A mixed-methods sequential explanatory design comparison between COVID-19 infection control guidelines\u2019 applicability and their protective value as perceived by Israeli healthcare workers, and healthcare executives\u2019 response

Anat Gesser-Edelsburg,Ricky Cohen,Rana Hijazi,Nour Abed Elhadi Shahbari

doi:10.1186/s13756-020-00812-8

Anat Gesser-Edelsburg, Ricky Cohen + Show 2 more

Open Access

https://doi.org/10.1186/s13756-020-00812-8

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Abstract

BackgroundHealthcare workers (HCWs) are on the front line of the COVID-19 outbreak, and their constant exposure to infected patients and contaminated surfaces puts them at risk of acquiring and transmitting the infection. Therefore, they must employ protective measures. In practice, HCWs in Israel were not fully prepared for this sudden COVID-19 outbreak. This research aimed to identify and compare: (1) Israeli HCWs’ perceptions regarding the official COVID-19 guidelines’ applicability and their protective value, and (2) HCWs executives’ response to HWCs’ concern regarding personal protective equipment (PPE) shortage.MethodsA mixed-methods sequential explanatory design consists of: (1) An online survey of 242 HCWs about the application of the guidelines and PPE, and (2) Personal interviews of 15 HCWs executives regarding PPE shortage and the measures they are taking to address it.ResultsA significant difference between the perceived applicability and protective value was found for most of the guidelines. Some of the guidelines were perceived as more applicable than protective (hand hygiene, signage at entrance, alcohol rub sanitizers at entrance, and mask for contact with symptomatic patients). Other were perceived as less applicable than protective (prohibited gathering of over 10 people, maintaining a distance of 2 m’, and remote services).ConclusionsHCWs need the support of the healthcare authorities not only to provide missing equipment, but also to communicate the risk to them. Conveying the information with full transparency, while addressing the uncertainty element and engaging the HCWs in evaluating the guidelines, are critical for establishing trust.

Highlights

Healthcare workers (HCWs) are on the front line of the COVID-19 outbreak, and their constant exposure to infected patients and contaminated surfaces puts them at risk of acquiring and transmitting the infection
A significant difference between applicability and protective value was found for several guidelines, except for three guidelines
“I sat with all the teams, from all the departments in the clinic, we developed a work procedure, which team members need to be protected, and together we came up with a “portion” of protective equipment (PPE) based on the number of staff members, the number of patients, and which needs or cases they deal with

Summary

Introduction

Healthcare workers (HCWs) are on the front line of the COVID-19 outbreak, and their constant exposure to infected patients and contaminated surfaces puts them at risk of acquiring and transmitting the infection. There is a dispute as to how the virus is transmitted from one person to another (droplet or airborne transmission). Some countries and organizations, including the US and European Centers for Disease Control and Prevention recommend airborne precautions for any situation involving the care of COVID-19 patients [3, 4]

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