Access To Personal Protective Equipment Research Articles

Cross-sectional study of personal protective equipment use, training and biosafety preparedness among healthcare workers during the first months of the SARS-CoV-2 pandemic in Brazil

ObjectivesBrazil has high rates of COVID-19 and tuberculosis among healthcare workers (HCWs). Personal protective equipment (PPE) is essential for their protection. We aimed to evaluate PPE use, training, and preparedness...

Personal Protective Equipment (PPE) and Nurses’ Anxiety During the Covid-19 Pandemic

Anxiety felt by nurses is a vague fear accompanied by feelings of uncertainty, helplessness, isolation, and insecurity when performing nursing care during the Covid-19 pandemic. Nurses need personal protective equipment as a barrier against substance penetration, solid, liquid, or airborne particles to protect against injury or the spread of disease. The purpose of this study is to identify characteristics, length of work, PPE training, Psychologic services, PPE access, booster vaccination, standard PPE nurse anxiety and the correlation between PPE and anxiety on nurses in the COVID-19 room. This research is a quantitative study using a causal - comparative study design that is non-experimental (ex post facto). The sampling method used is purposive sampling technique approach with a sample of 90 respondents using data entry with demographic data sheet, PPE completeness checklist sheet to determine PPE completeness and to determine nursing anxiety using the Hamilton Anxiety Rating Scale questionnaire. Results showed the majority of nurses were middle-aged, woman, diploma, married, working more than 2 years, have participated in PPE training, not aware of access to psychological service, experienced easy accessibility of PPE, has not received a booster vaccine, using standardized PPE and experienced mild anxiety. This study shows that there is no significant difference in mean (p value> 0.05), which means that PPE training, psychological services, access to PPE, booster vaccinations, standardized PPE did not correlate to nurses’ anxiety. The government is expected to give intervention through policies to address nurses’ anxiety and factors related to this, such as providing effective counselling services.

Personal protective equipment use among dental healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic and the impact of an educational video in clinical practice.

Dental healthcare personnel (DHCP) are at high risk of exposure to coronavirus disease 2019 (COVID-19). We sought to identify how DHCP changed their use of personal protective equipment (PPE) as a result of the COVID-19 pandemic, and to pilot an educational video designed to improve knowledge of proper PPE use. The study comprised 2 sets of semistructured qualitative interviews. The study was conducted in 8 dental clinics in a Midwestern metropolitan area. In total, 70 DHCP participated in the first set of interviews; 63 DHCP participated in the second set of interviews. In September-November 2020 and March-October 2021, we conducted 2 sets of semistructured interviews: (1) PPE use in the dental community during COVID-19, and (2) feedback on the utility of an educational donning and doffing video. Overall, 86% of DHCP reported having prior training. DHCP increased the use of PPE during COVID-19, specifically N95 respirators and face shields. DHCP reported real-world challenges to applying infection control methods, often resulting in PPE modification and reuse. DHCP reported double masking and sterilization methods to extend N95 respirator use. Additional challenges to PPE included shortages, comfort or discomfort, and compatibility with specialty dental equipment. DHCP found the educational video helpful and relevant to clinical practice. Fewer than half of DHCP reported exposure to a similar video. DHCP experienced significant challenges related to PPE access and routine use in dental clinics during the COVID-19 pandemic. An educational video improved awareness and uptake of appropriate PPE use among DHCP.

Family physicians’ responses to personal protective equipment shortages in four regions in Canada: a qualitative study

