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I was extremely impressed by the protocol for donning and doffing personal protective equipment (PPE) in the home setting as described by Kerley and colleagues. While the robust PPE in home settings protocol fills an urgent need in the authors’ community of Southern Ontario, it has far-reaching applications to home healthcare settings throughout the world.
As a current medical student, my clinical experiences have been limited to either the hospital or outpatient clinic setting. As such, ready access to PPE equipment and proper PPE disposal can be often taken for granted. Prior to the onset of the COVID-19 pandemic, I was able to easily discard gowns, gloves, and N95 masks between every patient while working in various inpatient and outpatient locations. However, careful review of Kerley et al.’s step-by-step protocol clearly outlines unique challenges pertaining to care of patients with respiratory illnesses in a home environment. As the ongoing COVID-19 pandemic has reduced available hospital bed space and healthcare-related resources, home visits provide the opportunity to care for patients outside of a formal clinical setting. This PPE protocol provides an avenue to ensure that home visits are conducted as safely and efficiently as possible.
It is my understanding that this protocol was developed in spring and summer 2020, and made public in July 2020, before more information about the transmission and infectiousness of coronavirus was fully known. I wonder if the procedure has been revised since its original publication? One part of the procedure that potentially merits updating was in Phase 2, “Entering the Home,” where it stipulates that the healthcare professional could not offer their own alcohol-based hand rub to the patient they were seeing. This home PPE protocol must continually be updated to ensure its most effective use.
All in all, I am glad that the authors were able to establish such a robust protocol regarding PPE use in the home environment, and I hope their procedure receives widespread use and recognition during these unprecedented times.