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Introduction: Prosthetic liners are widely used for a variety of indications such as improving prosthetic socket fit and suspension. However, these are associated with complications affecting the skin, including skin rubs, breakdown, and ulceration. Methods and Discussion: We outline the splinting effect of prosthetic liners as a possible contributing factor that results in increased shear during joint motion and propose a simple liner donning technique to minimize these shear forces by spreading liner/skin tension over the whole range of motion of the proximal joint. Clinical Relevance: The proposed dynamic donning technique would minimize the risk of skin ulcerations and improve joint range of motion in prosthetic limb users. [ABSTRACT FROM AUTHOR]

Abstract Background The incidence of prosthetic joint infection (PJI) is increasing, coincident with the rising volume of joint arthroplasty being performed. With recent controversy regarding the efficacy of surgical helmet systems (SHS) in preventing infection, the focus has turned to the correct donning techniques and usage of surgical hoods. The aim of this study was to compare the bacterial contamination of the operating surgeon’s gloves after two common donning techniques of SHS hoods. We also evaluated the baseline sterility of the SHS hoods at the beginning of the procedure. Methods The bacterial contamination rate was quantified using colony-forming units (CFUs), with 50 trials performed per donning technique. Samples were cultured on 5% Columbia blood agar in ambient air at 37 °C for 48 h and all subsequent bacterial growth was identified using a MALDI-TOF mass spectrometer. In Group 1, the operating surgeon donned their colleague’s hood. In Group 2, the operating surgeon had their hood applied by a non-scrubbed colleague. After each trial, the operating surgeon immediately inoculated their gloves onto an agar plate. The immediate sterility of 50 SHS hoods was assessed at two separate zones—the screen (Zone 1) and the neckline (Zone 2). Results There was no significant difference in contamination rates between the two techniques (3% vs. 2%, P = 0.99) or between right and left glove contamination rates. Immediately after donning, 6/50 (12%) of SHS hoods cultured an organism. Contamination rates at both the face shield and neckline zones were equivalent. The majority of bacteria cultured were Bacillus species. Discussion We found no significant difference in the operating surgeon’s glove contamination using two common SHS hood-donning techniques when they were performed under laminar airflow with late fan activation. We suggest the SHS hood should not be assumed to be completely sterile and that gloves are changed if it is touched intraoperatively.

Background: The incidence of prosthetic joint infection (PJI) is increasing, coincident with the rising volume of joint arthroplasty being performed. With recent controversy regarding the efficacy of surgical helmet systems (SHS) in preventing infection, the focus has turned to the correct donning techniques and usage of surgical hoods. The aim of this study was to compare the bacterial contamination of the operating surgeon's gloves after two common donning techniques of SHS hoods. We also evaluated the baseline sterility of the SHS hoods at the beginning of the procedure. Methods: The bacterial contamination rate was quantified using colony-forming units (CFUs), with 50 trials performed per donning technique. Samples were cultured on 5% Columbia blood agar in ambient air at 37 °C for 48 h and all subsequent bacterial growth was identified using a MALDI-TOF mass spectrometer. In Group 1, the operating surgeon donned their colleague's hood. In Group 2, the operating surgeon had their hood applied by a non-scrubbed colleague. After each trial, the operating surgeon immediately inoculated their gloves onto an agar plate. The immediate sterility of 50 SHS hoods was assessed at two separate zones—the screen (Zone 1) and the neckline (Zone 2). Results: There was no significant difference in contamination rates between the two techniques (3% vs. 2%, P = 0.99) or between right and left glove contamination rates. Immediately after donning, 6/50 (12%) of SHS hoods cultured an organism. Contamination rates at both the face shield and neckline zones were equivalent. The majority of bacteria cultured were Bacillus species. Discussion: We found no significant difference in the operating surgeon's glove contamination using two common SHS hood-donning techniques when they were performed under laminar airflow with late fan activation. We suggest the SHS hood should not be assumed to be completely sterile and that gloves are changed if it is touched intraoperatively. [ABSTRACT FROM AUTHOR]

