Cochrane · systematic review · CD011621
Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff
Verbeek, JH, Rajamaki, B, Ijaz, S, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
42
current version
GRADE rated
39
No studies
1
Included studies
NR
No studies 1 · 2.4%Ungraded 2 · 4.8%Very low 34 · 81%Low 5 · 11.9%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyPersonal protective equipment (PPE) types: powered, air‐purifying respirator (PAPR) plus coverall versus N95 mask plus gown
Population: healthcare staff volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any contamination: fluorescent marker Personal protective equipment (PPE) types: powered, air‐purifying respirator (PAPR) plus coverall vs N95 mask plus gown | RR 0.27 [0.17, 0.43] | 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Compliance: noncompliance with donning guidance Personal protective equipment (PPE) types: powered, air‐purifying respirator (PAPR) plus coverall vs N95 mask plus gown | RR 7.5 [1.81, 31.1] | 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Compliance: noncompliance with doffing guidance Personal protective equipment (PPE) types: powered, air‐purifying respirator (PAPR) plus coverall vs N95 mask plus gown | RR 0.5 [0.2, 1.23] | 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Personal protective equipment (PPE) types: more protective versus less protective
Population: healthcare worker volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of contaminated spots: trunk Fluorescent marker Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Number of contaminated spots: neck Fluorescent marker Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Number of contaminated spots: foot Fluorescent marker Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Number of contaminated spots: palm Fluorescent marker Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Number of contaminated spots: trunk or neck Fluorescent marker Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | NR | No studies |
Usability score Range 1 to 5, higher indicating better Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Compliance with guidance Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | 0 studies · 0 participants | Ungraded |
Personal protective equipment (PPE) types: gowns versus aprons
Population: healthcare worker volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination with marker: individual type of doffing Personal protective equipment (PPE) types: gowns vs aprons | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Contamination with marker: CDC‐recommended doffing Personal protective equipment (PPE) types: gowns vs aprons | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Compliance with guidance Personal protective equipment (PPE) types: gowns vs aprons | no estimate extracted | 0 studies · 0 participants | Ungraded |
Personal protective equipment (PPE) types: different types of PPE attire
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any contamination | no estimate extracted | 1 study · 59 participants | Very low Downgraded: risk of bias, imprecision |
Compliance | no estimate extracted | 1 study · 59 participants | Very low Downgraded: risk of bias, imprecision |
Modified personal protective equipment (PPE): sealed gown‐glove interface versus standard gown
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination: fluorescent lotion Modified personal protective equipment (PPE): sealed gown‐glove interface vs standard gown | RR 0.27 [0.09, 0.78] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Contamination: MS2 Modified personal protective equipment (PPE): sealed gown‐glove interface vs standard gown | RR 0.68 [0.47, 0.98] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Modified personal protective equipment (PPE): gown ‐ easy to doff compared to standard gown
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination: fluorescent marker Modified personal protective equipment (PPE): gown ‐ easy to doff vs standard gown | RR 0.08 [0.01, 0.55] | 1 study · 62 participants | Low |
Contamination: bacteriophage Modified personal protective equipment (PPE): gown ‐ easy to doff vs standard gown | RR 0.53 [0.29, 0.94] | 1 study · 62 participants | Low |
Modified personal protective equipment (PPE): gown with gown‐glove improvement compared to standard gown and gloves
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
People with contamination Modified personal protective equipment (PPE): gown with gown‐glove improvement vs standard gown and gloves | RR 0.45 [0.26, 0.78] | 2 studies · 50 participants | Low Downgraded: risk of bias |
Modified personal protective equipment (PPE): gloves with tab versus standard gloves
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any contamination of hands Modified personal protective equipment (PPE): gloves with tab vs standard gloves | RR 0.22 [0.15, 0.31] | 1 study · 317 participants | Very low Downgraded: risk of bias, indirectness |
Modified personal protective equipment (PPE): mask plus tabs versus standard masks
