Guo 2014.
| Methods | Randomised multiple arm cross‐over simulation study | |
| Participants | N = 50; Voluntary HCW who gave informed consent; excluded were those who were allergic to the fluorescent marker; 34/50 female, 20/50 nurses, 10/50 doctors, 15/50 support staff, 5/50 allied health workers; age 32.9 ± 5.7 years average; working experience 10.9 ± 5.1 years Location: Hong Kong China |
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| Interventions | Intervention 1: N = 50 participants. Three types of protective clothing: 1. Disposable water resistant non‐woven gown, 2. Reusable woven cotton gown, 3. Disposable non‐woven plastic apron; and two different removal methods: individually determined or CDC recommended. Each of the 50 subjects was required to test the 3 different types of PPE followed by one of two different removal methods. Intervention 2: First the participant should doff according to their own views (individual method), then a CDC instruction video was shown and participants were asked to perform the donning or doffing method for gowns that was recommended by CDC in 2007: Gown front and sleeves are contaminated! Unfasten neck, then waist ties. Remove gown using a peeling motion; pull gown from each shoulder toward the same hand. Gown will turn inside out. Hold removed gown away from body, roll into a bundle and discard into waste or linen receptacle. Control: Cross‐over N = 50 participants. Three types of protective clothing were compared against each other. |
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| Outcomes | 1. small patches of fluorescence < 1 cm². 2.large patches of fluorescence > 1 cm². 3.patches on the hands 4.patches on the shoes 5. underwear patches 6. patches in the environment; a fluorescent powder (GloGermCo,Moab,UT) especially developed for determining hand hygiene compliance was used in this study. The Glo Germ powder was mixed with light olive oil and water to resemble human aerosol as closely as possible. The authors used repeated measures analysis to take into account the cross‐over design of the study |
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| Notes | Funding Hong Kong polytechnic University; no conflict of interest declared | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | interventions were offered "in random order"; authors asked for clarification |
| Allocation concealment (selection bias) | Unclear risk | not reported |
| Blinding of participants and personnel (performance bias) All outcomes | Low risk | No blinding possible, but no performance bias expected as participants would not have an interest with any intervention |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | not reported |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | no loss to follow‐up |
| Selective reporting (reporting bias) | Low risk | all data reported |
| Other bias | Low risk | not detected |