Introduction: In response to the 2014 Ebola outbreak, MedStar Washington Hospital Center established the Biocontainment Unit (BCU) to provide safe treatment of patients infected with special pathogens. Through federal funding for infectious disease preparedness from the Administration for Strategic Preparedness and Response and the Centers for Disease Control and Prevention, the MedStar BCU became one of thirteen Regional Emerging Special Pathogen Treatment Centers in the United States. The Medstar BCU is designed to deliver safe and effective clinical care for patients infected with high-consequence infectious diseases. Methods: Providers, including physicians, advanced practice providers, and registered nurses, underwent quarterly simulation-based training that focused on donning and doffing personal protective equipment (PPE) including a powered air purifying respirator, coverall, isolation gown, two layers of elbow-length gloves, one layer of examination gloves, foam clogs, and boot covers. All post-training surveys included two primary outcomes related to PPE, and the distributions of these responses were summarized. Results: 89% of participants were comfortable, very comfortable, or extremely comfortable with donning and doffing PPE, while 11% of participants were still not comfortable after training. Training proctors monitored for PPE breaches. Of 100 respondents, 4 responded that a PPE breach had occurred during training. 87% of participants were comfortable, very comfortable, or extremely comfortable with caring for patients in full biocontainment PPE, however, 12% of responders were extremely uncomfortable or not comfortable. Distributions in post-training comfort level did not vary significantly between training sessions, suggesting that each session had a relatively consistent impact on these two measures. Conclusion: Simulation-based medical training can increase provider preparedness in high-level isolation unit settings by improving PPE proficiency and self-efficacy. PPE proficiency and competency are integral to the low-frequency, high-consequence events of providing safe care for patients infected with special pathogens.
Wiest et al. (Sun,) studied this question.