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination of mask from hands Modified personal protective equipment (PPE): mask plus tabs vs standard masks | RR 0.33 [0.14, 0.8] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Contamination of head from hands Modified personal protective equipment (PPE): mask plus tabs vs standard masks | RR 0.96 [0.83, 1.12] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Procedures: doffing according to Centers for Disease Control and Prevention method versus individual doffing
Population: healthcare worker volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination with fluor marker when using gowns Procedures: doffing according to Centers for Disease Control and Prevention method vs individual doffing | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Contamination with fluor marker when using aprons Procedures: doffing according to Centers for Disease Control and Prevention method vs individual doffing | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Procedures: single‐step doffing compared to Centers for Disease Control and Prevention standard
Population: preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Fluorescent contamination Procedures: single‐step doffing vs Centers | RR 0.98 [0.75, 1.28] | 1 study · 22 participants | Very low |
Bacterial contamination Procedures: single‐step doffing vs Centers | RR 0.2 [0.05, 0.77] | 1 study · 27 participants | Very low |
Procedures: doffing with double gloves compared to doffing with single gloves
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination: virus detected ‐ all body parts Procedures: doffing with double gloves vs doffing with single gloves | RR 0.34 [0.17, 0.66] | 1 study · 58 participants | Very low |
Contamination: virus detected ‐ face Procedures: doffing with double gloves vs doffing with single gloves | RR 4.39 [0.53, 36.37] | 1 study · 58 participants | Very low |
Contamination: virus detected ‐ shirt Procedures: doffing with double gloves vs doffing with single gloves | RR 1.01 [0.79, 1.29] | 1 study · 58 participants | Very low |
Contamination: virus detected ‐ pants Procedures: doffing with double gloves vs doffing with single gloves | RR 0.91 [0.52, 1.58] | 1 study · 36 participants | Very low |
Non‐compliance: any error Procedures: doffing with double gloves vs doffing with single gloves | RR 1.08 [0.7, 1.67] | 1 study · 36 participants | Very low |
Contamination with fluorescent Procedures: doffing with double gloves vs doffing with single gloves | RR 0.98 [0.75, 1.28] | 1 study · 22 participants | Very low |
Procedures: donning and doffing with instructions compared to without instruction
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
People with one or more errors Procedures: donning and doffing with instructions vs without instruction | RR 0.31 [0.11, 0.93] | 1 study · 120 participants | Very low |
Mean errors Procedures: donning and doffing with instructions vs without instruction | no estimate extracted | 1 study · 120 participants | Very low |
Fluorescence contamination Procedures: donning and doffing with instructions vs without instruction | no estimate extracted | 1 study · 24 participants | Low |
Procedures: doffing with extra sanitation of gloves compared to standard no sanitation
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Bacterial contamination: alcohol‐based hand rub Procedures: doffing with extra sanitation of gloves vs standard no sanitation | RR 0.75 [0.39, 1.45] | 1 study · 46 participants | Low |
Bacterial contamination: quaternary ammonium Procedures: doffing with extra sanitation of gloves vs standard no sanitation | no estimate extracted | 1 study · 20 participants | Very low Downgraded: risk of bias |
Bacterial contamination: bleach Procedures: doffing with extra sanitation of gloves vs standard no sanitation | no estimate extracted | 2 studies · 20 participants | Very low Downgraded: risk of bias |
Procedures: doffing with hypochlorite versus doffing with alcohol‐based glove sanitiser
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination: MS2 Procedures: doffing with hypochlorite vs doffing with alcohol‐based glove sanitiser | RR 4 [0.47, 34.24] | 1 study · 15 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Contamination: Ph6 Procedures: doffing with hypochlorite vs doffing with alcohol‐based glove sanitiser | no estimate extracted | 1 study · 15 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Teaching: video‐based learning versus traditional lecture
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Skills in PPE donning Teaching: video‐based learning vs traditional lecture | no estimate extracted | 1 study · 26 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Personal protective equipment (PPE) types: powered, air‐purifying respirator (PAPR) plus coverall versus N95 mask plus gown
