Abstract

Aims and ObjetivesExplore nurses' experiences and perception of risk regarding the use of personal protective equipment during the first wave of the pandemic in Spain.BackgroundThe contribution of our study is to use qualitative methods to understand nurses' experiences and perceptions of the risk of the contagion linked to the shortage of PPE during the first wave of the pandemic, whose explosive start strained health systems around the globe.DesignQualitative descriptive design according to the Rapid Research Evaluation and Appraisal model.MethodsSemi‐structured videoconference interviews were conducted to explore the experiences of 29 nurses including staff nurses, nursing supervisors and nursing directors from hospital and community services of the Spanish health system. Interviews lasted 30–45 min and were conducted in May 2020. We carried out a thematic analysis using Dedoose. The COREQ checklist was used to report findings.ResultsWe identified the following themes and subthemes: 1. Experiences with personal protective equipment: scarcity, inequality, reutilization, self‐protection, delegation of responsibility, and gap between protocols and reality; 2. Perception of the risk of contagion: lack of credibility, lack of trust, lack of support, and meeting subjective needs.ConclusionsThe scarcity of personal protective equipment and inequality in its distribution led nurses to take initiatives to feel more protected. Mid‐ranking supervisors were caught between the responsibility of monitoring and rationing personal protective equipment and providing the necessary protection to nurses. The disjuncture between protocols and the available supply of personal protective equipment caused confusion. Lack of credibility, lack of trust and lack of support from management influenced participants' perception of the risk of contagion. Mid‐ranking supervisors were often responsible for trying to alleviate fear among nursing staff.Relevance to clinical practiceUnderstanding the factors involved in risk perception can be helpful to decision‐makers who help protect nurses in clinical practice. These results can help administrators and policymakers because they point to the need for nurses to feel that their departments and centers look after their safety at work. Transparent communication and emotional support may contribute to their well‐being in the face of risk.

Highlights

  • The World Health Organization (WHO) declared the outbreak of COVID-­19 an international public health emergency on 30 January 2020 (Mahase, 2020)

  • The scarcity of protective equipment (PPE) and inequality in their distribution led participants to take initiatives to feel more protected and maintain their commitment to care for people infected with COVID-­19

  • Participants who were mid-­ranking supervisors were caught between the responsibility of monitoring and rationing PPE and providing the necessary protection to nurses

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Summary

Introduction

The World Health Organization (WHO) declared the outbreak of COVID-­19 an international public health emergency on 30 January 2020 (Mahase, 2020). Through Royal Decree 463/2020 of March 14, 2020, the Spanish government declared a state of alarm that included a stay-­ at-­home order to prevent the spread of the disease (Ministerio de la Presidencia & Relaciones con las Cortes y Memoria Democrática, 2020). This was the start of an unprecedented public health crisis that has upset people’ lives and the country’s social, economic, political and health structure. In 1996, they were revised as the ‘standard precautions’, which defined protection against the main transmission pathways for infectious disease: aerosols, drops and contact (Wolf, 2005). PPE includes gowns, gloves, masks, face shields and goggles (Wolf, 2005)

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