Personal Protective Equipment Training Research Articles

RADIOGRAPHY CLINICAL EDUCATION AMIDST THE COVID-19 PANDEMIC: PERSPECTIVE OF RADIOGRAPHY STUDENTS INTERNATIONALLY

Purpose: The COVID-19 pandemic has signifi cantly impacted clinical practice. This study explored the impact of the pandemic on diagnostic radiography clinical education from the perspective of radiography students internationally. Materials and methods: A qualitative approach was used to gain insight into students' experience of clinical placement during the pandemic. A total of sixteen radiography students from six countries were recruited from an international Radiography summer research school. Qualitative data was gathered via three semi-structured focus groups (5-6 students per focus group). Data was analysed using Braun and Clark’s phases of thematic analysis. Results: Five key themes emerged in relation to clinical education during the COVID-19 pandemic, (i) unequal student access to personal protective equipment (PPE) (ii) challenges in achieving clinical learning outcomes (iii) impact of online education on clinical readiness (iv) emotional impact, and (v) coping strategies. Students indicated that they were particularly afraid of transmitting COVID-19 to their family and friends. Some students reported that they felt under pressure to receive COVID-19 vaccinations prior to clinical practice. Others reported confusion with respect to infection control guidelines and application of PPE. Conclusion: Student radiographers identifi ed key challenges which require consideration by educators to ensure students are appropriately prepared for and supported on clinical placement during a pandemic. Implications for practice: • The COVID-19 pandemic has impacted clinical education internationally and this study identifi es the implications for radiography students in terms of clinical readiness and their clinical placement experience. • Simulation-based in-person learning in the X-ray lab and PPE training were perceived by students to be important factors impacting clinical readiness.

Occupational Injuries and Its Determinants Among Cement Factory Workers: A Cross Sectional Study

Abstract Introduction: Cement manufacturing industry workers face inevitable circumstances and are unintentionally exposed to different injuries at the workplace. The purpose of this study was to establish the pattern of injuries and their related risk factors. Materials and Methods: This cross-sectional study involved 360 workers from different departments within three cement factories in Chhattisgarh, India. Results: 55% of employees had either abrasion (30%) or dust in their eyes (23%). Workers in open areas (unadjusted odds ratio [UOR] = 3.28 [2.08–5.18]) and those who do not have training in personal protective equipment (UOR = 2.19 [1.42–3.39]) were more likely to get injured. Conclusions: A high number of workers suffered from injuries, as reported by this study; therefore, there is a need for thorough training and safety procedures.

Infection prevention and control status at public hospitals and factors associated with COVID-19 infection among healthcare workers in Myanmar: A cross-sectional study

BackgroundHospitals should prepare for emerging diseases and protect healthcare workers (HCWs) from work-related infection. This study aims to assess public hospital preparedness for the coronavirus disease 2019 (COVID-19) a year after the Myanmar government began implementing COVID-19 prevention measures, and to identify factors associated with work-related COVID-19 infection among HCWs in Myanmar.MethodsIn January 2021, data were collected from 101 hospitals and 706 HCWs who had COVID-19 in Myanmar in 2020. Data from the hospitals included basic information, the status of infection prevention and control (IPC), the preparedness for COVID-19 (guidelines, checklists, fever screening, patient pathway, and training), handwashing facilities, and availability of personal protective equipment (PPE). Data of COVID-19 infected HCWs included age, occupation, workplace, severity and source of COVID-19 infection, knowledge and practice of handwashing, and working environment. Chi-square test was performed to compare the preparedness for COVID-19 among three hospital levels (primary, secondary and tertiary levels). Logistic regression analysis was performed to identify the associated factors of work-related infection of HCWs.ResultsThe total number of beds, HCWs, and COVID-19 patients in 2020 at the 101 hospitals was 12,888, 14,421, and 19,835, respectively. The availability of PPE was high in hospitals at all levels. Approximately 80% of hospitals had functional status of IPC, set up fever screening and patient pathway, and provided training on IPC and COVID-19. However, only 39.6% of hospitals had developed COVID-19 guidelines and 55.4% had developed checklists. The percentage of hospitals that prepared each measurement was lowest at the primary level. The factors associated with work-related COVID-19 among HCWs were being 30–39 years old, working as a doctor, working at isolation wards, having disinfection technique training, and having enough PPE at the workplace.ConclusionThe preparedness for COVID-19 at public hospitals in Myanmar in January 2021 was insufficient, especially in the availability of the guidelines and checklists and at primary hospitals. A support system for hospital pandemic preparedness and monitoring of IPC implementation is needed. The government should prepare for emerging diseases and provide appropriate and adequate PPE and additional training to all HCWs, especially HCWs who work for isolation wards.

