Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Public Health

First Advisor

Lisa Casanova

Second Advisor

Katherine Masyn

Third Advisor

Christine Stauber

Fourth Advisor

Colleen Kraft


Healthcare workers are at a significantly higher risk of exposure to infectious agents. Standard and transmission-based precautions are employed to protect healthcare workers during patient contact. Personal protective equipment and healthcare worker behavior influence the successful performance of standard and transmission-based precautions.

The three studies in this dissertation provide critical insights into personal protective equipment use and healthcare worker behavior to prevent exposure to infectious agents at the point of care. In the first study, we use patient contact simulations that incorporate viral assays and human factors analysis to determine the contribution of powered air-purifying respirator hood design to healthcare worker errors that lead to self-contamination during the use of high-level personal protective equipment. In the second study, data collected from a newly developed electronic hand hygiene monitoring system is used to identify improvements in hand hygiene behavior among healthcare workers. In the third study, we use a controlled laboratory disinfection procedure to assess the efficacy of common disinfection agents for reprocessing of elastomeric half-face respirators.

Healthcare systems rely on evidence-based methods to develop and improve infection prevention practices for healthcare workers. Therefore, this dissertation highlights crucial aspects of personal protective equipment use and healthcare worker behavior that can be optimized to successfully protect healthcare workers and provide recommendations that infection preventionists can apply to improve these areas of infection prevention.


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