The utilization of simulation has proved to be a valuable tool to train students in the academic setting in preparation for the clinical environment. Student registered nurse anesthetists (SRNAs) receive limited education and training on the use of powered air-purifying respirators when caring for patients with highly infectious diseases (i.e., COVID-19). The purpose of this pilot study was to assess SRNAs' knowledge, self-confidence, and psychomotor skills for the safe performance of donning and doffing of powered air-purifying respirators while managing the airway. A single group pretest and posttest descriptive study was conducted over 7 months which included 45 SRNAs. There was a statistically significant increase in knowledge (P = < .001) and self-confidence (P = < .001) on safe donning and doffing of powered air-purifying respirators for emergent intubation. Descriptive statistics on the psychomotor skills revealed that the SRNAs were able to demonstrate donning and doffing of powered air-purifying respirators for emergent intubation during simulation. Findings suggest that simulation is an appropriate strategy and is relevant for nurse anesthesia educators to consider when training SRNAs to don and dof while managing the airway for patients with COVID-19. [ABSTRACT FROM AUTHOR]

Background: Due to the dependence of personal protective equipment's efficacy on user behavior, it is thought that personal protective equipment should be placed at the bottom of the infection control hierarchy. Personal protective equipment should be used in accordance with standards and transmission to prevent the spread of healthcare-associated diseases, according to the Healthcare Infection Control Practices Advisory Committee (HICPAC). -related illness prevention measures. Methods: A descriptive quantitative method was used to evaluate the knowledge of 40 nurses working in the Al-Hayat Wards in the holy city of Kerbala, Iraq, regarding the donning and donning of personal protective equipment. The study started on January 15, 2022, and it concluded on May 25, 2022. The tool was divided into two sections. The first section dealt with the sample's socio-demographic characteristics, including age, gender, education level, years of nursing experience, and participation in particular training courses connected to PERSONAL PROTECTIVE EQUIPMENT. Part two deal with the nurses clinical knowledge about donning and doffing methods of personal protective equipment which involved 18 questions. The validity of the measurement tool was obtained from 11 experts, reliability was = 0.8, data were analyzed through the use of SPSS program edition 22, the analytical approaches used in this study is description and inferential analyses. Results: outcomes of the study confirmed that know answers was 24.30%, while don't know and not sure both answers was 25.69%. Conclusions: the study concluded that nurses' clinical knowledge toward PERSONAL PROTECTIVE EQUIPMENT donning and doffing is very good. [ABSTRACT FROM AUTHOR]

Background: In the fight against the pandemic, personal protective equipment (PPE) has played a vital role. However, working with PPE has its own difficulties and problems. The aim of this study was to find out the reasons of early doffing, that is, in doffing in emergency situations before the shift among healthcare workers (HCWs) working in PPE in the COVID areas in resource-limited settings. Methods: This cross-sectional, survey-based study was carried out on healthcare workers involved in direct care of patients with COVID-19 in tertiary care COVID center, India. The questionnaire was sent as a Google form through email and social media platforms like WhatsApp and Facebook. The data was reported as the mean ± SD for continuous variables and as the percentage for categorical variables. Findings: Among 252 healthcare workers who participated in the survey, 145 (57.5%) participants doffed early on 300 occasions. Out of these 145, 50% doffed early only once and rest doffed early multiple times. The most common reason of early doffing was found to be breach in PPE (15.33%) followed by fogging (14%) and headache (12%), and most commonly, breach was in mask or coverall/gown (32.6% each). Conclusion: Although PPE decreases the risk of infection, it is challenging for HCWs to work in PPE leading to instances of early doffing. The most common reason for early doffing in our study was the breach in PPE and the most common component of breach was found to be mask and coverall/gown. Therefore, we suggest that the proper sizes of the PPE should be made available and proper training in donning should be imparted to HCWs working in PPE. [ABSTRACT FROM AUTHOR]

Background: Fever clinics were established across the country for screening of patients suggestive of coronavirus disease-2019 (COVID-19). The doctors posted in these clinics were provided with personal protective equipment (PPE) for their protection. Improper use of these equipment may result in infection. Objectives: The objective is to assess the awareness of doctors posted at fever clinic regarding donning and doffing of PPE. Materials and Methods: A cross-sectional descriptive study was carried out from May to June 2020 on doctors posted at the fever clinic of Sambhunath Pandit Hospital, Kolkata by census method using a predesigned, pretested structured questionnaire (Google form). Statistical analysis was done with the help of appropriate statistical software. Results: None of the doctors working in the fever clinic had adequate knowledge regarding steps of donning and doffing of PPE while 77.4% doctors did not know the correct steps of maintaining hand hygiene. Still the percentage of participants with satisfactory knowledge and satisfactory attitude regarding PPE was 84.9% and 62.3%, respectively. Conclusions: This study suggests that there is a need for active training of the study population in order to effectively protect them from COVID-19.

