Personal protective equipment for protecting healthcare staff from highly infectious diseases

Added November 23, 2021

Citation: Verbeek JH, Rajamaki B, Ijaz S, Sauni R, Toomey E, Blackwood B, Tikka C, Ruotsalainen JH, Balci FS. Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff. Cochrane Database of Systematic Reviews. 2020;(4):CD011621.

Language: Abstract available in EN / ES / FR / PO / CH. Full text available in EN. 

Free to view: Yes.

Funding sources: Internal sources of support: Cochrane Collaboration, UK Bursary; Finnish Institute of Occupational Health; National Institute for Occupational Safety and Health. External sources: None reported.

What is this? A variety of types of personal protective equipment (PPE) are used to try to protect healthcare workers from infection with, for example, the SARS-CoV-2 virus.

In this Cochrane review, the authors searched for studies of the effects of different types of PPE, ways to put it on and remove it and how to train workers to comply with guidance on its use. They did not restrict their searches by date, language or type of publication and did the search in March 2020. They identified 14 randomized, 1 quasi-randomized and 9 non-randomized trials (total: 2278 participants).

What was found: A powered, air-purifying respirators may protect better than a N95 mask and gown but was more difficult to put on.

Long gowns may protect better against contamination than coveralls and were easier to take off; and gowns may protect better against contamination than aprons.

PPE made of more breathable material may lead to a similar number of spots on the trunk compared to more water‐repellent material but may have greater user satisfaction.

Other interventions that may reduce contamination include sealed gown and glove combinations; a better fitting gown around the neck, wrists and hands; a better cover of the gown‐wrist interface; and tabs to grab to facilitate the removal of masks or gloves; using Centers for Disease Control and Prevention recommendations for removing PPE; one‐step removal of gloves and gown; double‐gloving compared to single gloving; and spoken instructions and extra sanitation of gloves with quaternary ammonium or bleach when removing PPE.

For training: the use of additional computer simulation, a video lecture on putting PPE on and face‐to‐face instruction may be better than providing folders or videos only.

Implications: Consistent use of full-body PPE can decrease the risk of infection for healthcare workers.

Other considerations: The authors of the review discussed their findings in the context of Education.

Podcast of this review available here.

 

This summary was prepared by Joly Ghanawi, edited and finalized by Mike Clarke.

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