were evaluated using black light after each doffing encounter to evaluate new contamination sites and were assessed for the cumulative surface area that occurred due to PPE doffing . Additionally , participants ’ workstations were evaluated for contamination .
The researchers found that all participants experienced some contamination on their upper extremities , neck and face . The highest cumulative area of fomite transfer risk was associated with the hook and paper bag storage methods , and the least contamination occurred with the tabletop storage method . Storing a reused N95 respirator on a tabletop was found to be a safer alternative than the current CDC recommendation to use a paper bag for storage . All participants donning and doffing PPE were contaminated .
The researchers concluded that PPE re-usage practices pose an unacceptably high level of risk of accidental cross-contamination to healthcare workers . They add that the current design of PPE requires complete redesign with improved engineering and usability to protect healthcare workers .
And that may be the crux of the issue . We have all heard that making it easier to do the right thing is one of the first steps in securing compliance with protocols , whether it ’ s PPE usage , hand hygiene or surface disinfection . Human behavior being what it is , it demonstrates that engineering success into clinical products may have to be our new normal .
Until next month , bust those bugs ! Kelly M . Pyrek Editor & Publisher kelly @ healthcarehygienemagazine . com
Reference : Doos D , et al . The dangers of reused personal protective equipment : healthcare workers and workstation contamination . J Hospital Infect . Vol . 127 , P59-68 , Sept . 1 , 2022 . Available at : https :// www . journalofhospitalinfection . com / article / S0195-6701 ( 22 ) 00170-0 / fulltext healthcarehygienemagazine
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