BackgroundDespite well-documented increased demands and shortages of personal protective equipment (PPE) during previous disease outbreaks, health systems in Canada were poorly prepared to meet the need for PPE during the COVID-19 pandemic. In the primary care sector, PPE shortages impacted the delivery of health services and contributed to increased workload, fear, and anxiety among primary care providers. This study examines family physicians’ (FPs) response to PPE shortages during the first year of the COVID-19 pandemic to inform future pandemic planning.MethodsAs part of a multiple case study, we conducted semi-structured qualitative interviews with FPs across four regions in Canada. During the interviews, FPs were asked to describe the pandemic-related roles they performed over different stages of the pandemic, facilitators and barriers they experienced in performing these roles, and potential roles they could have filled. Interviews were transcribed and a thematic analysis approach was employed to identify recurring themes. For the current study, we examined themes related to PPE.ResultsA total of 68 FPs were interviewed across the four regions. Four overarching themes were identified: 1) factors associated with good PPE access, 2) managing PPE shortages, 3) impact of PPE shortages on practice and providers, and 4) symbolism of PPE in primary care. There was a wide discrepancy in access to PPE both within and across regions, and integration with hospital or regional health authorities often resulted in better access than community-based practices. When PPE was limited, FPs described rationing and reusing these resources in an effort to conserve, which often resulted in anxiety and personal safety concerns. Many FPs expressed that PPE shortages had come to symbolize neglect and a lack of concern for the primary care sector in the pandemic response.ConclusionsDuring the COVID-19 pandemic response, hospital-centric plans and a lack of prioritization for primary care led to shortages of PPE for family physicians. This study highlights the need to consider primary care in PPE conservation and allocation strategies and to examine the influence of the underlying organization of primary care on PPE distribution during the pandemic.

Learning from healthcare workers’ experiences with personal protective equipment during the COVID-19 pandemic in Aotearoa/New Zealand: a thematic analysis and framework for future practice

ObjectivesSafety and welfare are critical as pandemic-related demands on the healthcare workforce continue. Access to personal protective equipment (PPE) has been a central concern of healthcare workers throughout the COVID-19...

Experiences of personal protective equipment by Australian healthcare workers during the COVID-19 pandemic, 2020: A cross-sectional study.

The aim of this study was to capture Australian frontline healthcare workers’ (HCWs) experiences with personal protective equipment (PPE) during the COVID-19 pandemic in 2020. This was a cross-sectional study using an online survey consisting of five domains: demographics; self-assessment of COVID risk; PPE access; PPE training and confidence; and anxiety. Participants were recruited from community and hospital healthcare settings in Australia, including doctors, nurses, allied health professionals, paramedics, and aged care and support staff. Data analysis was descriptive with free-text responses analysed using qualitative content analysis and multivariable analysis performed for predictors of confidence, bullying, staff furlough and anxiety. The 2258 respondents, comprised 80% women, 49% doctors and 40% nurses, based in hospital (39%) or community (57%) settings. Key findings indicated a lack of PPE training (20%), calls for fit testing, insufficient PPE (25%), reuse or extended use of PPE (47%); confusion about changing guidelines (48%) and workplace bullying over PPE (77%). An absence of in-person workplace PPE training was associated with lower confidence in using PPE (OR 0.21, 95%CI 0.12, 0.37) and a higher likelihood of workplace bullying (OR 1.43; 95% CI 1.00, 2.03) perhaps reflecting deficiencies in workplace culture. Deficiencies in PPE availability, access and training linking to workplace bullying, can have negative physical and psychological impacts on a female dominant workforce critical to business as usual operations and pandemic response.

Characteristics of healthcare personnel who reported concerns related to PPE use during care of COVID-19 patients

