利用螢光劑檢測分析醫療照護人員個人防護裝備脫除時染污風險之研究報告

The Risk of Contamination During Doffing of Personal Protective Equipment Among Healthcare Workers: A Fluorescent Marker-Based Analysis

個人防護裝備（Personal Protective Equipment, PPE）是醫療照護人員在照顧高傳染性疾病患者時必備之工具，如何正確穿戴與脫除PPE對於醫療照護人員於臨床照護病患至關重要。本研究透過螢光劑檢測方式，分析醫療人員PPE穿脫的正確性及污染情形，用以提醒其相關操作技巧並提升其操作能力。
本研究於2024年3月至11月進行，總計118名醫療人員參與，其中護理人員79人（66.9%），醫師32人（27.1%），其他工作人員7人（5.9%）。結果顯示，59位（50.0%）人員在脫除PPE過程中發生污染，主要污染部位依序為頸部（20.8%）、前胸（11.5%）及手臂（10.4%）、手指（含指尖指縫）10.4%（並列第三）。多變項分析發現，年齡為唯一顯著影響污染風險之因子（OR=1.059,p=0.049），且即使曾經受過訓練，仍有部分人員在PPE脫除時發生內側乾淨面污染，顯示實務操作之必要。
進一步分析發現，PPE脫除過程中的錯誤主要集中於手套與隔離衣的移除，包括未正確脫除手套、觸碰污染面、隔離衣未內捲等。教育訓練後問卷調查結果發現，37位（71.2%）學員認為螢光劑輔助教學對未來感染管制作業「非常有幫助」，而38位（73.1%）表示對提升PPE穿脫技能「非常有幫助」、13位（25.0%）則認為「有幫助」，整體授課滿意度達100%。
為減少錯誤與污染風險，本研究藉由在教育訓練中加入螢光劑檢測，透過視覺化回饋機制，使學習者即時察覺污染部位，加深其記憶並提升實作準確性，參與活動之醫療照護人員給予正向回饋。未來我們將納入更多實際演練與重複測試，以提升醫療照護人員正確穿戴與脫除PPE，保護醫療照護人員並確保臨床照護品質，降低臨床環境感染風險。

Personal Protective Equipment (PPE) is an essential tool for healthcare workers caring for patients with highly infectious diseases. Correct donning and doffing of PPE is critical to ensure the safety of both healthcare workers and patients during clinical care. This study used fluorescent marker detection to analyze the accuracy of PPE donning and doffing among healthcare personnel and assess contamination events to improve practical skills and procedural awareness.
Conducted from March to November 2024, the study enrolled 118 healthcare workers, including 79 nurses (66.9%), 32 physicians (27.1%), and 7 other healthcare professionals (5.9%). The results showed that 59 participants (50.0%) experienced contamination during the PPE doffing process. The most commonly contaminated sites were the neck (20.8%), chest (11.5%), and both arms and fingers (including fingertips and interdigital areas) at 10.4%. Multivariate analysis identified age as the only significant factor associated with contamination risk (OR = 1.059, p = 0.049). Notably, contamination of the clean inner surfaces occurred even among some participants who had received prior training, which underscores the necessity of hands-on practice.
Further analysis revealed that errors during PPE doffing primarily involved the removal of gloves and gowns, including improper glove removal, touching contaminated surfaces, and failure to roll the gown inward. Post-training surveys showed that 37 participants (71.2%) found fluorescent marker-assisted teaching to be“very helpful”for future infection control tasks, whereas 38 (73.1%) found it“very helpful”and 13 (25.0%) found it“helpful”for improving PPE donning and doffing skills. Overall satisfaction with the training reached 100%.
To reduce procedural errors and contamination risks, this study integrated fluorescent marker detection into training sessions, to provide real-time visual feedback to help learners identify contamination sites, reinforce memory, and improve procedural accuracy. Participants gave highly positive feedback. Future training will incorporate more practical simulations and repeated testing to enhance PPE proficiency, minimize clinical contamination risks, protect healthcare workers, and ensure the quality of clinical care.