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. 2022 Dec 1;11(12):e36549.
doi: 10.2196/36549.

Perceived Workload Using Separate (Filtering Facepiece Respirator and Face Shield) and Powered Air-Purifying Respirator and Integrated Lightweight Protective Air-Purifying Respirator: Protocol for an International Multisite Human Factors Randomized Crossover Feasibility Study

Amy Price  1 , Ying Ling Lin  2 , Anna S Levin  3 , Fabio Tumietto  4 , Rodrigo Almeida  5 , Ana Almeida  5 , Caroline Lopes Ciofi-Silva  6 , Luca Fontana  2 , Naila Oliveira  7 , Nicola Francesco Parisi  8 , Giulia Marcelino Mainardi  7 , Luciana Cordeiro  7 , Marco Roselli  8 , Paul Shepherd  9 , Luana Morelli  8 , Najmeh Mehrabi  8 , Kathleen Price  10 , Whitney Chan  1 , Shrinidhy Srinivas  1 , T Kyle Harrison  11 , May Chu  12 , Maria Clara Padoveze  7 , Larry Chu  1   11
Affiliations

Perceived Workload Using Separate (Filtering Facepiece Respirator and Face Shield) and Powered Air-Purifying Respirator and Integrated Lightweight Protective Air-Purifying Respirator: Protocol for an International Multisite Human Factors Randomized Crossover Feasibility Study

Amy Price et al. JMIR Res Protoc. .

Abstract

Background: The design of personal protective equipment (PPE) may affect well-being and clinical work. PPE as an integrated item may improve usability and increase adherence by healthcare professionals. Human factors design and safety may reduce occupational-acquired diseases. As an integrated PPE, a lightweight protective air-purifying respirator (L-PAPR) could be used during health procedures where healthcare professionals are exposed to airborne pathogens. The human factors affecting the implementation of alternative PPE such as L-PAPR have not been thoroughly studied. The population of interest is health care professionals, the intervention is the performance by PPE during tasks across the three PPE types 1.) N95 respirators and face shields, 2.)traditional powered air-purifying respirator(PAPR), and 3.) L-PAPR. The outcomes are user error, communications, safety, and end-user preferences.

Objective: This study will assess whether the L-PAPR improves health care professionals' comfort in terms of perceived workload and physical and psychological burden during direct patient care when compared with the traditional PAPR or N95 and face shield. This study also aims to evaluate human factors during the comparison of the use of L-PAPR with a combination of N95 respirators plus face shields or the traditional PAPRs.

Methods: This is an interventional randomized crossover quality improvement feasibility study consisting of a 3-site simulation phase with 10 participants per site and subsequent field testing in 2 sites with 30 participants at each site. The 3 types of respiratory PPE will be compared across medical tasks and while donning and doffing. We will evaluate the user's perceived workload, usability, usage errors, and heart rate. We will conduct semistructured interviews to identify barriers and enablers to implementation across each PPE type over a single continuous wear episode and observe interpersonal communications across conditions and PPE types.

Results: We expect the research may highlight communication challenges and differences in usability and convenience across PPE types along with error frequency during PPE use across PPE types, tasks, and time.

Conclusions: The design of PPE may affect overall well-being and hinder or facilitate clinical work. Combining 2 pieces of PPE into a single integrated item may improve usability and reduce occupational-acquired diseases. The human factors affecting the implementation of an alternative PPE such as L-PAPR or PAPR have not been thoroughly studied.

International registered report identifier (irrid): PRR1-10.2196/36549.

Keywords: N95; SARS-CoV-2; health care; health care workers; human factors; human factors field study; human factors simulation; patient care; personal protective equipment; safety.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
(A) Traditional powered air-purifying respirator (PAPR) and (B) lightweight protective air-purifying respirator (L-PAPR).
Figure 2
Figure 2
Phases of the study design and sites where the protocol will be put into action. L-PAPR: lightweight protective air-purifying respirator; PAPR: powered air-purifying respirator.
Figure 3
Figure 3
Schema of data collection methods and respective outcomes measures. NASA-TLX: National Aeronautics and Space Administration Task Load Index score; SUS: System Usability Scale.
See this image and copyright information in PMC

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