Population: healthcare staff volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any contamination: fluorescent marker Personal protective equipment (PPE) types: powered, air‐purifying respirator (PAPR) plus coverall vs N95 mask plus gown | RR 0.27 [0.17, 0.43] | 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Compliance: noncompliance with donning guidance Personal protective equipment (PPE) types: powered, air‐purifying respirator (PAPR) plus coverall vs N95 mask plus gown | RR 7.5 [1.81, 31.1] | 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Compliance: noncompliance with doffing guidance Personal protective equipment (PPE) types: powered, air‐purifying respirator (PAPR) plus coverall vs N95 mask plus gown | RR 0.5 [0.2, 1.23] | 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Personal protective equipment (PPE) types: more protective versus less protective
Population: healthcare worker volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of contaminated spots: trunk Fluorescent marker Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Number of contaminated spots: neck Fluorescent marker Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Number of contaminated spots: foot Fluorescent marker Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Number of contaminated spots: palm Fluorescent marker Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Number of contaminated spots: trunk or neck Fluorescent marker Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | NR | No studies |
Usability score Range 1 to 5, higher indicating better Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Compliance with guidance Personal protective equipment (PPE) types: more protective vs less protective | no estimate extracted | 0 studies · 0 participants | Ungraded |
Personal protective equipment (PPE) types: gowns versus aprons
Population: healthcare worker volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination with marker: individual type of doffing Personal protective equipment (PPE) types: gowns vs aprons | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Contamination with marker: CDC‐recommended doffing Personal protective equipment (PPE) types: gowns vs aprons | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Compliance with guidance Personal protective equipment (PPE) types: gowns vs aprons | no estimate extracted | 0 studies · 0 participants | Ungraded |
Personal protective equipment (PPE) types: different types of PPE attire
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any contamination | no estimate extracted | 1 study · 59 participants | Very low Downgraded: risk of bias, imprecision |
Compliance | no estimate extracted | 1 study · 59 participants | Very low Downgraded: risk of bias, imprecision |
Modified personal protective equipment (PPE): sealed gown‐glove interface versus standard gown
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination: fluorescent lotion Modified personal protective equipment (PPE): sealed gown‐glove interface vs standard gown | RR 0.27 [0.09, 0.78] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Contamination: MS2 Modified personal protective equipment (PPE): sealed gown‐glove interface vs standard gown | RR 0.68 [0.47, 0.98] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Modified personal protective equipment (PPE): gown ‐ easy to doff compared to standard gown
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination: fluorescent marker Modified personal protective equipment (PPE): gown ‐ easy to doff vs standard gown | RR 0.08 [0.01, 0.55] | 1 study · 62 participants | Low |
Contamination: bacteriophage Modified personal protective equipment (PPE): gown ‐ easy to doff vs standard gown | RR 0.53 [0.29, 0.94] | 1 study · 62 participants | Low |
Modified personal protective equipment (PPE): gown with gown‐glove improvement compared to standard gown and gloves
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
People with contamination Modified personal protective equipment (PPE): gown with gown‐glove improvement vs standard gown and gloves | RR 0.45 [0.26, 0.78] | 2 studies · 50 participants | Low Downgraded: risk of bias |
Modified personal protective equipment (PPE): gloves with tab versus standard gloves
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any contamination of hands Modified personal protective equipment (PPE): gloves with tab vs standard gloves | RR 0.22 [0.15, 0.31] | 1 study · 317 participants | Very low Downgraded: risk of bias, indirectness |
Modified personal protective equipment (PPE): mask plus tabs versus standard masks
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination of mask from hands Modified personal protective equipment (PPE): mask plus tabs vs standard masks | RR 0.33 [0.14, 0.8] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Contamination of head from hands Modified personal protective equipment (PPE): mask plus tabs vs standard masks | RR 0.96 [0.83, 1.12] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Procedures: doffing according to Centers for Disease Control and Prevention method versus individual doffing
Population: healthcare worker volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination with fluor marker when using gowns Procedures: doffing according to Centers for Disease Control and Prevention method vs individual doffing | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Contamination with fluor marker when using aprons Procedures: doffing according to Centers for Disease Control and Prevention method vs individual doffing | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Procedures: single‐step doffing compared to Centers for Disease Control and Prevention standard
