Ensuring Safety in Education: The Vital Role of Personal Protective Equipment (PPE)

Workers across diverse industries rely on personal protective equipment (PPE) to mitigate exposure to hazardous chemicals, fire, particulates, and other health risks. In healthcare, PPE protocols are crucial, yet adherence is often low due to comfort and workability issues. Education and consistent reinforcement of proper PPE usage are vital, especially in healthcare settings where lives are at stake.

Understanding the Importance of PPE

Personal Protective Equipment (PPE) is worn to prevent exposure to contaminants that cause illness. PPE includes items like gloves, goggles, masks, and lab coats that help protect students and staff from potential hazards. The primary goal of PPE is to protect the wearer from pathogens and other contaminants when providing patient care. PPE is a key component of infection control measures, but it's not a perfect solution and comes with limitations.

Factors Influencing PPE Use

The 2008 Institute of Medicine (IOM) report and other studies categorized factors impacting PPE-related behaviors and compliance into three areas:

Individual factors: Knowledge, beliefs, attitudes, perception of risk, history, and sociodemographics.
Environmental factors: Availability of equipment and negative-pressure rooms.
Organizational factors: Management’s expectations and performance feedback, workplace policies, and training and education programs.

These factors highlight the need for concerted efforts by healthcare personnel, managers, and institutions to improve the safety culture in healthcare facilities.

Cultivating a Culture of Safety

Implementing a culture of safety requires changes in an organization’s policies, procedures, managerial actions, priorities, and resources dedicated to safety, including access to effective safety equipment. The commitment to safety must be conveyed to workers at all levels through active engagement by leadership, who should model, encourage, and enforce appropriate PPE use. Individual accountability is also key to improving and sustaining PPE use.

The 2008 report identified four key factors in promoting a culture of safety within healthcare facilities:

Provide leadership, commitment, and role modeling for worker safety: Employees perceiving a strong commitment to safety are more likely to adhere to protocols.
Emphasize healthcare worker education and training: Safety education demonstrates an organization’s commitment to safety and increases individual knowledge of safety practices.
Improve feedback and enforcement of PPE policies and use: Promoting habitual safety practice requires employees to feel uncomfortable when not wearing PPE in appropriate situations, with supervisors reinforcing its importance and enforcing policies.
Clarify worksite practices and policies: Identifying and disseminating best practices in infection control can increase worker and patient safety.

The PRECEDE Model for Healthcare Worker Education

The CDC recommends following the PRECEDE model for educating healthcare workers about PPE best practices. The PRECEDE-PROCEED model is a comprehensive structure for assessing health needs for designing, implementing, and evaluating health promotion and other public health programs to meet those needs. PRECEDE stands for Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation.

The steps include:

Identifying predisposing aspects: Knowledge, practices, opinions, and attitudes about PPE use.
Addressing enabling factors: Educational in-services about PPE and its role in the hospital’s infection prevention strategy, including PPE promotion campaigns and consistent availability at the point of care.
Addressing reinforcing factors: Providing frequent feedback to healthcare workers and providers about PPE use rates.
Engaging leadership: Ensuring buy-in, support, and investment from leadership to reinforce protocols and standards.
Evaluating outcomes: Reassessing the knowledge of and adherence to PPE protocols.

The Forgetting Curve and Training Frequency

German psychologist Hermann Ebbinghaus discovered that after seven days, individuals could forget up to 90% of the information they took in. Training frequency is critical, as is offering engaging training. Regular hands-on training, explaining the importance of PPE, and daily reminder-style training about proper use are all beneficial. Frequent conversations versus lectures, including references to recent outbreaks, can also be effective. Unit champions or competitions, judged based on correctly following PPE protocols, can further reinforce proper PPE use.

Recent Research on Organizational Factors

Recent research on organizational factors that impact PPE use has reinforced factors identified in the 2008 IOM report, including:

Availability of and participation in training and refresher courses.
Supervisor and peer use of PPE.
Organizational support for worker safety and health.
Positive reinforcement of individual compliance behavior.
Negative reinforcement (e.g., verbal warnings).

Studies have also highlighted the need for better training, equipment, and facilities, as well as addressing barriers to implementing evidence-based practices.

PPE in Special Education Settings

Maintaining a high safety standard for special education schools is not just best practice-it’s a legal requirement. A special needs educational facility in the United States was recently heavily fined for an oversight in safety protocols. This OSHA fine sets a definitive legal standard within the industry, emphasizing that safety measures, especially concerning PPE, must be proactive and integrated from the onset. Protective equipment must be provided, used, and maintained wherever necessary due to hazards that can cause injury or impairment, including not just the obvious risks associated with machinery or chemicals but also those found in educational environments, such as the potential for physical injury from student behaviors.

Key OSHA Standards Related to PPE

OSHA’s standards outlined in Part 1910, specifically in Subpart I titled “Personal Protective Equipment,” extend far beyond traditional industrial or construction settings. According to OSHA Standard 1910.132(a), protective equipment must be provided, used, and maintained wherever necessary due to hazards that can cause injury or impairment. This includes not just the obvious risks associated with machinery or chemicals but also those found in educational environments, such as the potential for physical injury from student behaviors.

Implementing PPE Safety Training in Schools

Schools can integrate PPE courses into science safety training, employee onboarding, or annual professional development programs. Many states and districts recommend or require PPE training as part of occupational safety compliance and science lab safety programs.

Proper Procedures for Donning and Doffing PPE

It's not only important that healthcare workers wear appropriate PPE, but that they also follow correct procedures for donning and doffing.

Read also: Becoming a Neonatal Nurse

Donning PPE:

Gown goes on first and should cover the torso to the knees.
Mask or respirator.
Goggles or face shield.
Gloves. Assume the outside of the gloves are contaminated and only touch the inside of the gloves.

Doffing PPE:

Gloves.
Gown. Assume the front and sleeves are contaminated.
Goggles or face shield.
Mask or respirator. Remove from the back by grasping the ties or elastic.

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