Healthcare Workers' Perception and Compliance on Personal Protective Equipment Use in Critical Care Units of a Tertiary Care Hospital in Bahrain.

Introduction Contact precautions or the use of personal protective equipment (PPE), specifically gowns and gloves, has become a common practice in intensive care units (ICUs) as part of robust infection prevention and control efforts. Hence, a positive attitude toward PPE used among healthcare workers (HCWs) is critical to prevent healthcare-associated infections (HAIs). Aim This study aimed to determine the perception and compliance of HCWs working at critical care units regarding PPE used at government hospitals (GHs) in Bahrain. Subject and methods A cross-sectional study was conducted among HCWs working in critical units at GHs, Bahrain. A self-administered questionnaire consisting of three sections was sent to the targeted HCWs. The questionnaire consisted of socio-demographic characteristics (i.e., age, gender, job category, etc.), previous participation in PPE training, and a 15-item questionnaire to assess the perception and compliance of HCWs regarding PPE use. Results Among the 119 HCWs enrolled, 73.1% were females, and 48.7% were between 31 and 40 years old. The results of this study suggested that although 95.8% of participants received education about PPE use, only 48.7% had a good perception of PPE, and an even smaller percentage (12.6%) demonstrated good compliance. A positive, highly statistically significant correlation was found between perception and compliance scores (p<0.001). Increased perception and compliance scores were associated with increasing age, non-Bahrainis, and years of experience. Interestingly, doctors were more likely to demonstrate lower perception and compliance scores toward PPE use. Conclusion The perception of HCWs regarding PPE use was adequate, but their actual adherence was unsatisfactory. However, doctors' perceptions and compliance with PPE use were significantly lower than other HCWs. Further larger studies are required to establish the level of perception and compliance among HCWs in our region.

Self-contamination with use of personal protective equipment: Concept analysis using Rodgers’ evolutionary method

Background: Although self-contamination has been identified through relevant studies on the safe utilization of personal protective equipment (PPE) by healthcare personnel and the prevention of healthcare-associated infection transmission, there is a lack of in-depth understanding of self-contamination. This study aimed to review previous research on self-contamination and clarify the concept. By understanding this concept, healthcare personnel can improve their conscientiousness regarding self-contamination and gain a foundation for the requisite interventions to reduce self-contamination in healthcare settings. Method: MeSH terms such as “Health Personnel,” “Students, Health Occupations,” and keywords related to PPE combined with “contaminat*” and “self-contamination” to retrieve literature in OVID, EMBASE, Cochrane, CINAHL, and PsycINFO databases without time limits through December 2023 (Figure 1). The concept of self-contamination’s antecedents, attributes, and consequences were explained based on Rodgers’ evolutionary Results: After eliminating duplicates from the 2,195 studies that were initially searched, the authors reviewed the articles and determined eligibility independently. A total of 25 articles, published between 2006 and 2023, were included and analyzed. Antecedents to self-contamination were classified into three groups for each component (Figure 2). First, PPE factors included 1) types of PPE and/or ensemble choices, and 2) problems with PPE designs and/or their functions. Second, user factors involved 1) mistakes (errors of intent), 2) violations (deviations from recommendations), and 3) slips (natural flaws in humans). Third, organizational factors covered 1) unstandardized PPE protocol, 2) suboptimal and inconsistent PPE training, and 3) inadequate clinical environment. In total, five major concept attributes were the conveyance of organisms, unintentional behavior, preventable action, incidental contact, and difficulty discerning. Consequences were categorized into: 1) raising concerns about occupationally acquired infections, and 2) the potential transmission of the infection to the environment or other people (cross-contamination). Conclusion: While studies have raised questions about whether self-contamination causes infection, self-contamination was obvious among healthcare personnel when dealing with PPE. Considering the wide range of causes and potential results of self-contamination, multifaceted interventions, including improvement of the PPE design, tailoring protocols, and training for specific ensembles, should be implemented over an extended time period with suitable intervals to optimize interventions’ effectiveness.

