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Use of personal protective equipment in Canadian pediatric emergency departments

Published online by Cambridge University Press:  11 May 2015

Sarah M. Reid ,
Ken J. Farion ,
Kathryn N. Suh ,
Tobey Audcent ,
Nicholas J. Barrowman  and
Amy C. Plint
Sarah M. Reid*
Affiliation:
Departments of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, ON
Ken J. Farion
Affiliation:
Departments of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, ON
Kathryn N. Suh
Affiliation:
Departments of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, ON
Tobey Audcent
Affiliation:
Departments of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, ON
Nicholas J. Barrowman
Affiliation:
Departments of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, ON Clinical Research Unit of Ottawa, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON
Amy C. Plint
Affiliation:
Departments of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, ON
*
Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON K1H 8L1; reid_sa@cheo.on.ca

Abstract

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Objective:

Numerous barriers to maintaining infection control practices through the use of personal protective equipment (PPE) exist in the emergency department (ED). This study examined the knowledge, self-reported behaviours, and barriers to compliance with infection control practices and the use of PPE in Canadian pediatric EDs.

Methods:

A self-administered survey instrument consisting of 21 questions was developed and piloted for this study. The survey was mailed to all individuals listed in the Pediatric Emergency Research Canada database of physicians practicing pediatric emergency medicine in Canada.

Results:

A total of 186 physicians were surveyed, and 123 (66%) participated. Twenty-two percent of participants reported that they had never received PPE training and 32% had not been trained in the previous 2 years. Fifty-three percent reported being very or somewhat comfortable with their knowledge of transmission-based isolation practices. Participants were correct on a mean of 4.9 of 11 knowledge-based questions (SD 1.7). For scenarios assessing self-reported use of PPE, participants selected answers that reflected PPE use in accordance with national infection control standards in a mean of 1.0 of 6 scenarios (SD 1.0). Participants reported that they would be more likely to use PPE if patients were clearly identified prior to physician assessment, equipment was accessible, and PPE use was made a priority in their ED.

Conclusions:

Knowledge and self-reported adherence to recommended infection control practices among Canadian pediatric emergency physicians is suboptimal. Early identification of patients requiring PPE, convenient access to PPE, and improved education regarding isolation and PPE practices may improve adherence.

Keywords

emergency medicinepediatricpersonal protective equipment
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 13 , Issue 2 , March 2011 , pp. 71 - 78
Copyright
Copyright © Canadian Association of Emergency Physicians 2011

