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Over a six-month period, Okamoto and colleagues observed 125 health care workers, including 83 nurses and 24 doctors, in four adult intensive care units at their hospital. Half of the doctors and nurses had received formal training in the use of personal protective equipment for the Ebola virus within the previous year, and 90 percent had received “donning and doffing” training within the previous five years.
During the study, the workers oversaw 95 patients with contact precautions for methicillin-resistant Staphylococcus aureus, or MRSA, as well as vancomycin-resistant Enterococci and multidrug-resistant gram-negative bacilli.
According to a report published in Infection Control and Hospital Epidemiology, they found that more than a third of the health care workers acquired a multidrug-resistant organism during a patient encounter. Notably, four health care workers had it on their hands, four had it on their clothes or jewelry, three had it on their stethoscope, and two had it on their in-hospital mobile phones. About 70 percent of environmental sites had organisms, especially items that were close to patients such as blood pressure cuffs, call buttons and bed rails.
Overall, 49 workers, or 39 percent, made multiple doffing errors and were more likely to have contaminated clothes after a patient interaction. For instance, all four health care workers with hand contamination made errors while removing their gowns and gloves. In particular, hand contamination was 10 times higher when gloves were removed before gowns.