Self-reported exposure to dust and diesel exhaust, respiratory symptoms, and use of respiratory protective equipment among Arctic miners

ABSTRACT Arctic miners face significant risks from diesel exhaust and dust exposure, potentially leading to adverse respiratory health. Employers must limit harmful exposures, using personal protective equipment (PPE) as a last line of defense. This study explored the association between reported respiratory exposure and symptoms, and PPE training and usage. Data from the MineHealth study (2012–2014) included a total of 453 Arctic open pit miners in Norway, Sweden, and Finland. Participants answered questions on exposure to dust and diesel exhaust, respiratory symptoms, and PPE use, in addition to age, gender, BMI, smoking, and self-rated health. Estimated exposure to dust was common, reported by 91%, 80%, and 82% and that of diesel exhaust by 84%, 43%, and 47% of workers in Sweden, Finland, and Norway, respectively. Reported dust exposure was significantly related to respiratory symptoms (OR 2.2, 95% CI 1.3–3.7), diesel exposure increased the occurrence of wheezing (OR 2.6, 95% CI 1.3–5.4). PPE use varied between the studied mines. Non-use was common and related to reduced visibility, wetness, skin irritation and fogging of the respiratory PPE. Future research should employ more precise exposure assessment, respiratory function as well as explore the reasons behind the non-compliance of PPE use.

Knowledge of Infection Prevention and Control and Practice Behaviors among Career and Volunteer Firefighters in Rural Communities

Due to the emerging threat conditions in the work environment, firefighters are at a high risk of exposure to not only toxic substances but also biological agents in the dayroom and during emergency runs. The aim of this study is to evaluate firefighter (career and volunteer) knowledge and practice behaviors on infection control. This study surveyed 444 firefighters (210 career, 234 volunteer) in rural Northwestern Kentucky. The self-reported survey focused on individual characteristics, knowledge on exposure incident control, precautionary actions, and personal protections. We evaluated the descriptive characteristics of knowledge and practice scores stratified by firefighter groups (career and volunteers). The associations between infection control training received (yes/no) and firefighter knowledge and practice scores were also examined. Firefighters who were trained on infection control prevention had significantly higher knowledge scores (M = 63.7, SD = 13.4 vs. M = 59.7, SD = 15.9; p = 0.012). Volunteer firefighters exhibited better infection control practice behaviors than career firefighters (M = 70.6, SD = 13.0 vs. M = 67.4, SD = 11.1; p = 0.05). Firefighters who followed infection control guidelines (M = 69.5, SD = 11.9 vs. M = 58.1, SD = 9.9; p = 0.012) and expressed need for a comprehensive training on personal protective equipment (PPE) selection (β = 3.41, SE = 1.54, aOR = 30.22, 95% CI: 1.47–620.87; p = 0.028) had significantly higher practice scores compared to those who did not. The study results have policy implications for infection prevention and control (IPC) in rural fire departments, both career and volunteer. A review of infection control policies is needed, especially as it relates to training and practice behaviors during emergency calls and in the dayroom. Results also suggest the need to develop strategies to improve the culture of PPE use and training on the selection of PPEs appropriate to the emergency response type.

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...

