Design Strategies to Improve Healthcare Worker Safety in Biocontainment Units: Learning from Ebola Preparedness

Details

• Personal Author:
  Casanova LM ; DuBose JR ; Durso FT ; Erukunuakpor K ; Jacob JT ; Kraft CS ; Matic Z ; Mumma JM ; Shah P ; Walsh VL ; Wong Sala MF ; Zimring CM
• Corporate Authors:
  CDC Prevention Epicenters Program
• Description:
  Objective: To identify ways that the built environment may support or disrupt safe doffing of personal protective equipment (PPE) in biocontainment units (BCU). Design: We observed interactions between healthcare workers (HCWs) and the built environment during 41 simulated PPE donning and doffing exercises. Setting: The BCUs of 4 Ebola treatment facilities and 1 high-fidelity BCU mockup. Participants: A total of 64 HCWs (41 doffing HCWs and 15 trained observers) participated in this study. Results: In each facility, we observed how the physical environment influences risky behaviors by the HCW. The environmental design impeded communication between trained observers (TOs) and HCWs because of limited window size or visual obstructions with louvers, which allowed unobserved errors. The size and configuration of the doffing area impacted HCW adherence to protocol, and lack of clear demarcation of zones resulted in HCWs inadvertently leaving the doffing area and stepping back into the contaminated areas. Lack of standard location for items resulted in equipment and supplies frequently shifting positions. Finally, different solutions for maintaining balance while removing shoe covers (ie, chair, hand grips, and step stool) had variable success. We identified the 5 key requirements that doffing areas must achieve to support safe doffing of PPE, and we developed a matrix of proposed design strategies that can be implemented to meet those requirements. Conclusions: Simple, low-cost environmental design interventions can provide structure to support and improve HCW safety in BCUs. These interventions should be implemented in both current and future BCUs. [Description provided by NIOSH]
• Subjects:
  Behavior Environmental Exposure Health Care Facilities Workforce And Services Health Personnel Occupational Health Risk Assessment Risk Factors Safety Workplace
• Keywords:
  Exposure Levels Health Care Health Care Facilities Health Care Personnel Health Care Workers Intervention Intervention Effectiveness Risk Factors Work Environment Workers Worker Safety

  More +
• ISSN:
  0899-823X
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Georgia ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  39
• Issue:
  8
• NIOSHTIC Number:
  nn:20064433
• Citation:
  Infect Control Hosp Epidemiol 2018 Aug; 39(8):961-967
• Contact Point Address:
  Jennifer R. DuBose, SimTigrate Design Lab, 828 West Peachtree St. NW, Suite #334, Atlanta, GA 30332-0477
• Email:
  Jennifer.dubose@design.gatech.edu
• Federal Fiscal Year:
  2018
• Performing Organization:
  Georgia State University
• Peer Reviewed:
  True
• Start Date:
  20150901
• Source Full Name:
  Infection Control and Hospital Epidemiology
• End Date:
  20180831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:0d5153f88b14c0ea379fb686a07c1f2fc5e27429cba72008fa9091a3361716a8e0740176a95e878670210ade1f534401b19fdce57730b13339499a84ba6c1944
• Download URL:
  https://stacks.cdc.gov/view/cdc/222890/cdc_222890_DS1.pdf
• File Type:
  [PDF - 779.31 KB ]