Population: preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Fluorescent contamination Procedures: single‐step doffing vs Centers | RR 0.98 [0.75, 1.28] | 1 study · 22 participants | Very low |
Bacterial contamination Procedures: single‐step doffing vs Centers | RR 0.2 [0.05, 0.77] | 1 study · 27 participants | Very low |
Procedures: doffing with double gloves compared to doffing with single gloves
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination: virus detected ‐ all body parts Procedures: doffing with double gloves vs doffing with single gloves | RR 0.34 [0.17, 0.66] | 1 study · 58 participants | Very low |
Contamination: virus detected ‐ face Procedures: doffing with double gloves vs doffing with single gloves | RR 4.39 [0.53, 36.37] | 1 study · 58 participants | Very low |
Contamination: virus detected ‐ shirt Procedures: doffing with double gloves vs doffing with single gloves | RR 1.01 [0.79, 1.29] | 1 study · 58 participants | Very low |
Contamination: virus detected ‐ pants Procedures: doffing with double gloves vs doffing with single gloves | RR 0.91 [0.52, 1.58] | 1 study · 36 participants | Very low |
Non‐compliance: any error Procedures: doffing with double gloves vs doffing with single gloves | RR 1.08 [0.7, 1.67] | 1 study · 36 participants | Very low |
Contamination with fluorescent Procedures: doffing with double gloves vs doffing with single gloves | RR 0.98 [0.75, 1.28] | 1 study · 22 participants | Very low |
Procedures: donning and doffing with instructions compared to without instruction
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
People with one or more errors Procedures: donning and doffing with instructions vs without instruction | RR 0.31 [0.11, 0.93] | 1 study · 120 participants | Very low |
Mean errors Procedures: donning and doffing with instructions vs without instruction | no estimate extracted | 1 study · 120 participants | Very low |
Fluorescence contamination Procedures: donning and doffing with instructions vs without instruction | no estimate extracted | 1 study · 24 participants | Low |
Procedures: doffing with extra sanitation of gloves compared to standard no sanitation
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Bacterial contamination: alcohol‐based hand rub Procedures: doffing with extra sanitation of gloves vs standard no sanitation | RR 0.75 [0.39, 1.45] | 1 study · 46 participants | Low |
Bacterial contamination: quaternary ammonium Procedures: doffing with extra sanitation of gloves vs standard no sanitation | no estimate extracted | 1 study · 20 participants | Very low Downgraded: risk of bias |
Bacterial contamination: bleach Procedures: doffing with extra sanitation of gloves vs standard no sanitation | no estimate extracted | 2 studies · 20 participants | Very low Downgraded: risk of bias |
Procedures: doffing with hypochlorite versus doffing with alcohol‐based glove sanitiser
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination: MS2 Procedures: doffing with hypochlorite vs doffing with alcohol‐based glove sanitiser | RR 4 [0.47, 34.24] | 1 study · 15 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Contamination: Ph6 Procedures: doffing with hypochlorite vs doffing with alcohol‐based glove sanitiser | no estimate extracted | 1 study · 15 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Teaching: video‐based learning versus traditional lecture
Population: healthcare workers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Skills in PPE donning Teaching: video‐based learning vs traditional lecture | no estimate extracted | 1 study · 26 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
PPE‐types: One type of PPE versus another – PAPR versus E‐RCP attire
Population: Healthcare staff volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any contamination fluorescent marker PPE‐types: One type of PPE vs another – PAPR versus E‐RCP attire | RR 0.27 [0.17, 0.43] | 50 participants | Very low Downgraded: imprecision, indirectness |
Compliance with guidance ‐ Noncompliance with donning guidance PPE‐types: One type of PPE vs another – PAPR versus E‐RCP attire | RR 7.5 [1.81, 31.1] | 50 participants | Very low Downgraded: imprecision, indirectness |
Compliance with guidance ‐ Noncompliance with doffing guidance PPE‐types: One type of PPE vs another – PAPR versus E‐RCP attire | RR 0.5 [0.2, 1.23] | 50 participants | Very low Downgraded: imprecision, indirectness |
Infection with EVD PPE‐types: One type of PPE vs another – PAPR versus E‐RCP attire | no estimate extracted | 0 studies · 0 participants | Ungraded |
PPE‐types: One type of PPE versus another – Three types of PPE attire
