Potential Health Care Worker Contamination from Ebola Virus Disease during Personal Protective Equipment Removal and Disposal

Abstract

The transmission of Ebola Virus (EV) to health care workers (HCW) has been documented in highly-resourced care settings, even with HCW use of personal protective equipment (PPE). This research describes an observational study involving simulated Ebola Virus Disease (EVD) patient scenarios in four tertiary acute care centers. Researchers recorded and analyzed audiovisual data to identify instances of potential HCW EV contamination. Video-analysis was based on a coding taxonomy developed in collaboration with Infection Prevention and Control (IPC) professionals. The analysis focused on events and actions associated with potential HCW contamination during doffing and PPE disposal, and contributing system factors. The events and actions identified included out-of-sync doffing teams, HCW deviations from doffing protocols, and improper disposal of doffed PPE including the compression of PPE in biomedical waste containers containing potentially contaminated sharps. These observations are discussed along with recommendations for the re-design of doffing procedural aids and waste disposal.