Effectiveness of Virtual Reality Training in Teaching Personal Protective Equipment Skills

Training on the proper use of personal protective equipment (PPE) is critical for infection prevention among health care workers. Traditional methods, such as face-to-face and video-based training, can strain resources and present challenges. To determine the effectiveness of 360° virtual reality (VR) training for PPE donning and doffing compared with face-to-face and video training in enhancing the PPE use skills of prospective health care practitioners. A blinded, prospective, and randomized noninferiority clinical trial was conducted from August to December 2021 at Teikyo University School of Medicine in Tokyo, Japan, with a mixed population of medical students. Participants were second- to fourth-year medicine, medical technology, or pharmacy students aged 20 years or older with no prior PPE training. Participants were randomized into 1 of 3 training groups (VR, face-to-face, or video) based on their enrollment order. An intention-to-treat analysis was conducted. A 30-minute lecture on PPE procedures was delivered to all participants before the training. After the lecture, the VR group trained with an immersive 360° VR tool, the face-to-face group trained with actual PPE, and the video group trained by watching video footage on a computer and a projector. After 3 days, a standardized practical skills test was administered. The primary outcome was the mean score on a 20-point practical skills test, and the secondary outcome was the percentage of correct execution. A total of 91 participants were recruited and randomized into 3 groups: VR (n = 30), face-to-face (n = 30), and video (n = 31) training. After excluding 1 participant due to illness, 90 participants (mean [SD] age, 24.2 [3.15] years; 54 males [60.0%]) completed the assessment. The mean (SD) scores were 17.70 (2.10) points for the VR group, 17.57 (2.45) points for the face-to-face group, and 15.87 (2.90) points for the video group. The VR group demonstrated no significant difference in performance from the face-to-face group. However, the VR group had significantly higher effectiveness than the video group (17.70 vs 15.87 points; P = .02). Results of this trial indicate that VR training was as effective as face-to-face training in enhancing PPE donning and doffing skills and was superior to video training. The findings suggest that VR training is a viable resource-conserving training option. Japan Registry of Clinical Trials Identifier: jRCT103021029.

Occupational Health Hazards of Pesticides Use among Commercial Vegetable Farmers of Kirtipur Municipality, Kathmandu

Background: Occupational health and safety are the integral components of the general concepts of health. In Nepalese context, misuse of pesticides have been observed and practiced in several ways. Nepalese farmers use too much pesticide than needed with too little protection when using pesticides due to which many accidental poisonings occur annually. This study aims to assess the occupational health hazards related to pesticide use among commercial vegetable farmers of Kirtipur municipality, Kathmandu. Methodology: A community-based cross-sectional study was conducted among 107 randomly selected commercial vegetable farmers in Kirtipur Municipality of Kathmandu by using semi-structured questionnaire. Data were collected using face to face interview method. The questionnaire included socio-demographic characters, pesticide use practices, storage and disposal techniques and health effects among the farmers. Data were entered in Epidata and then analyzed in SPSS version 21. Frequency, percentage, mean, and standard deviation were calculated to measure the practice of pesticide use and occupational health hazards related to pesticide use among farmers. Result: The study is comprised of 52% male and 48% female. About 89% of farmers were wearing Personal Protective Equipment (PPE) during spraying of pesticides. Maximum numbers of farmers change clothes and take a bath right after the application of pesticide i.e. 87% and 88% respectively. Almost half of the vegetable farmers (45.1%) use burn method for disposal of empty pesticide containers. However, 45.6% of the respondents experience health problems within 48 hours of pesticide application. Conclusion: The study concluded that almost half of the pesticide users have shown various symptoms of health hazards. Unsafe equipment and condition, inadequate training, limited availability and use of PPE all contribute to the health hazards of pesticide users.

Healthcare workers safety in the COVID-19 era: the impact of pre-pandemic personal protective equipment (PPE) training in Pakistan