Background: Healthcare facilities have experienced many challenges during the COVID-19 pandemic, including limited personal protective equipment (PPE) supplies. Healthcare personnel (HCP) rely on PPE, vaccines, and other infection control measures to prevent SARS-CoV-2 infections. We describe PPE concerns reported by HCP who had close contact with COVID-19 patients in the workplace and tested positive for SARS-CoV-2. Method: The CDC collaborated with Emerging Infections Program (EIP) sites in 10 states to conduct surveillance for SARS-CoV-2 infections in HCP. EIP staff interviewed HCP with positive SARS-CoV-2 viral tests (ie, cases) to collect data on demographics, healthcare roles, exposures, PPE use, and concerns about their PPE use during COVID-19 patient care in the 14 days before the HCP’s SARS-CoV-2 positive test. PPE concerns were qualitatively coded as being related to supply (eg, low quality, shortages); use (eg, extended use, reuse, lack of fit test); or facility policy (eg, lack of guidance). We calculated and compared the percentages of cases reporting each concern type during the initial phase of the pandemic (April–May 2020), during the first US peak of daily COVID-19 cases (June–August 2020), and during the second US peak (September 2020–January 2021). We compared percentages using mid-P or Fisher exact tests (α = 0.05). Results: Among 1,998 HCP cases occurring during April 2020–January 2021 who had close contact with COVID-19 patients, 613 (30.7%) reported ≥1 PPE concern (Table 1). The percentage of cases reporting supply or use concerns was higher during the first peak period than the second peak period (supply concerns: 12.5% vs 7.5%; use concerns: 25.5% vs 18.2%; p Conclusions: Although lower percentages of HCP cases overall reported PPE concerns after the first US peak, our results highlight the importance of developing capacity to produce and distribute PPE during times of increased demand. The difference we observed among selected groups of cases may indicate that PPE access and use were more challenging for some, such as nonphysicians and nursing home HCP. These findings underscore the need to ensure that PPE is accessible and used correctly by HCP for whom use is recommended.Funding: NoneDisclosures: None

Bearing a Disproportionate Burden: Racial/Ethnic Disparities in Experiences of U.S.-Based Social Workers during the COVID-19 Pandemic.

While social workers have served as frontline workers responding to the needs of vulnerable populations during COVID-19 pandemic, little is known about how social work professionals themselves have been impacted. This article explored the impact of COVID-19 on social work professionals' mental health, physical health, and access to personal protective equipment (PPE). This was a cross-sectional web-based survey of social workers practicing in the United States (N = 3,118); data on demographic and workplace characteristics, physical and mental health, and safety concerns were collected between June and August of 2020. Univariate statistics were used to characterize the sample. Ordinal logistic and multinomial regression were used to achieve the research aims. The majority of participants reported either moderate or severe concerns related to mental (55 percent) and physical (55 percent) health; 36 percent of respondents indicated concerns about PPE access. Respondents' concerns differed by demographic (e.g., race, age) and workplace characteristics (e.g., setting, role, region). Social workers of color are experiencing COVID-19-related concerns of significantly greater severity relative to their White counterparts. Findings highlight an immediate need to deepen understanding of the factors that contribute to these trends and identify mechanisms to support the frontline social work workforce most impacted.

American Frontline Healthcare Personnel's Access to and Use of Personal Protective Equipment Early in the COVID-19 Pandemic.

Objectives:To quantify adequacy of personal protective equipment (PPE) for U.S. healthcare personnel (HCP) at the outset of the COVID-19 pandemic and its association with infection risk.Methods:March–May 2020 survey of the national Nurses’ Health Studies and the Growing Up Today study regarding self-reported PPE access, use, and reuse. COVID-19 endpoints included SARS-CoV-2 tests and COVID-19 status predicted from symptoms.Results:Nearly 22% of 22,232 frontline HCP interacting with COVID-19 patients reported sometimes or always lacking PPE. Fifty percent of HCP reported not needing respirators, including 13% of those working in COVID-19 units. Lack of PPE was cross-sectionally associated with two-fold or greater odds of COVID-19 among those who interacted with infected patients.Conclusion:These data show the need to improve the U.S. infection prevention culture of safety when confronting a novel pathogen.

Availability and crisis standards of care for personal protective equipment during fall 2020 of the COVID-19 pandemic: A national study by the APIC COVID-19 task force