Population: Healthcare worker volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of contaminated spots ‐ Neck fluorescent marker PPE‐types: One type of PPE vs another – Three types of PPE attire | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Number of contaminated spots ‐ Foot fluorescent marker PPE‐types: One type of PPE vs another – Three types of PPE attire | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Number of contaminated spots ‐ Palm fluorescent marker PPE‐types: One type of PPE vs another – Three types of PPE attire | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Infection with EVD PPE‐types: One type of PPE vs another – Three types of PPE attire | no estimate extracted | 0 studies · 0 participants | Ungraded |
Compliance with guidance PPE‐types: One type of PPE vs another – Three types of PPE attire | no estimate extracted | 0 studies · 0 participants | Ungraded |
PPE‐types:One type of PPE versus another – Gowns versus aprons
Population: Healthcare worker volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination with marker; individual type of doffing PPE‐types:One type of PPE vs another – Gowns versus aprons | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Contamination with marker; CDC recommended doffing PPE‐types:One type of PPE vs another – Gowns versus aprons | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Infection with EVD PPE‐types:One type of PPE vs another – Gowns versus aprons | no estimate extracted | 0 studies · 0 participants | Ungraded |
Compliance with guidance PPE‐types:One type of PPE vs another – Gowns versus aprons | no estimate extracted | 0 studies · 0 participants | Ungraded |
PPE types: One type of PPE versus another ‐ Five types of PPE attire
Population: Preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any contamination PPE types: One type of PPE vs another ‐ Five types of PPE attire | no estimate extracted | 1 study · 1 participants | Very low |
PPE‐types: One type of PPE versus another ‐ Sealed suit compared to Traditional suit
Population: Preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination fluorescent lotion PPE‐types: One type of PPE vs another ‐ Sealed suit compared to Traditional suit | RR 0.27 [0.09, 0.78] | 1 study · 30 participants | Very low Downgraded: indirectness |
Contamination MS2 PPE‐types: One type of PPE vs another ‐ Sealed suit compared to Traditional suit | RR 0.68 [0.47, 0.98] | 1 study · 30 participants | Very low Downgraded: indirectness |
Procedures: Doffing with double gloves versus doffing with single gloves
Population: Healthcare staff volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination: virus detected ‐ All body parts Procedures: Doffing with double gloves vs doffing with single gloves | RR 0.36 [0.16, 0.78] | 18 participants | Very low Downgraded: imprecision, indirectness |
Compliance with guidance ‐ Noncompliance: any error Procedures: Doffing with double gloves vs doffing with single gloves | RR 1.08 [0.7, 1.67] | 18 participants | Very low Downgraded: imprecision, indirectness |
Infection with EVD Procedures: Doffing with double gloves vs doffing with single gloves | no estimate extracted | 0 studies · 0 participants | Ungraded |
Procedures: Gloves with tab versus standard gloves
Population: Preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any contamination of hands Procedures: Gloves with tab vs standard gloves | OR 0.07 [0.04, 0.12] | 1 study · 317 participants | Very low Downgraded: risk of bias |
Procedures: Mask tabs versus No mask tabs
Population: Preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination of mask from hands Procedures: Mask tabs vs No mask tabs | RR 0.33 [0.14, 0.8] | 1 study · 20 participants | Very low Downgraded: risk of bias |
Contamination of head from hands Procedures: Mask tabs vs No mask tabs | RR 0.96 [0.83, 1.12] | 1 study · 120 participants | Very low Downgraded: risk of bias |
Procedures: Doffing according to CDC method versus individual doffing
Population: Healthcare staff volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination with fluor marker when using gowns Procedures: Doffing according to CDC method vs individual doffing | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Contamination with fluor marker when using aprons Procedures: Doffing according to CDC method vs individual doffing | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Infection with EVD Procedures: Doffing according to CDC method vs individual doffing | no estimate extracted | 0 studies · 0 participants | Ungraded |
Compliance with guidance Procedures: Doffing according to CDC method vs individual doffing | no estimate extracted | 0 studies · 0 participants | Ungraded |
Procedures: Doffing with Hypochlorite versus doffing with Alcohol‐based glove sanitizer
Population: Preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination MS2 Procedures: Doffing with Hypochlorite vs doffing with Alcohol‐based glove sanitizer | RR 4 [0.47, 34.24] | 1 study · 15 participants | Very low Downgraded: risk of bias |
Contamination Ph6 Procedures: Doffing with Hypochlorite vs doffing with Alcohol‐based glove sanitizer | no estimate extracted | 1 study · 15 participants | Ungraded |
Procedures: Doffing with Chlorine spray versus doffing without spray
Population: Preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Infection Rate (IgG level) Procedures: Doffing with Chlorine spray vs doffing without spray | no estimate extracted | 0 studies · 1 participants | Very low Downgraded: risk of bias |
