Donning of personal protective equipment under direct supervision- A quality improvement study in COVID-ICUs of a tertiary care facility, South India

: Personal protective equipment has a major role in reducing the transmission of infections to healthcare workers despite the fact that improper doffing techniques can pose a threat of acquiring nosocomial infections. Compliance to donning or doffing is an all or none phenomenon where lack of adherence to sequence or technique can result is transmission of infections. Conducting doffing audit with the help of trained supervisors (dofficers) can significantly improve compliance with doffing guidelines. : This quality improvement study, was conducted at a large-scale tertiary care hospital located in South India, for a one-year period in COVID-ICUs. Doffing audit was conducted by trained dofficers in designated doffing areas for proper technique & sequence of doffing and disposal all through the shifts. : 5834 health care professionals were supervised over 8760 hours with a total doffing compliance of 66.6%. Nurses had better overall and individual component doffing compliance. Biomedical waste segregation compliance was also high among nurses (90.4%). Most common breach is with mask removal. : Nosocomial transmission of infections can be controlled with adherence to proper doffing techniques. Auditing and on spot interventions will help improve the compliance to doffing.