Barriers and facilitators to implementing reusable personal protective equipment in hospitals, and their impacts on environment, care safety, costs, and supply chain resilience: a scoping review protocol
Bibliographic record
Abstract
INTRODUCTION: emissions attributed to single-use PPE. In response to the pandemic, some hospitals have begun adopting and implementing reusable PPE as a sustainable alternative to reduce emissions, enhance resilience to supply chain disruptions and achieve cost savings. This scoping review aims to synthesise the available evidence on the adoption, implementation barriers and facilitators, as well as the impacts of reusable PPE in hospital settings. METHODS AND ANALYSIS: This protocol is based on York's five-stage framework outlined by Arksey and O'Malley. We will map evidence on the environmental and economic impacts of reusable versus disposable PPE, and the associated infection risks. Using an adapted Consolidated Framework for Implementation Research, our scoping review will identify enablers and barriers to implementation across different clinical settings. The methodology will adhere to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review guidelines and will include a comprehensive search of peer-reviewed articles in five databases (Medline, Embase, CINAHL, Web of Science and Global Health) and grey literature. Databases will be searched from inception to December 2024. Two reviewers will independently evaluate the eligibility of all identified titles and abstracts for inclusion in the full-text review, as well as for data extraction. Descriptive data will provide insights into the enablers and facilitators of reusable PPE adoption and implementation, along with its impacts on patient and staff safety, costs, the environment and supply chain resilience to disruptions will be reported. ETHICS AND DISSEMINATION: We expect the results to both identify research gaps and generate novel ideas for future studies on transitioning to reusable PPE in healthcare settings. This review will offer healthcare decision-makers valuable insights into the factors influencing the shift from disposable to reusable PPE and its associated impacts. By refining PPE management strategies, the findings will enable managers to clearly understand the challenges and anticipated outcomes, thereby guiding effective decision-making and facilitating a smooth transition that minimises operational disruptions while upholding patient and staff safety. Ethics approval was not required for this review. The findings will be shared through conferences on healthcare management and sustainability, and submitted to peer-reviewed journals in healthcare management and implementation science. TRIAL REGISTRATION DETAILS: https://doi.org/10.17605/OSF.IO/DESVU.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.145 | 0.140 |
| Meta-epidemiology (narrow) | 0.006 | 0.005 |
| Meta-epidemiology (broad) | 0.011 | 0.015 |
| Bibliometrics | 0.019 | 0.013 |
| Science and technology studies | 0.006 | 0.006 |
| Scholarly communication | 0.008 | 0.010 |
| Open science | 0.008 | 0.009 |
| Research integrity | 0.012 | 0.006 |
| Insufficient payload (model declined to judge) | 0.050 | 0.011 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".