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The Impact of Environmental Design on Doffing Personal Protective Equipment in a Healthcare Environment: A Formative Human Factors Trial

Published online by Cambridge University Press:  02 May 2017

Tracey A. Herlihey ,
Stefano Gelmi ,
Joseph A. Cafazzo  and
Trevor N. T. Hall
Tracey A. Herlihey*
Affiliation:
Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Canada
Stefano Gelmi
Affiliation:
Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Canada
Joseph A. Cafazzo
Affiliation:
Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Canada
Trevor N. T. Hall
Affiliation:
Emergency Preparedness & Ontario’s Emergency Medical Assistance Team, Sunnybrook Health Sciences Centre, Toronto, Canada
*
Address correspondence to Tracey A. Herlihey, PhD, CPsychol, Healthcare Human Factors, Techna Institute, University Health Network, R. Fraser Elliott Building, 4th Floor, Toronto, Canada, M5G 2C4 (traceyherlihey@gmail.com).
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Abstract

OBJECTIVE

To explore the impact of environmental design on doffing personal protective equipment in a simulated healthcare environment.

METHODS

A mixed-methods approach was used that included human-factors usability testing and qualitative questionnaire responses. A patient room and connecting anteroom were constructed for testing purposes. This experimental doffing area was designed to overcome the environmental failures identified in a previous study and was not constructed based on any generalizable hospital standard.

RESULTS

In total, 72 healthcare workers from Ontario, Canada, took part in the study and tested the simulated doffing area. The following environmental design changes were tested and were deemed effective: increasing prominence of color-coded zones; securing disinfectant wipes and hand sanitizer; outlining disposal bins locations; providing mirrors to detect possible contamination; providing hand rails to assist with doffing; and restricting the space to doff. Further experimentation and iterative design are required with regard to several important features: positioning the disposal bins for safety, decreasing the risk of contamination and user accessibility; optimal positioning of mirrors for safety; communication within the team; and positioning the secondary team member for optimal awareness. Additional design suggestions also emerged during this study, and they require future investigation.

CONCLUSIONS

This study highlights the importance of the environment on doffing personal protective equipment in a healthcare setting. Iterative testing and modification of the design of the environment (doffing area) are important to enhancing healthcare worker safety.

Infect Control Hosp Epidemiol 2017;38:712–717

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 6 , June 2017 , pp. 712 - 717
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

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