Background: At least 115,000 health and care workers (HCWs) are estimated to have lost their lives to COVID-19, according to the the chief of the World Health Organization (WHO). Personal protective equipment (PPE) is the first line of defense for HCWs against infectious diseases. At the height of the pandemic, PPE supplies became scarce, necessitating reuse, which increased the occupational COVID-19 risks to HCWs. Currently, there are few robust studies addressing PPE reuse and practice variability, leaving HCWs vulnerable to accidental contamination and harm.Objective: The objective of this study was to assess potential HCW contamination during PPE donning, doffing, and reuse.Methods: The study included 28 active acute care physicians, nurses, and nurse practitioners that evaluated 5 simulated patients with COVID-like symptoms while donning and doffing PPE between each patient encounter. An N95 mask was contaminated with a transparent fluorescent gel applied to the outside of the N95 mask to simulate contamination that might occur during reuse. Participants were evaluated after PPE doffing for each encounter using a black light to assess for face and body contamination.Results: All participants had multiple sites of contamination, predominantly on their head and neck. None of the participants were able to don and doff PPE without contaminating themselves during five consecutive simulation cycles.Conclusions: The current Centers for Disease Control and Prevention PPE guidelines for donning and doffing fall short in protecting HCWs. They do not adequately protect HCWs from contamination. There is an urgent need for PPE and workflow redesign. [ABSTRACT FROM AUTHOR]

• Using the personal protective equipment (PPE) in wrong ways may lead to higher contagion risks. • YouTube is a social media sharing information on several medical issues. • Increased interest on donning and doffing of PPE was observed on the worldwide web. • Overall reliability and quality of YouTube videos on this topic were reasonable. • YouTube may be recommended as a reliable source on correct usage of PPE for Covid-19 patients care. The correct use of personal protective equipment (PPE) during the Covid-19 pandemic is mandatory to minimize the contagion risk. The current study aimed to evaluate quality information of YouTube videos on PPE use during the pandemic. Using Google Trend tool, the frequency of worldwide YouTube and Google searches for "donning and doffing" was examined. We queried YouTube with terms related to donning and doffing of PPE. Validated quality information assessment tools were used. From the December 1, 2019 to the January 31, 2021, according to YouTube and Google searches, both peaks occurred in April 2020 (69.5% and 72.0%, respectively). Of all videos, 144 were eligible for the analyses. According to misinformation tool, 90 (62.5%) videos contained inaccuracies. The median DISCERN Section 1 ranged from 3 to 5. The median DISCERN Section 3 was 4. According to Global Quality Score, 8.3% (n = 12), 14.6% (n = 21), 22.9% (n = 33), 30.6% (n = 44) and 23.6% (n = 34) were classified as poor, partially poor, moderate, partially good and excellent quality videos, respectively. Nowadays, YouTube may be recommended as a reliable source of information. Nevertheless, a not negligible number of videos contained inaccuracies. Future authors should improve videos contents to provide more complete information. [ABSTRACT FROM AUTHOR]

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the novel Coronavirus, the causative agent of Coronavirus Disease-2019 (COVID-19) pandemic has grasped the whole world. Healthcare Workers (HCWs) are at an increased risk. The usage and awareness of entire Personal Protective Equipment (PPE) kit in hospitals on such wide scale has not been seen for some time in healthcare setting. Improper use of these equipment may result in the spread of infection. Aim: To assess the knowledge and attitude of HCWs regarding the correct use of PPE at the beginning of COVID-19 pandemic in order to find the gap in knowledge and to address the perceived barriers in compliance and further to assess the same after training and reinforcement to ensure the HCWs safety. Materials and Methods: A cross-sectional hospital based study was carried out in a designated COVID-19 hospital of Shaheed Hasan Khan Mewati Government Medical College from April 2020 to October 2020 on frontline HCWs posted in various areas of hospital. Sample size was calculated as a minimum of 500 HCWs using appropriate statistical formula. A predesigned, pretested structured questionnaire both online and offline mode was used. The data that was obtained was analysed using SPSS version 20. Results: Seven hundred frontline HCWs were included in the study. Mean age of study population was 30.5 years. A total of 52% of the participants were males and 48% were females. Knowledge level of PPE kit and its use varied across doctors, nursing staff and housekeeping staff. Knowledge about donning and doffing was largely lacking with only 9% doctors and none of other staff were aware which improved to more than 80% posttraining. Attitude regarding PPE kit usage was largely positive. Conclusion: The study concludes that there is a constant need of training and re-training of HCWs in order to keep them safe from not only COVID-19 but future infections. An active infection prevention training program is crucial to ensure HCWs safety. [ABSTRACT FROM AUTHOR]

