Development and validation of tools for assessing use of personal protective equipment in health care

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Incorrect use of personal protective equipment (PPE) may lead to the spread of infectious agents among health care workers and patients. Although novel education programs show promise, there is no standard evaluation for the competencies developed during training.


A Delphi methodology was used in which checklist and global rating items for evaluating the performance of PPE skills involving gloves, gowns, masks, eye protection, and hand hygiene were generated and iteratively distributed to a panel of experts. The panel rated the importance of each item until agreement was reached, and the relevant items were used to form the Tools for Assessment of PPE Skills (TAPS), comprising 3 checklist sections (hand hygiene, donning, and doffing) and a global rating scale. Newly trained and experienced PPE users participated in experiments to evaluate the reliability, construct validity, and responsiveness of TAPS.


TAPS demonstrated interobserver reliability, and its global rating scale differentiated the performance of newly trained users and experienced users and was sensitive to changes in performance over time.


Pending further validation studies, the TAPS may facilitate the development and evaluation of educational programs to support learning and retention of PPE skills, leading to enhanced patient and health care worker safety.

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