Increase compliance of

Personal Protective Equipment

In hospital setting
Done by: Elecia Trowers
Liza McGill
Sandra Goodall
Vivarian Malcolm

Proposed change
After observing the use of personal protective equipment (PPE) at
several hospitals in the central Florida , it became apparent that
more could be done to increase adherence.
Although personal protective equipment (PPE) is one of the best
lines of protection against hazardous exposures, many healthcare
workers either shun this protective apparel or do not wear it in an
appropriate manner at the appropriate time .
It is proposed that periodic education, training , and accountability
be implemented. This would be beneficial in increasing compliance
of PPE and potentially decreasing the transmission of
communicable diseases in the hospital setting.

Plan

Statistics

According to Occupational Safety & Health Administration

(OSHA) the use of personal protective equipment is required to
reduce employee exposure to hazards and communicable
diseases.

The graph depicts infection rate when healthcare workers are

compliant with PPE (International Federation of Infection
Control 2014).

Plan

Education & Training

Recognizing patients with communicable diseases before

exposure to workers (CDC, 2014)
Identification of hazards and appropriate PPE (Infection
Control Today, 2011)
Train healthcare providers on proper use of selected PPE
Simulation
Bi-Annual In-services
In a survey conducted by the Canadian Journal of
Emergency Medicine (2011), 22% of participants
reported that they had never received PPE training and
32% had not been trained in the past two years and 53%
reported that they were somewhat comfortable in their
knowledge for PPE.

PlanEducation & Training

National Academies (2008), Mandatory training is needed
across all levels of the organization to communicate the
institutions safety rules.
Provide leadership, commitment, and role modeling for worker
safety: Employees who perceive a strong organization-wide
commitment to safety have been found to be more than 2.5
times more likely to adhere to safety protocols than those who
lack such perceptions (Gershon , 2011).
According to the National Institute of Health (2010), Emphasize
healthcare worker education and training: The presence of
safety education within a hospital or other healthcare facility
demonstrates the organizations commitment to safety and
increases individual knowledge of safety practices.

Plan

Accountability

Sincere engagement by those in leadership positions who

enforce appropriate PPE use and safety.
positive reinforcement of individual compliance behavior,
and
negative reinforcement (e.g., verbal warnings).
According to a study performed by Visentin and
colleagues (2009), healthcare personnel often rely
on their own personal assessments of risk in
deciding whether or not to use PPE
Identify staff members who actively and openly oppose
changes in practice.
According to National Institute of Health (2010),
Promotion and encouragement of worker participation in
health and safety discussions, significantly increased
compliance with PPE use.

Do Evaluate & Educate

Requirements for proposed change:
Evaluation:
Determine the occurrence of communicable infections at the
prospective hospital for the proposed change
Utilize self assessments for healthcare providers to determine
their compliance to PPE
Utilize a Hospital Consumer Assessment of Healthcare Providers
and Systems (HCAHPS) to assess healthcare workers compliance
with PPE from the patients perspective
Create an evaluation tool to assess knowledge, competency, and
compliance of PPE among staff

Do

Evaluate & Educate

EDUCATION:
Infection control will teach nursing staff proper donning,
removal, and protocol for communicable diseases.
Evidenced based articles will be mandated for staff to read
outlining the advantages of PPE and staff role
ENGAGEMENT:
Staff buy in will be orchestrated through the educators, unit
managers, charge nurses, clinicians, and special committees
promotion of the importance of the proposed change, put the
change into action, reinforcing it, and hold those accountable for
non-compliance.
PILOT PROGRAM:
Infection control program on the Medical Surgical Units

Do Implement an Infection
Control Program

The CDC highlights the importance of proper usage of personal

protective equipment which can help to decrease the incidences of
communicable diseases in patients from healthcare providers cross
contamination
Recommendations: According to the National Institute of health
(2010),
Identify and disseminate effective leadership and training
strategies and other interventions to improve PPE use. Such as,
to develop, implement, and evaluate comprehensive leadership,
training strategies and interventions that go beyond simple
knowledge-based training
examine long-term practice change and safety
culture implementation related to educational interventions
Identifying and evaluating strategies to mitigate organizational
barriers that limit the use of PPE by healthcare personnel

Study
During a three month span the evaluation of implemented
plans will be made by:
Observing staff members when donning PPE
Conduct an anonymous survey to get staff feedback on
the new initiative .
Compare data for infection rate during the three
months after implementation.
Compare data for PPE usage within the current three
months and three months before implementation.
Based on the result from observation, statistics and staff
feedback, alterations will be made to enhance the
implemented plans or make complete changes if
necessary.

Act

Generalizability

Implementation of an evaluation, education & training, and

increasing accountability in an infection control plan to promote PPE
will be initiated through the hospital
Recommended materials, and trainings will be provided to all units
with the assistance of the infection control specialists, unit
educations, managers, and charge nurses.
In services will be provided bi annually to all hospital staff by
members of the infection control committee as a refresher on PPE

References

Centers for Disease Control and Prevention [CDC]. (2010). Personal

Protective Equipment (PPE) in Healthcare Settings. Retrieved
from
http://www.cdc.gov/HAI/prevent/ppe_train.html
Gershon, R. R. M., 2011. Compliance with universal precautions among
healthcare workers at three regional hospitals. American Journal
of
Infection Control.
Infection Control Today. (2011). Addressing the Challenges of PPE NonCompliance. Retrieved from
http://www.infectioncontroltoday.com/articles/2011/10/addressing
the-challenges-of-ppe-non-compliance.aspx?pg=2#content
Occupational Safety & Health Administration [OSHA]. (2012). PPE
Assessments. Retrieved from https://
www.osha.gov/dte/library/ppe_assessment/ppe_assessm ent.html

References
Continued

Occupational Safety & Health Administration [OSHA]. (2012). Personal

Protective Equipment. Retrieved from
https://www.osha.gov/SLTC/personalprotectiveequipment/
National Institute of Health [NIH]. (2010). Preventing Transmission of
Pandemic Influenza and Other Viral Respiratory Diseases. Using PPE:
Individual and Organizational Issues. Retrieved from
http://www.ncbi.nlm.nih.gov/books/NBK209587/
Visentin, L. M., S. J. Bondy, B. Schwartz, and L. J. Morrison. 2009. Use of
personal protective equipment during infectious disease outbreak and
non-outbreak conditions: A survey of emergency medical technicians.
Canadian Journal of Emergency Medicine 11(1):44-56