Personal Protective Equipments (PPEs) are used to safeguard the health of workers. Airborne aerosol with size below 5 micron can enter lower respiratory system directly whereas bigger size particles either settles on surrounding equipment and become fomites. COVID 19 can stay in air after 3 hours with airborne spread in health care with fomites especially plastic showing infection up to 72 hours. Examples of PPE include items as mask, gloves, shield, goggles, gowns and full body suits. All health care workers need to be taught the correct sequence of wearing and taking off the PPE in order to avoid contamination.

Introduction: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the novel Coronavirus, the causative agent of Coronavirus Disease-2019 (COVID-19) pandemic has grasped the whole world. Healthcare Workers (HCWs) are at an increased risk. The usage and awareness of entire Personal Protective Equipment (PPE) kit in hospitals on such wide scale has not been seen for some time in healthcare setting. Improper use of these equipment may result in the spread of infection. Aim: To assess the knowledge and attitude of HCWs regarding the correct use of PPE at the beginning of COVID-19 pandemic in order to find the gap in knowledge and to address the perceived barriers in compliance and further to assess the same after training and reinforcement to ensure the HCWs safety. Materials and Methods: A cross-sectional hospital based study was carried out in a designated COVID-19 hospital of Shaheed Hasan Khan Mewati Government Medical College from April 2020 to October 2020 on frontline HCWs posted in various areas of hospital. Sample size was calculated as a minimum of 500 HCWs using appropriate statistical formula. A predesigned, pretested structured questionnaire both online and offline mode was used. The data that was obtained was analysed using Statistical Package for the Social Science (SPSS) version 20.0. Results: Seven hundred frontline HCWs were included in the study. Mean age of study population was 30.5 years. Among 700 HCWs, 200 (28.57%) were doctors, 360 (51.42%) were nursing staff and 140 (20%) were housekeeping staff. Knowledge level of PPE kit and its use varied across doctors, nursing staff and housekeeping staff. Knowledge about donning and doffing was largely lacking with only 9% doctors and none of other staff were aware which improved to more than 80% post-training. Attitude regarding PPE kit usage was largely positive. Conclusion: The study concludes that there is a constant need of training and re-training of HCWs in order to keep them safe from not only COVID-19 but also from future infections. An active infection prevention training program is crucial to ensure HCWs safety.

Changing gloves more frequently is encouraged, more now than ever given the COVID-19 pandemic. When the donning process has moisture introduced, however, complications can arise, which consumes vital time. Most commonly, gloves undergo a chlorination treatment to reduce glove tack, allowing easier donning. To assess the effects of different chlorination strengths and glove thicknesses on donning, acrylonitrile butadiene gloves were manufactured at two different thicknesses (0.05 and 0.10 mm) with 4 different chlorination treatments: 0, 500, 1000 and 2000 ppm. Six participants were used to assess the time taken to don each of the glove sets with dry and wet hands (16 tests in total). Overall, the thicker gloves took longer to don, due to differences in the material stiffness hindering the donning process. The quickest performance from the chlorinated gloves was noted in the 1000 and 2000 ppm concentrations. Wet conditions also showed significant increases in the donning time. Practitioners Summary: The study was conducted based on the gaps identified in previous literature reviews which revealed the requirement for a greater understanding of glove donning process. It was found a stronger chlorination was detrimental when the hands were wet, but better when dry. Thicker gloves were also found to be detrimental. Abbreviations: PPE: personal protective equipment; NBR: acrylonitrile butadiene rubber; NRL: natural rubber latex; EN: European standards; s: seconds; Ts: tensile strength; Fb: force at break; T: thickness; Eb: elongation at break; HSD: honest significant difference; FTIR: Fourier transform infrared; covid-19: coronavirus disease 2019 [ABSTRACT FROM AUTHOR]

