Coming from a manufacturing environment it was hard to folks to look beyond worker failure as the source of the problem. When you create a safety culture, you look for the root cause of the issue.

I agree with you…removing gloves first seems problematic. Back in the 70’s the disposable gowns had ties that were not easily torn in the institution that I worked in.

The thought is the back of the gown is less likely to be contaminated than the other parts and you wanted to keep contaminated gloves away from the skin while untying the gown.

With new emerging infectious diseases and easier gown design, it seems it is not necessary to remove gloves first unless soiled. For me personally, double gloving reduces dexterity.

I think we should look at design of isolation protection ( gowns, gloves, etc.)  and best practices…is it possible to have a decontamination area or other processes that reduce contamination and transmission?

Just some thoughts…..

Kathy Dayvault RN, BSN, MPH, COHN-S/CM

JET Consulting

Independent Occupational Health Nurse Consultant

Kdayvault11@att.net

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Band, Michael DO
Sent: Monday, October 13, 2014 5:31 PM
To: 'MCOH/EH'
Subject: [Bulk] [MCOH-EH] Ebola infected HCW

I thought I would start the discussion on this topic.  I am surprised how quiet we are.

Something about Ebola does not pass my “sniff test.”  I have always been disturbed that HCWs have been infected from patient care in Africa and now one of our HCWs has become infected.  Are we missing something?

I told our committee reviewing Ebola planning I disagreed with the Ebola PPE removal process as recommended by CDC.  They recommend removing gloves first and then removing rest of PPE with bare hand.   Seems like double gloving or donning a new pair of gloves would be better, then last step removing second set of gloves.

Is the spread through contact source still apply? Are we missing something?

Michael Band DO, MS

Watson Clinic

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