Journal article
Timing and type of personal protective equipment adherence lapses in pediatric trauma resuscitation: A retrospective video study
American journal of infection control, v 53(12), pp 1325-1329
Dec 2025
PMID: 40885257
Abstract
Although personal protective equipment (PPE) reduces the transmission of infectious diseases, adherence among health care providers remains inconsistent. Developing strategies to improve PPE use requires understanding the factors associated with adherence lapses, defined as the partial undoing or removal of PPE, leading to nonadherence.
We performed a retrospective video review of 10 pediatric trauma resuscitations from March 2023 to July 2024. We recorded the number of lapses, the time from adherence to lapse (time-to-lapse), and the timing of lapses during resuscitation. We observed provider actions before and after a lapse to understand situational factors.
We observed 292 lapses among 120 providers. The median time-to-lapse was 7.7 minutes (interquartile range [IQR] 3.8-15.1) for gloves, 1.5 minutes (IQR 0.3-6.8) for masks, and 13.4 minutes (IQR 6.6-26.6) for gowns. Lapses in masks (estimate −0.4, 95% confidence interval −0.6 to −0.3, P < .001) occurred earlier in the resuscitations. Of 292 lapses, 105 (36.0%) were corrected. The most common provider action before a lapse included “observing” (n = 109/292, 37.3%).
PPE lapses were frequent in the postpandemic setting. The time-to-lapse and lapse timing varied by PPE type. Aligning PPE monitoring with lapse patterns may optimize nonadherence detection and correction.
•PPE adherence among providers stayed low in the post-COVID-19 period.•Only one-third of adherence lapses were corrected.•Lapses were common among observers without clinical roles.•A policy is needed to improve PPE adherence and restrict patient area access.
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Details
- Title
- Timing and type of personal protective equipment adherence lapses in pediatric trauma resuscitation: A retrospective video study
- Creators
- Mary S. Kim - Division of Trauma and Burn Surgery, Children’s National Hospital, Washington, DCDylan W. Arkowitz - Children's NationalAlice A. Currie - Children's NationalAleksandra Sarcevic - Drexel University, Information ScienceRandall S. Burd - Children's National
- Publication Details
- American journal of infection control, v 53(12), pp 1325-1329
- Publisher
- Elsevier Inc
- Number of pages
- 5
- Grant note
- National Institutes of Health (NIH)NIH: R01EB03281
This paper is the result of funding in whole or in part by the National Institutes of Health (NIH). It is subject to the NIH Public Access Policy. Through acceptance of this federal funding, NIH has been given a right to make this paper publicly available in PubMed Central upon the Official Date of Publication, as defined by NIH. This work was supported by the NIH: award number R01EB03281.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Information Science
- Web of Science ID
- WOS:001630085700012
- Scopus ID
- 2-s2.0-105016486587
- Other Identifier
- 991022086146704721
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Infectious Diseases
- Public, Environmental & Occupational Health