A Systems View of Health Care Worker Personal Protective Equipment (PPE) Compliance in a Simulated Setting

BACKGROUND: Health care worker (HCW) compliance with personal protective equipment (PPE) protocols is critical for preventing infection transmission but remains a challenge. This study investigated how environmental and task-related factors impact PPE donning, doffing, and in-room compliance among nursing students in a simulated health care setting, using a system's engineering perspective. METHODS: The study utilized a 2³ factorial design to examine 3 independent variables: computer workstation placement (in/out of room), trash can fullness (full/empty), and work interruptions (phone call/no call). Compliance issues were assessed by a nursing instructor and an experienced PPE researcher who adhered to CDC guidelines. RESULTS: The findings indicated that computer placement inside the patient room significantly increased total, donning, and doffing compliance issues when assessed against strict CDC guidelines. Interruptions significantly increased in-room compliance issues for both assessor types. CONCLUSION: These results highlight the influence of work system design on PPE adherence. The study suggests that specific environmental and work task factors, such as computer placement and interruptions, can significantly affect health care workers' adherence to crucial PPE protocols. Targeted interventions are needed to improve HCW safety.