Faced with emerging threats of new pathogens and antibiotic-resistant bacteria, many healthcare providers are placing a renewed focus on reducing healthcare-associated infections.
Personal protective equipment is a crucial aspect of reducing infection transmission between patients and clinicians. However, clinicians don't always use PPE correctly to ensure maximum protection, according to two PPE experts from Dublin, Ohio-based Cardinal Health.
Mary Cross, a senior consultant for clinical operations and surgical gloves, and Caroline Ginn, a senior clinical consultant, recently spoke with Becker's Hospital Review about the importance of proper PPE use for both clinicians and patients.
Ms. Cross and Ms. Ginn hold nearly fifty years of clinical experience combined, predominately in perioperative settings. Drawing on their extensive clinical backgrounds, they discussed the most common PPE mistakes they've seen clinicians make and shared advice for how hospitals can boost PPE compliance.
Note: Responses have been lightly edited for length and clarity.
Question: What is PPE and why is it important?
Caroline Ginn: By definition, PPE is clothing and other equipment that protects clinicians in instances where they may be exposed to harmful pathogens.
Mary Cross: PPE really ensures we're creating a safe environment for healthcare providers. Clinicians are not just protecting themselves from bloodborne pathogens and other infectious materials with PPE, but also the next patient they treat, which can magnify to the entire community. It's not just important that clinicians have PPE, but that they know how to properly put it on and take it off.
Q: Can you share some of the most common PPE mistakes you've seen during your clinical experience?
CG: Staff members often don't have a clear understanding of the protection level they need to be wearing. There are nurses who think they can just hold their breath to go into a respiratory isolation room to turn off a patient's IV alarm, instead of taking half a second to put on face protection to ensure they're not coming into contact with any airborne viruses or bacteria. Clinicians also often incorrectly wear and remove PPE after exposure, or don't wear gloves at all.
MC: The most common thing I see is clinicians who throw on an isolation gown and don't tie it up, thinking they only need to protect the front side of their body. They don't realize they're probably not adequately protected. I also see clinicians who are wearing the wrong level of protection, or who don't wear facemasks or eye protection, not thinking about splash.
Q: Why is there a need for healthcare facilities to focus on PPE compliance?
CG: Today's healthcare communities are different than they were five to 10 years ago. Clinicians are constantly exposed to pathogens and unknown micro-organisms. If they go from one patient room to another, they're then bilaterally exposing patients.
In terms of Medicare and Medicaid reimbursements, insurance companies don't want to pay for longer lengths of stay associated with hospital-acquired infections. Despite these consequences, clinicians often downplay the importance of PPE. Even something as simple as hand washing is exponentially important in decreasing transmission of certain organisms and bacteria.
MC: Everything comes back to education. Are clinicians educated on how to protect themselves and properly wear PPE? We need to create an environment and culture of safety so people are confident they're being protected and prepared for any disease that may cross our borders.
Q: What tips or recommendations do you have on how healthcare facilities could better manage PPE compliance with their staff?
CG: Healthcare providers must develop an in-depth education program and stringent compliance program to ensure proper PPE use. The education side needs to be more robust. Instead of reviewing PPE once a year and glossing over the information, hospitals must assess what clinicians are learning and retaining. Hospitals must also consider the best way for clinicians to learn. I'm a very hands-on person, and I learn best by physically doing and seeing something. We live in a very technologically-driven world, but screens are not always the best way to instruct PPE compliance, since the products must be worn and removed in a specific fashion.
MC: Healthcare workers are scientists and problem solvers — they want to know the "why." I think it's important for them to know how and why certain products protect them and their patients. We need to give clinicians a solid foundation of knowledge about PPE so they can make better decisions on how to protect themselves in the future. For example, infographics or visual reminders can be very helpful to inform clinicians of proper PPE use when taking care of patients with specific infection control precautions.
Q: Why is it important to understand how the level of protection varies between certain PPE products?
CG: There are multiple manufacturers of PPE products across the market, and we're all closely matched. However, not all products offer the same level of protection. For example, one face mask may protect against airborne illnesses, while another may protect against droplets. Healthcare providers need to make sure they are procuring products that will give clinicians a broad spectrum of coverage and protection. Understanding those barrier protection qualities is key to ensuring you're ordering a product that is best suited for clinical exposure. Clinicians must also act as their own advocates to ensure the hospital is purchasing the right products to ensure their safety.
MC: Each clinician needs to know what level of protection the PPE they're wearing affords and if they are being protected. We don't know when the last time their product selection was reviewed. There could be an update or a new product available that offers them better protection from the previous year's products. Clinicians must be responsible and accountable for their own protection. Yes, the hospital will help them with product selection, but they still need to know they're choosing the right PPE and wearing it appropriately to achieve proper protection.
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