This research investigated the feasibility of replacing cornstarch with calcium carbonate in surgery glove manufacturing. Cornstarch in slurry form is currently used as the releasing agent in order to prevent the gloves from sticking to the formers, to each other, and to the hands of the users. However, some people have a protein allergy and a skin infection can develop from the protein and bacteria contained in cornstarch. Therefore, calcium carbonate could be used as an alternative releasing agent. The quality of gloves prepared from different compositions of calcium carbonate in slurry form were assessed and compared with those of standard gloves prepared from various concentrations of cornstarch. As the amount of calcium carbonate increased, residual powder increased which resulted in high grip forces and stickiness, i.e. unsatisfactory donning. Calcium carbonate (5% w/w) resulted in comparable properties to gloves manufactured from 20% w/w cornstarch which suggested that calcium carbonate has potential application as the releasing agent in slurry form for surgery glove manufacturing.

BACKGROUND: Fever clinics were established across the country for screening of patients suggestive of coronavirus disease-2019 (COVID-19). The doctors posted in these clinics were provided with personal protective equipment (PPE) for their protection. Improper use of these equipment may result in infection. OBJECTIVES: The objective is to assess the awareness of doctors posted at fever clinic regarding donning and doffing of PPE. MATERIALS AND METHODS: A cross-sectional descriptive study was carried out from May to June 2020 on doctors posted at the fever clinic of Sambhunath Pandit Hospital, Kolkata by census method using a predesigned, pretested structured questionnaire (Google form). Statistical analysis was done with the help of appropriate statistical software. RESULTS: None of the doctors working in the fever clinic had adequate knowledge regarding steps of donning and doffing of PPE while 77.4% doctors did not know the correct steps of maintaining hand hygiene. Still the percentage of participants with satisfactory knowledge and satisfactory attitude regarding PPE was 84.9% and 62.3%, respectively. CONCLUSIONS: This study suggests that there is a need for active training of the study population in order to effectively protect them from COVID-19. [ABSTRACT FROM AUTHOR]

Background and Introduction: Donning and doffing of personal protective equipments (PPE) has become relevant especially during COVID-19 pandemic and neurosurgeons operating upon COVID-19 positive or suspect patients should be aware of proper technique of donning and doffing of PPE.[1] Surgeries involving direct exposure of anterior nasal spaces/paranasal sinuses carry significantly more risk of infection and it may be prudent to use PPE while operating all such cases.[2].Objective: In this video, we present our extensive protocol of donning and doffing of PPE which we have devised for our operating room.Technique: Donning consists of wearing of the PPE in a proper sequence so as to afford maximal protection from viral infection while conducting the surgical procedure. Various components of PPE and procedure of donning is shown followed by doffing, the sequential and safe removal of the PPE.Results: A meticulous method of donning and doffing PPE for neurosurgeons handling COVID-19 positive / suspect cases has been shown .Conclusion: Proper sequence of donning and doffing of PPE gear is of crucial importance during the COVID pandemic to prevent infection to the health care workers while handling COVID-19 positive/suspect cases and this video demonstrates the protocol we use at our institute. [ABSTRACT FROM AUTHOR]

Introduction: Practitioners typically rely on patient self-report for information about prosthesis use and limb volume accommodation. Electronic monitoring may provide a more accurate and easier means of collecting these data. Methods: A novel low-profile sensor was used for 2 weeks to track when the limb was within the socket. Each participant also recorded daily prosthesis don times, doff times, and sock changes in a written log. Results: Participants (n = 21) wore their prosthesis frequently, for approximately 14.1 hrs/day (interquartile range [IQR], 12.5–14.9), and doffed their prosthesis for 0.5 hr/day (IQR, 0.1–1.2). Of those participants who performed sock changes, participants most often performed sock changes 0.4 times per day (IQR, 0.3–1.0) and socket releases (temporary doffs) 1.3 times per day (IQR, 0.5–3.8). Measured and self-reported beginning-of-prosthesis day were not significantly different (P = 0.002), whereas end-of-prosthesis day were significantly different (P = 0.573). Conclusions: The developed electronic monitor may improve recording of prosthesis use and monitoring of socket releases. Data collected in this study may serve as a starting point for characterizing socket wear and accommodation in people with limb loss. [ABSTRACT FROM AUTHOR]

