Improving healthcare worker adherence to the use of transmission-based precautions through application of human factors design: a prospective multi-centre study

V R Williams; J A Leis; P Trbovich; T Agnihotri; W Lee; B Joseph; L Glen; M Avaness; F Jinnah; N Salt; J E Powis

doi:10.1016/j.jhin.2019.03.014

Improving healthcare worker adherence to the use of transmission-based precautions through application of human factors design: a prospective multi-centre study

J Hosp Infect. 2019 Sep;103(1):101-105. doi: 10.1016/j.jhin.2019.03.014. Epub 2019 Mar 30.

Authors

V R Williams¹, J A Leis², P Trbovich³, T Agnihotri¹, W Lee⁴, B Joseph⁴, L Glen⁴, M Avaness¹, F Jinnah¹, N Salt¹, J E Powis⁵

Affiliations

¹ Infection Prevention and Control, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
² Infection Prevention and Control, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Medicine and Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada.
³ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Research and Innovation, North York General Hospital, Toronto, Ontario, Canada.
⁴ Infection Prevention and Control, Michael Garron Hospital, Toronto, Ontario, Canada.
⁵ Infection Prevention and Control, Michael Garron Hospital, Toronto, Ontario, Canada. Electronic address: Jeff.Powis@tehn.ca.

PMID: 30935983
DOI: 10.1016/j.jhin.2019.03.014

Abstract

A key component of transmission-based precautions (TBPs) is the use of personal protective equipment (PPE) but healthcare worker (HCW) adherence remains suboptimal. A human factors-based intervention was implemented to improve adherence to TBPs including (i) improved signage, (ii) standardized placement of signage, (iii) introduction of a mask with integrated face shield, and (iv) improvement in PPE availability. Donning of the correct PPE by HCWs improved significantly (79.7 vs 56.4%; P < 0.001). This approach may be more effective than education alone, but further study is required to determine sustainability and subsequent impact on transmission of healthcare-associated infections.

Keywords: Human factors; Personal protective equipment; Transmission-based precautions.

Publication types

Multicenter Study

MeSH terms

Attitude of Health Personnel*
Behavior Therapy / methods*
Cross Infection / prevention & control*
Disease Transmission, Infectious / prevention & control*
Equipment and Supplies Utilization
Guideline Adherence*
Health Personnel / psychology*
Humans
Personal Protective Equipment / supply & distribution
Prospective Studies