Teaching: Video‐based learning versus traditional lecture
Population: Preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Skills in PPE donning Teaching: Video‐based learning vs traditional lecture | no estimate extracted | 1 study · 26 participants | Very low Downgraded: risk of bias |
Comparison 1: One type of PPE versus another – PAPR versus E‐RCP attire
Population: healthcare staff volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Any contamination fluorescent marker Comparison 1: One type of PPE vs another – PAPR versus E‐RCP attire | RR 0.27 [0.17, 0.43] | 50 participants | Very low Downgraded: imprecision, indirectness |
Compliance with guidance ‐ Noncompliance with donning guidance Comparison 1: One type of PPE vs another – PAPR versus E‐RCP attire | RR 7.5 [1.81, 31.1] | 50 participants | Very low Downgraded: imprecision, indirectness |
Compliance with guidance ‐ Noncompliance with doffing guidance Comparison 1: One type of PPE vs another – PAPR versus E‐RCP attire | RR 0.5 [0.2, 1.23] | 50 participants | Very low Downgraded: imprecision, indirectness |
Infection with EVD Comparison 1: One type of PPE vs another – PAPR versus E‐RCP attire | no estimate extracted | 0 studies · 0 participants | Ungraded |
Comparison 1: One type of PPE versus another – Three types of PPE attire
Population: healthcare worker volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of contaminated spots ‐ Neck fluorescent marker Comparison 1: One type of PPE vs another – Three types of PPE attire | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Number of contaminated spots ‐ Foot fluorescent marker Comparison 1: One type of PPE vs another – Three types of PPE attire | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Number of contaminated spots ‐ Palm fluorescent marker Comparison 1: One type of PPE vs another – Three types of PPE attire | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Infection with EVD Comparison 1: One type of PPE vs another – Three types of PPE attire | no estimate extracted | 0 studies · 0 participants | Ungraded |
Compliance with guidance Comparison 1: One type of PPE vs another – Three types of PPE attire | no estimate extracted | 0 studies · 0 participants | Ungraded |
Comparison 1: One type of PPE versus another – Gowns versus aprons
Population: healthcare worker volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination with marker; individual type of doffing Comparison 1: One type of PPE vs another – Gowns versus aprons | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Contamination with marker; CDC recommended doffing Comparison 1: One type of PPE vs another – Gowns versus aprons | no estimate extracted | 1 study · 50 participants | Very low Downgraded: imprecision, indirectness |
Infection with EVD Comparison 1: One type of PPE vs another – Gowns versus aprons | no estimate extracted | 0 studies · 0 participants | Ungraded |
Compliance with guidance Comparison 1: One type of PPE vs another – Gowns versus aprons | no estimate extracted | 0 studies · 0 participants | Ungraded |
Comparison 2: One procedure for donning/doffing versus another – Doffing with double gloves compared to doffing with single gloves
Population: healthcare staff volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination: virus detected ‐ All body parts Comparison 2: One procedure for donning/doffing vs another – Doffing with double gloves compared to doffing with single gloves | RR 0.36 [0.16, 0.78] | 18 participants | Very low Downgraded: imprecision |
Compliance with guidance ‐ Noncompliance: any error Comparison 2: One procedure for donning/doffing vs another – Doffing with double gloves compared to doffing with single gloves | RR 1.08 [0.7, 1.67] | 18 participants | Very low Downgraded: imprecision |
Infection with EVD Comparison 2: One procedure for donning/doffing vs another – Doffing with double gloves compared to doffing with single gloves | no estimate extracted | 0 studies · 0 participants | Ungraded |
Comparison 2: One procedure for donning/doffing versus another – CDC method versus individual doffing
Population: healthcare staff volunteers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Contamination with fluor marker when using gowns Comparison 2: One procedure for donning/doffing vs another – CDC method versus individual doffing | no estimate extracted | 1 study · 50 participants | Very low Downgraded: indirectness |
Contamination with fluor marker when using aprons Comparison 2: One procedure for donning/doffing vs another – CDC method versus individual doffing | no estimate extracted | 1 study · 50 participants | Very low Downgraded: indirectness |
Infection with EVD Comparison 2: One procedure for donning/doffing vs another – CDC method versus individual doffing | no estimate extracted | 0 studies · 0 participants | Ungraded |
Compliance with guidance Comparison 2: One procedure for donning/doffing vs another – CDC method versus individual doffing | no estimate extracted | 0 studies · 0 participants | Ungraded |