• UNC instituted PPE monitors in high-risk zones during the COVID-19 pandemic. • PPE monitors aided health care personnel in donning and doffing. • This contributed to nearly zero transmission of COVID in high-risk zones. We instituted Personal Protective Equipment (PPE) Monitors as part of our care of COVID-19 patients in high-risk zones. PPE Monitors aided health care personnel (HCP) in donning and doffing, which contributed to nearly zero transmission of COVID-19 to HCP, despite their care of over 1400 COVID-19 patients. [ABSTRACT FROM AUTHOR]

There is none in this world who is totally able and none who is totally disabled. Disability is impairment of structure of function imposed by disease, accidents or inheritance. Functional garments are important for disabled as they reduce dependence on others for dressing and undressing. The study was conducted on 40 spastic respondents, selected through purposive sampling technique. It was found that most of the respondents faced problems in donning, doffing and manipulating fasteners. Hence in designing garments for these persons focus was given on type of fasteners used, comfort, factors that provide ease in donning and doffing, ease of care and cost of garment. [ABSTRACT FROM AUTHOR]

A patient suffering from diabetes and a trans-tibial amputation presented with stump wounds caused by improper donning of the liner. His diminished hand function resulted in improper donning, with air being trapped between the liner and stump. This caused blisters on the skin after loading the prosthesis. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare workers have a high risk of cross-infection during the care of Covid-19 cases. Personal protective equipment can reduce the risk. However, healthcare workers must be trained for the proper use of personal protective equipment to decrease exposure risk. This study aimed to investigate whether videos available on YouTube, presenting procedures of donning and doffing personal protective equipment, can be a useful learning resource for healthcare workers., Methods: A search of YouTube was conducted using the keywords "Covid-19, personal protective equipment, donning, doffing". Two investigators reviewed each video and collected the basic video information. Total videos were assessed independently as educationally useful and non-useful categories using a valid tool. The relationship of each video's usefulness with viewers' preferences and the upload source were analyzed., Results: A total of 300 videos were assessed; 66 (22%) fulfilled the inclusion criteria. Total video scores of educationally useful videos were higher than non-useful ones; the differences were significant. Healthcare/government agencies and hospitals mostly created educationally useful videos, e-learning platforms, and individuals mainly created non-useful videos. Significant correlations were observed between the video's usefulness and the total view and views per day., Conclusions: During a pandemic, YouTube might be a resource for learning donning and doffing of personal protective equipment for healthcare workers if an appropriate selection process applied for determining educationally useful videos., (Copyright © 2020 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction The COVID-19 pandemic exposed gaps in the knowledge of correct donning and doffing of personal protective equipment (PPE) among healthcare workers, causing hospitals to ramp up training. However, social distancing measures forced most institutions and workplaces to shift to remote operations, allowing only essential personnel onsite. Virtual simulation is a growing trend in healthcare simulation education, even more so in this pandemic era. Yet, we have found no evidence of the perceived effectiveness of virtual simulation for training healthcare providers in the proper donning and doffing of PPE. This study aims to determine learner perceptions of the effectiveness of a virtual simulation PPE training module. Methods To address this gap, we used a virtual simulation training module in an online format to determine the perceived efficacy of this method of instruction with the contribution of a variety of healthcare providers and trainees, including physicians, surgeons, pharmacists, dentists, and nurses. Results We found a statistically significant difference in the confidence level of observing best practices of donning and doffing PPE before and after the training sessions. We also found that participants believe virtual simulation can be an effective educational tool for clinical skills. Conclusions This paper presents an international, guideline-based virtual simulation training module that can serve to educate, train, and assess healthcare workers in the proper sequence and technique of donning (putting on), doffing (removing), and disposing of PPE without contaminating themselves or others., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Mosher et al.)