References

REFERENCES

1.Rothman, RE, Irvin, CB, Moran, GJ, et al. Respiratory hygiene in the emergency department. Ann EmergMed 2006;48:570–82.Google Scholar
2.Kumar, A., Zarychanski, R, Pinto, R, et al. Critically ill patients with 2009 influenza A (H1N1) infection in Canada. JAMA 2009;302:1872–9.CrossRefGoogle ScholarPubMed
3.Varia, M, Wilson, S, Sarwal, S, et al. Investigation of a nosocomial outbreak of severe acute respiratory syndrome (SARS) in Toronto, Canada. CMAJ 2003;169:285–92.Google Scholar
4.Designing an effective PPE program. Canadian Centre for Occupational Health and Safety. Available at: http://www.ccohs.ca/oshanswers/prevention/ppe/designin.html" (accessed February 26, 2010).Google Scholar
5.Pittet, D, Hugonnet, S, Mourouga, P, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet 2000;356:1307–12.CrossRefGoogle ScholarPubMed
6.Boyce, JM, Pittet, D. Guideline for hand hygiene in healthcare settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR Recomm Rep 2002;51:1–45.Google ScholarPubMed
7.Centers for Disease Control and Prevention. Guidelines for the prevention and control of nosocomial infections: guideline for handwashing and hospital environmental control. Atlanta (GA): US Public Health Service; 1985.Google Scholar
8.Jefferson, T, Del Mar, C, Dooley, L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 2010;(1):CD006207.Google Scholar
9.Albert, RK, Condie, F. Hand-washing patterns in medical intensive-care units. N Engl J Med 1981;304:1465–6.Google Scholar
10.Pittet, D, Mourouga, P, Perneger, TV. Compliance with handwashing in a teaching hospital. Infection Control Programme. Ann Intern Med 1999;130:126–30.Google Scholar
11.Donowitz, LG. Handwashing technique in a pediatric intensive care unit. Am J Dis Child 1987;141:683–5.Google Scholar
12.Raju, TN, Kobler, C. Improved handwashing habits in the newborn nurseries. Am J Med Sci 1991;302:355–8.Google Scholar
13.Courington, KR, Patterson, SL, Howard, RJ. Universal precautions are not universally followed. Arch Surg 1991;126:93–6.Google Scholar
14.Ros, SP, Cabrera-Ros, BL. Poor compliance with universal precautions: a universal phenomenon? Pediatr Emerg Care 1990;6:183–5.Google Scholar
15.Moore, S, Goodwin, H, Grossberg, R, et al. Compliance with universal precautions among pediatric residents. Arch Pediatr Adolesc Med 1998;152:554–7.Google Scholar
16.Jusot, JF, Vanhems, P, Benzait, F, et al. The procedures of hygiene to control hospital-acquired diarrhea in paediatric wards: a multicentre audit. J Hosp Infect 2004;57:44–51.CrossRefGoogle ScholarPubMed
17.Meengs, MR, Giles, BK, Chisholm, CD, et al. Hand washing frequency in an emergency department. Ann Emerg Med 1994;23:1307–12.CrossRefGoogle ScholarPubMed
18.Parker, MJ, Goldman, RD. Paediatric emergency department staff perceptions of infection control measures against severe acute respiratory syndrome. Emerg Med J 2006;23:349–53.CrossRefGoogle ScholarPubMed
19.Pediatric Emergency Research Canada website. Available at: http://perc.srv.ualberta.ca/ (accessed February 26, 2010).Google Scholar
20.Nunnally, JC, Bernstein, IH. Psychometric theory New York: McGraw-Hill;1994.Google Scholar
21.Streiner, DL, Norman, GR. Health measurement scales: a practical guide to their development and use New York: Oxford University Press;1989.Google Scholar
22.Health Canada. Routine practices and additional precautions for preventing the transmission of infection in health care. Can Commun Dis Rep 1999;25 Suppl 4:1–155. Available at:http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/99pdf/cdr25s4e.pdf (accessed February 26, 2010).Google Scholar
23.Dillman, D. Mail and Internet surveys: the tailored design method New York: John Wiley & Sons; 2000.Google Scholar
24.Sax, H, Perneger, T, Hugonnet, S, et al. Knowledge of standard and isolation precautions in a large teaching hospital. Infect Control Hosp Epidemiol 2005;26:298–304.CrossRefGoogle Scholar
25.Pittet, D, Simon, A, Hugonnet, S, et al. Hand hygiene among physicians: performance, beliefs and perceptions. Ann Intern Med 2004;141:1–8.Google Scholar
26.Larson, EL, Early, E, Cloonan, P, et al. An organizational climate intervention associated with increased handwashing and decreased nosocomial infections. Behav Med 2000;26:14–22.Google Scholar
27.Lankford, MG, Zembower, TR, Trick, WE, et al. Influence of role models and hospital design on hand hygiene of healthcare workers. Emerg Infect Dis 2003;9:217–23.Google Scholar
28.Doumit, G, Gattellari, M, Grimshaw, J, et al. Local opinion leaders: effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2007;(1):CD000125.Google ScholarPubMed
29.Whitby, M, McLaws, ML, Slater, K, et al. Three successful interventions in health care workers that improve compliance with hand hygiene: is sustained replication possible? Am J Infect Control 2008;36:349–55.CrossRefGoogle ScholarPubMed
30.Williams, CO, Campbell, S, Henry, K, et al. Variables influencing worker compliance with universal precautions in the emergency department. Am J Infect Control 1994;22:138–48.CrossRefGoogle ScholarPubMed
31.Pittet, D. The Lowbury Lecture: behaviour in infection control. J Hosp Infect 2004;58:1–13.Google Scholar