Design Strategies for Biocontainment Units to Reduce Risk During Doffing of High-level Personal Protective Equipment

Area of Science:

• Healthcare engineering
• Infection control
• Occupational safety

Background:

• Limited data exists for designing biocontainment unit doffing areas, impacting healthcare worker (HCW) contamination risk during personal protective equipment (PPE) removal.
• The physical design of doffing spaces is crucial for mitigating contamination risks.

Purpose of the Study:

• To assess the impact of physical design changes in biocontainment unit doffing areas on HCW performance and contamination risk.
• To identify optimal design elements and layouts for doffing areas to reduce risky behaviors and physical/cognitive load.

Main Methods:

• Phase I: Simulated patient care tasks with 56 HCWs to analyze high-level PPE doffing.
• Phase II: Rapid cycle improvement testing balance aids and redesigning layouts with 38 students.
• Phase III: Tested 1 redesigned layout with 10 HCWs, comparing performance and load to Phase I.

Main Results:

• Physical load was highest without balance aids; chairs and grab bars reduced effort.
• The redesigned layout significantly decreased HCW risky behaviors (P = .004), eliminating 5 behaviors.
• Physical load decreased during shoe cover removal (P = .04), with similar reported workload (P = .43).

Conclusions:

• Optimized doffing space design and layout significantly reduced risky behaviors during high-level PPE removal.
• Physical design interventions can enhance HCW safety and reduce contamination risks in biocontainment settings.