BackgroundThe COVID-19 pandemic resulted in personal protective equipment (PPE) shortages in spring 2020, necessitating crisis protocols. MethodsAn online survey was administered to all Association for Professionals in Infection Control and Epidemiology members in October, 2020 to assess PPE availability and crisis standards utilized in fall, 2020. ResultsIn total, 1,081 infection preventionists participated. A quarter lacked sufficient disinfection supplies, N95s, isolation gowns, and gloves; 10%-20% lacked eye protection and hand hygiene supplies. Significantly more were reusing respirators than masks (65.6% vs 46.8%, respectively; P < .001); a third (32.0%, n = 735) were reusing isolation gowns. About half (45.9%, n = 496) were decontaminating respirators. Determinants of believing current PPE reuse protocols were safe and evidence-based included the infection preventionists being involved in developing COVID-19 protocols (both), having respirator reuse protocols that involve ≤ 5 reuses (both), using reusable respiratory protection (both), decontaminating respirators (perceived safe), and not reusing masks (perceived safe; P < .05 for all). ConclusionsAlthough most health care facilities had adequate PPE in fall 2020, PPE supply chains were still disrupted, resulting in the need to reuse or decontaminate PPE. Ongoing gaps in PPE access need to be addressed in order to minimize health care associated infections and occupational illness.

Site of Care for COVID-19-Like Respiratory Illnesses.

COVID-19 is primarily a respiratory illness. Historically, upper and lower respiratory illness has been cared for at home or in the ambulatory primary care setting. It is likely that patients experiencing COVID-19-like symptoms may first contact their primary care provider. The Medical Expenditure Panel Survey (MEPS) is a representative sample of patients from the United States that regularly assesses their use of medical care services. We analyzed 2017 MEPS data to determine the number and proportion of patients who were seen in primary care or family medicine ambulatory settings or hospitalized for upper or lower respiratory illness or pneumonia. In a given year, 19.5 million patients are seen by primary care for an upper respiratory illness, 10.7 million patients for bronchitis, and 9 million for pneumonia. In contrast, 890,000 patients are hospitalized with pneumonia. Given that a primary etiology for respiratory illness in early 2020 was SARS CoV-2 (COVID-19), primary care practices likely were the site of first contact for most patients with COVID-19 illness. Unfortunately, there has been inadequate support for in-person and telehealth visits. Primary care clinicians reported serious shortages of personal protective equipment (PPE) and testing capacity. Inadequate reimbursement for telehealth visits coupled with decreased in-person visits put primary care practices at risk of layoffs and closure. Policies related to primary care payment, federal relief efforts, PPE access, testing and follow-up capacity, and telehealth technical support are essential so primary care can provide first contact and continuity for their patients and communities throughout the COVID-19 pandemic response and recovery.

Results on PPE access and impacts of COVID-19 in a diverse population of workers.

Background: SARS-CoV2 (COVID-19) is the first major pandemic in 100 years. Knowledgeable experts for decades have warned about increasing spillover of novel infectious agents into human populations. The cause is clear: accelerated human encroachment into previously wildland areas reduces natural habitats, forcing new species, some carrying dangerous microbes, into closer contact with people. That this trend would produce a deadly pandemic with quick, uncontrolled spread was considered inevitable. Yet most countries were ill-prepared for the scale and intensity of this viral pandemic, which departed China in January and has reached every country.Methods: An online survey was launched in May 2020 in the US, to document critical needs of frontline workers and the economic and family impacts on all workers, including those laid off and those working remotely. Frontline workers include a wide range of occupations including health care, food production and distribution, warehouses, retail, transportation, firefighting, police and security services, postal service, social services, home care, and some government programs. The survey includes questions about COVID-19 symptoms and testing; contact with infected persons; employment status both prior to and after March 15, industry, changes in employment, contact with the public and with co-workers, access to personal protective equipment (PPE) and other infection control measures implemented by employers; size of household, health of household members, changes to their daily lives; concerns and stresses, including financial; deaths from COVID of relatives, friends, and acquaintances; and knowledge of protective behaviors. The survey is publicized through unions, social media, associations of non-unionized workers, and other outreach.Results: The targeted study population is large and diverse. Access to PPE, handwashing opportunities, and physical distancing will be reported by region, industry, job and demographics.Conclusions: Findings will highlight areas of deficiency or neglect in public health systems and identify industries and jobs of highest vulnerability.

Emergency department preparation for COVID-19: accelerated care units

By 11 February 2020 when the WHO named the novel coronavirus (SARS-CoV-2) and the disease it causes (COVID-19), it was evident that the virus was spreading rapidly outside of China....