Introduction: Healthcare providers are at high risk of becoming infected when taking care of patients who have COVID-19, especially while attending aerosol generating procedures. Protective personal equipment must be used in the correct manner to prevent transmission of the disease. Published protocols on protective personal equipment (PPE) donning and doffing have been issued by disease control agencies., Methods: A questionnaire-based cross-sectional study was designed. An online anonymous questionnaire, which was validated and tested for reliability, focused on PPE related knowledge, donning and doffing practices of healthcare providers across the eastern region of Saudi Arabia., Results: A total of 312 healthcare providers across the eastern region of Saudi Arabia participated in the study, 208 physicians (66.7%) and 104 non-physicians (33.3%). Results indicate poor practice regarding PPE donning (13.8% reported the correct sequence) and PPE doffing (3.5% reported the correct sequence) among participants. In addition, practice and confidence scores regarding other issues with PPE were analyzed. Based on questionnaire responses, being male (T = 2.825; p = 0.008), being a non-physician (T = -2.120; p = 0.014) and being an allied medical professional (F = 5.379; p = 0.003) were significantly associated with higher confidence levels. Also, being a consultant was significantly associated with higher practice scores (F = 4.774; p = 0.008)., Conclusion: The study demonstrates deficiencies among healthcare providers in following the recommended practices for correctly using PPE during the pandemic. Poor practice in PPE donning and doffing necessitates additional educational and training programs focused on infection control practices., Competing Interests: Conflict of interest statement The authors declare no conflict of interest., (©2021 Pacini Editore SRL, Pisa, Italy.)

Quantitative respirator fit test protocols are typically defined by a series of fit test exercises. A rationale for the protocols that have been developed is generally not available. There also is little information available thatdescribes the effect or effectiveness of the fit test exercises currently specified in respiratory protection standards. This study was designed to assess the relative impact of fit test exercises and mask donning on respirator fit as measured by a controlled negative pressure and an ambient aerosol fit test system. Multiple donnings of two different sizes of identical respirator models by each of 14 test subjects showed that donning affects respirator fit to a greater degree than fit test exercises. Currently specified fit test protocols emphasize test exercises, and the determination of fit is based on a single mask donning. A rationale for a modified fit test protocol based on fewer, more targeted test exercises and multiple mask donnings is presented. The modified protocol identified inadequately fitting respirators as effectively as the currently specified Occupational Safety and Health Administration (OSHA) quantitative fit test protocol. The controlled negative pressure system measured significantly (p < 0.0001) more respirator leakage than the ambient aerosol fit test system. The bend over fit test exercise was found to be predictive of poor respirator fit by both fit test systems. For the better fitting respirators, only the talking exercise generated aerosol fit factors that were significantly lower (p < 0.0001) than corresponding donning fit factors. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare workers have a high risk of cross-infection during the care of Covid-19 cases. Personal protective equipment can reduce the risk. However, healthcare workers must be trained for the proper use of personal protective equipment to decrease exposure risk. This study aimed to investigate whether videos available on YouTube, presenting procedures of donning and doffing personal protective equipment, can be a useful learning resource for healthcare workers., Methods: A search of YouTube was conducted using the keywords "Covid-19, personal protective equipment, donning, doffing". Two investigators reviewed each video and collected the basic video information. Total videos were assessed independently as educationally useful and non-useful categories using a valid tool. The relationship of each video's usefulness with viewers' preferences and the upload source were analyzed., Results: A total of 300 videos were assessed; 66 (22%) fulfilled the inclusion criteria. Total video scores of educationally useful videos were higher than non-useful ones; the differences were significant. Healthcare/government agencies and hospitals mostly created educationally useful videos, e-learning platforms, and individuals mainly created non-useful videos. Significant correlations were observed between the video's usefulness and the total view and views per day., Conclusions: During a pandemic, YouTube might be a resource for learning donning and doffing of personal protective equipment for healthcare workers if an appropriate selection process applied for determining educationally useful videos., (Copyright © 2020 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Publicado por Elsevier España, S.L.U. All rights reserved.)

Sterility is of utmost importance during surgery, particularly orthopaedic surgery. The literature suggests sterility, when compromised, is frequently contaminated at the point of donning sterile gowns and gloves. We describe a novel method to assess the compliance of sterility whilst applying surgical gloves using an ultraviolet lightbox and an ultraviolet-sensitive 'Germ paint'. We carried out an audit of 'sterility' using this method with our surgical trainees. A subsequent educational programme described methods of glove-donning. Repeat assessment yielded significantly improved results. Educating staff using this method may improve sterility in theatre. We believe this is a novel method to teach and assess sterility during glove-donning. The equipment is readily accessible within each NHS hospital. Medical and theatre staff should use this as part of training and departmental induction programmes.