Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Aug;16(8):575-581.
doi: 10.1080/15459624.2019.1628350. Epub 2019 Jul 10.

Personal protective equipment doffing practices of healthcare workers

Linh T Phan  1 , Dayana Maita  2 , Donna C Mortiz  2 , Rachel Weber  1 , Charissa Fritzen-Pedicini  1 , Susan C Bleasdale  2 , Rachael M Jones  1 ; CDC Prevention Epicenters Program
Affiliations

Personal protective equipment doffing practices of healthcare workers

Linh T Phan et al. J Occup Environ Hyg. 2019 Aug.

Abstract

During the doffing of personal protective equipment (PPE), pathogens can be transferred from the PPE to the bodies of healthcare workers (HCWs), putting HCWs and patients at risk of exposure and infection. PPE doffing practices of HCWs who cared for patients with viral respiratory infections were observed at an acute care hospital from March 2017 to April 2018. A trained observer recorded doffing performance of HCWs inside the patient rooms using a pre-defined checklist based on the Centers for Disease Control and Prevention (CDC) guideline. Doffing practices were observed 162 times during care of 52 patients infected with respiratory viral pathogens. Out of the 52 patients, 30 were in droplet and contact isolation, 21 were in droplet isolation, and 1 was in contact isolation. Overall, 90% of observed doffing was incorrect, with respect to the doffing sequence, doffing technique, or use of appropriate PPE. Common errors were doffing gown from the front, removing face shield of the mask, and touching potentially contaminated surfaces and PPE during doffing. Deviations from the recommended PPE doffing protocol are common and can increase potential for contamination of the HCW's clothing or skin after providing care. There is a clear need to change the approach used to training HCWs in PPE doffing practices.

Keywords: Doffing; healthcare workers; infection prevention; personal protective equipment.

PubMed Disclaimer

References

    1. Siegel J.D., Rhinehart, M. Jackson E., and Chiarello L.: 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Available at http://www.cdc.gov/hicpac/pdf/isolation/Isolation2007.pdf (accessed November 2016). - PMC - PubMed
    1. Chevalier M.S, Chung W., Smith J., et al. : Ebola virus disease cluster in the United States—Dallas County, Texas, 2014. Morb. Mortal. Wkly. (MMWR) 63(46):1087–1088 (2014). Available at https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6346a11.htm (accessed January 2017). - PMC - PubMed
    1. Mumma J.M., Durso F.T., Ferguson A.N., et al. : Human factors risk analyses of a doffing protocol for ebola-level personal protective equipment: Mapping errors to contamination. Clin. Infect. Dis. 66(6):950–958 (2018). doi: 10.1093/cid/cix957 - DOI - PMC - PubMed
    1. Casanova L., Alfano-Sobsey E., Rutala W.A., Weber D.J., and Sobsey M.: Virus transfer from personal protective equipment to healthcare employees’ skin and clothing. Emerg Infect Dis. 14(8):1291–3 (2008). - PMC - PubMed
    1. Kwon J.H., Burnham C-A.D., Reske K.A., et al. : Assessment of healthcare worker protocol deviations and self-contamination during personal protective equipment donning and doffing. Infect. Control Hosp. Epidemiol. 38(9):1077–1083 (2017). doi: 10.1017/ice.2017.121 - DOI - PMC - PubMed

Publication types

MeSH terms