BackgroundThe COVID-19 pandemic has revealed vulnerabilities in healthcare systems worldwide, emphasizing the importance of healthcare worker safety through adequate utilization of personal protective equipment (PPE). This study aims to assess the impact of pre-pandemic PPE training on the practices and other associated factors among frontline healthcare workers during the COVID-19 pandemic in Pakistan and provide insights into the implications of such training programs for future initiatives.MethodsA cross-sectional study from May 9th to June 5th, 2020 was conducted among the frontline healthcare workers against COVID-19 in Pakistan, utilizing an online structured questionnaire shared via WhatsApp and Facebook by using purposive sampling. Statistical analyses, including chi-square tests for proportion and logistic regression for the association while multi-logistic regression for potential confounders, were performed using SPSS version 22.ResultsA total of 453 healthcare staff participated, with 68.9% (n = 312) reporting no prior PPE training and 31.1% (n = 141) having received training. Significant associations were found between prior training and healthcare group distribution (p = 0.006), with doctors exhibiting the highest proportion of training 82 (37.61%), followed by nurses 50 (27.32%) and paramedics 9 (17.31%). Those who didn’t receive any prior training in PPEs showed a higher perceived professional risk of 216 (69.23%) compared to those who received prior PPE training 96 (30.77%, p-value 0.005). Similarly, a higher frequency 137 (63.72%) of Perceived Personal risk was observed in those who didn’t receive training, labeled as “high risk” compared to those who were trained 78 (36.28%, P value 0.02). Multi-logistic regression analysis identified paramedics as 0.26 times less likely to have received prior PPE training (Adjusted OR 0.26, 95% CI 0.10–0.65, p = 0.01) compared to medical doctors. Healthcare workers in tertiary care hospitals were 0.46 times less likely to undergo PPE training (Adjusted OR 0.46, 95% CI 0.25–0.87,p = 0.01) compared to those working at COVID-19 facilities/hospitals/quarantine centers. Likewise, individuals who doffed disposable gowns [Adjusted OR 3.86, (95% CI, 1.23–12.08, p = 0.02] were 3.86 times more interested in getting prior training in PPE compared to those who don’t have skills to wear them.ConclusionOur findings highlight that healthcare levels, type of healthcare, and doffing skills are important predictors of whether healthcare workers have taken prior training in PPE. These findings imply developing effective training programs for healthcare workers to ensure safety while providing care during pandemics like COVID-19.

Personal protective equipment and medical students in times of COVID-19: experiences and perspectives from the final clerkship year

BackgroundThe availability and correct use of personal protective equipment (PPE) to prevent and control infections plays a critical role in the safety of medical students in clinical placements. This study explored their experiences and perspectives in their final clerkship year with PPE during the COVID-19 pandemic.MethodsThis qualitative study was based on social constructivism and was conducted in 2021 at the Charité - Universitätsmedizin Berlin. In three online focus group discussions, 15 medical students in their final clerkship year reported their experiences with PPE training and use during the COVID-19 pandemic. Data were recorded, transcribed and analysed based on Kuckartz’s approach to content analysis. We drew upon the a priori dimensions of the capability, opportunity, motivation - behaviour (COM-B) model as main categories as well as emergent issues raised by the study participants (subcategories).ResultsIn addition to the three main categories of the COM-B model, eleven subcategories were identified through inductive analysis. The study participants reported several factors that hindered the correct use of PPE. In the area of capabilities, these factors were related to learning experience with PPE in terms of both theoretical and practical learning together with later supervision in practice. In the area of opportunities, these factors included the limited availability of some PPE components, a lack of time for PPE instruction and supervision and inappropriate role modelling due to the inconsistent use of PPE by physicians and nursing staff. The area of motivation to use PPE was characterized by an ambivalent fear of infection by the SARS-CoV-2 virus and the prioritization of patient safety, i.e., the need to prevent the transmission of the virus to patients.ConclusionsOur study revealed several limitations pertaining to the enabling factors associated with the trainable behaviour “correct use of PPE”. The concept of shared responsibility for student safety was used to derive recommendations for future improvement specifically for the medical school as an organization, the teachers and supervisors, and students themselves. This study may guide and stimulate other medical schools and faculties to explore and analyse components of student safety in clinical settings in times of infectious pandemics.

The PATH to PPE Mastery - Programme for Assessment and Training in HCID (High Consequence Infectious Diseases) PPE (Personal Protective Equipment), Mastery

