Validation of Algorithms for Donning and Doffing Personal Protective Equipment during the COVID-19 Pandemic

Miranda, Flávio Dutra; Almeida, Marcus Vinicius Teixeira de; Salomé, Geraldo Magela

doi:10.1055/s-0041-1739167

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Brasil

Journal of Coloproctology (Rio de Janeiro)

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Sumário

Original Article • J. Coloproctol. (Rio J.) 41 (04) • Oct-Dec 2021 • https://doi.org/10.1055/s-0041-1739167 copy

Validation of Algorithms for Donning and Doffing Personal Protective Equipment during the COVID-19 Pandemic

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

The prolonged or incorrect use of facial masks, respirators and glasses or visors results in friction, pressure and shear forces that constantly act on the facial skin, leading to lesions and dermatitis.

Objective

To develop and validate algorithms to guide health professionals in the correct use of personal protective equipment (PPE) and indicate preventive measures against skin injuries caused by inappropriate use during the COVID-19 pandemic.

Methods

For the develoment of the algorithms, an integrative literature review was performed using the following databases: PubMed, SciELO, and LILACS. The algorithms were evaluated by 59 health professionals (nurses, doctors, and physiotherapists), using the Delphi technique. A content validity index (CVI) was used for the statistical analysis.

Results

The experts classified the items of the algorithms from fully inadequate to fully adequate in the first round of consultations, and from partially adequate to fully adequate in the second round. The overall CVI values were of 0.83 and 1.0 in the first and second rounds respectively.

Conclusion

The algorithms validated by the expert panel can be used by health professionals when donning and doffing PPE, and to prevent the facial-skin lesions caused by their use.

Keywords:
coronavirus infection; protective devices; pressure injury; use of equipment and supplies; algorithms

First evaluation: summarized questions	Item suitability
	(1)		(2)		(3)		(4)		Total		CVI
	n	%	n	%	n	%	n	%	n	%	CVI
Is the content suitable for the target audience?	0	0	9	15.3	16	27.1	34	57.6	59	100	0.84
Is the text sequence logical and coherent?	0	0	8	13.6	12	20.3	39	66.1	59	100	0.81
Does the content make learning easier?	0	0	9	15.3	29	49.2	21	35.6	59	100	0.86
Is the vocabulary accessible?	1	1.7	10	16.9	10	16.9	38	64.4	59	100	0.84
Is the language easily comprehensible?	0	0	9	15.3	7	11.9	43	72.9	59	100	0.82
Does the content clarify doubts about the subject?	0	0	14	16.9	14	30.5	31	52.5	59	100	0.76
Graphic presentation	0	0	9	15.3	10	16.9	40	67.8	59	100	0.81
WHO-recommended PPE for use in the COVID-19 pandemic	0	0	9	15.3	25	42.4	25	42.4	59	100	0.83
Interface materials between PPE and the skin	0	0	9	15.3	7	11.9	43	72.9	59	100	0.79
Techniques for donning and doffing PPE	0	0	11	19.3	7	12.3	39	68.4	57	100	0.84
Guidelines for relief of pressure due to the use of PPE	0	0	11	19.0	5	8.6	42	72.4	58	100	0.79
Care before and after the wearing PPE	0	0	10	16.9	10	16.9	39	66.1	59	100	0.83
Skin cleansing and moisturizing technique	0	0	9	15.3	6	10.2	44	74.6	59	100	0.84
General CVI											0.831

Second evaluation: summarized questions	Item suitability
	(1)		(2)		(3)		(4)		Total		CVI
	n	%	n	%	n	%	n	%	n	%	CVI
Is the content suitable for the target audience?	0	0	0	0	7	11.9	52	88.1	59	100	1.0
Is the text sequence logical and coherent?	0	0	0	0	12	20.3	47	79.7	59	100	1.0
Does the content make learning easier?	0	0	0	0	12	20.3	47	79.7	59	100	1.0
Is the vocabulary accessible?	0	0	0	0	25	42.4	34	57.6	59	100	1.0
Is the language easily comprehensible?	0	0	0	0	28	47.5	31	52.5	59	100	1.0
Does the content clarify doubts about the subject?	0	0	0	0	6	10.2	53	89.8	59	100	1.0
Graphic presentation	0	0	0	0	13	22.0	46	78.0	59	100	1.0
WHO-recommended PPE for use in the COVID-19 pandemic	0	0	0	0	10	16.9	49	83.1	59	100	1.0
Interface materials between PPE and the skin	0	0	0	0	12	20.3	47	79.7	59	100	1.0
Techniques for donning and doffing PPE	0	0	0	0	9	15.3	50	84.7	59	100	1.0
Guidelines for pressure relief due to the use of PPE	0	0	0	0	22	37.3	37	62.7	59	100	1.0
Care before and after the wearing PPE	0	0	0	0	12	20.3	47	79.7	59	100	1.0
Skin cleansing and moisturizing technique	0	0	0	0	11	18.6	48	81.4	59	100	1.0
General CVI											1.0

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[1] Address for correspondence Geraldo Magela Salomé, RN, PhD, Universidade do Vale do Sapucaí, Av. Prefeito Tuany Toledo 470, CEP: 37550-000 Pouso Alegre, MG, Brasil (e-mail: salomereiki@univas.edu.br).