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의료종사자의 안전한 개인보호장비 탈의를 위한 공간 설계에 관한 연구

Using Design to Make Doffing of Personal Protective Equipment Safer for Healthcare Workers

의료.복지 건축 2020년 26권 3호 p.17 ~ 26
마틱 조라나, 오예인, 임리사,
소속 상세정보
마틱 조라나 ( Matic Zorana ) - 조지아공과대학교 건축학과
오예인 ( Oh Ye-Inn ) - 조지아공과대학교 건축학과
임리사 ( Lim Li-Sa ) - 텍사스공과대학교 건축학과

Abstract


Purpose: This paper presents research evidence that the environmental design of the doffing area in a biocontainment unit (BCU) can have a measurable impact on increasing the safety of frontline healthcare workers (HCW) during doffing of high-level personal protective equipment (PPE), and proposes optimized biocontainment unit design.

Methods: From 2016 to 2019, The SimTigrate Design Lab conducted 3 consecutive studies, focusing on ways in which the built environment may support or hinder safe doffing. In the first study, to identify the risky behaviors, we observed 56 simulation exercises with HCWs in 4 BCUs and 1 high-fidelity BCU mockup. In the second study, we tested the effectiveness of a redesigned doffing area on improving the HCWs performance and used simulation, observation, and rapid prototyping in 1 high-fidelity mockup of a doffing area. In a follow-up study, we used simulation and co-design with HCWs to optimize the design of a safer doffing area in a full-size pediatric BCU mock-up.

Results: We identified 11 specific risky behaviors potentially leading to occupational injury, or contamination of the PPE, or of the environment. We developed design strategies to create a space for safer doffing. In the second study, in a redesigned doffing area, the overall performance of HCW improved, and we observed a significant decrease in the number of risky behaviors; some risky behaviors were eliminated. There was a significant decrease in physical and cognitive load for the HCWs. Finally, we propose an optimized layout of a BCU for a safer process of PPE doffing.

Implications: The proposed BCU design supports better staff communication, efficiency, and automates safer behaviors. Our findings can be used to develop design guidelines for spaces where patients with other highly infectious diseases are treated when the safety of the patient-facing HCWs is of critical importance.

키워드

근거기반디자인; 격리병실; 바이오 격리병실; 감염 관리; 개인보호장비(PPE)
Evidence-Based Design; Isolation Unit; Biocontainment Unit; Infection Control; Personal Protective Equipment(PPE)

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