High Consequence Infectious Diseases (HCIDs), have the potential to cause pandemics and require particular focus for preparedness due to their high mortality rates. The application of Personal Protective Equipment (PPE) for HCIDs is complex and carries significant risk of Health Care Worker (HCW) contamination if done incorrectly. Previous reviews have reported a lack of information on the nature of training provided and the ideal timing of repeat training to best retain skills. Simulation Based Mastery Learning (SBML) is a methodology for skill acquisition which encompasses deliberate practice and repeated assessment until the learner achieves a pre-set Mastery standard. SBML has been demonstrated to improve competence, skill retention and patient outcomes in other clinical procedures. SBML has not been previously studied or utilised in HCID PPE training. We aimed to increase the likelihood of safe clinical practice by evidencing that Lothian modified SBML for PPE effectively prepares our priority learners. A quasi-experimental within group post-test design was used. Learners undertook a modified SBML programme which included two-hour asynchronous and two-hour synchronous components. 11 learners (10 infectious diseases registrars and 1 infectious diseases consultant) were enrolled in the programme with 8 completing all stages, all of whom achieved the Mastery passing standard. The resources were highly rated by learners with the exemplar videos of skills highlighted as particularly useful. Self-assessed preparedness for each skill increased following pre-learning and synchronous sessions. Modified SBML can be used as an effective methodology for the training and assessment of HCWs in the donning and doffing of HCID PPE.

SARS-CoV-2 in lions, gorillas and zookeepers in the Rotterdam Zoo, the Netherlands, a One Health investigation, November 2021.

In November 2021, seven western lowland gorillas and four Asiatic lions were diagnosed with COVID-19 at Rotterdam Zoo. An outbreak investigation was undertaken to determine the source and extent of the outbreak and to identify possible transmission routes. Interviews were conducted with staff to identify human and animal contacts and cases, compliance with personal protective equipment (PPE) and potential transmission routes. Human and animal contacts and other animal species suspected to be susceptible to SARS-CoV-2 were tested for SARS-CoV-2 RNA. Positive samples were subjected to sequencing. All the gorillas and lions that could be tested (3/7 and 2/4, respectively) were RT-PCR positive between 12 November and 10 December 2021. No other animal species were SARS-CoV-2 RNA positive. Forty direct and indirect human contacts were identified. Two direct contacts tested RT-PCR positive 10 days after the first COVID-19 symptoms in animals. The zookeepers' viral genome sequences clustered with those of gorillas and lions. Personal protective equipment compliance was suboptimal at instances. Findings confirm transmission of SARS-CoV-2 among animals and between humans and animals but source and directionality could not be established. Zookeepers were the most likely source and should have periodic PPE training. Sick animals should promptly be tested and isolated/quarantined.

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&gt; 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.

Usage of Personal Protective Equipment by Patient Care Nurses to Reduce Occupational Health Risk: Challenges and Related Policy Measures in Nepal

Personal protective equipment (PPE) plays a critical role in protecting healthcare workers from occupational hazards, including infectious diseases, chemical exposures, and physical injuries. In Nepal, patient care nurses face significant occupational health risks due to limited access to PPE and inadequate training on their proper use. This paper aims to explore the challenges faced by patient care nurses in Nepal in using PPE and to propose policy measures that can improve their occupational health and safety. Using systematic literature review, the study found that the availability and quality of PPE were major challenges faced by patient care nurses in Nepal. Inadequate training on the proper use of PPE and a lack of awareness about the risks of occupational hazards further increased the vulnerability of patient care nurses. To address these challenges, the paper proposes several policy measures, including improving access to high-quality PPE, providing comprehensive training on the proper use of PPE, and raising awareness about occupational health risks among healthcare workers and policymakers. These measures can significantly reduce the risks of occupational hazards faced by patient care nurses in Nepal and improve their overall occupational health and safety. The findings demonstrate the urgent need for policymakers and healthcare organizations to address the challenges faced by nurses in accessing and using appropriate PPE. By implementing the proposed policy measures, healthcare organizations and policymakers can ensure that patient care nurses are adequately protected from occupational health risks, enabling them to provide high-quality care while staying safe and healthy.

Changes in Personal Protective Equipment Usage Among Healthcare Personnel From the Beginning of Pandemic to Intra-COVID-19 Pandemic in Thailand.

Personal protective equipment (PPE) use is associated with reduced risk of SARS-CoV-2 infection among healthcare personnel (HCP). There are limited data on the impact of the novel coronavirus disease 2019 (COVID-19) pandemic on the PPE use of HCP. We describe the changes in PPE use from just before the widespread of community outbreaks ('pre-pandemic') to intra-pandemic time points, and examine factors associated with not changing in PPE use behavior among HCP in four Thai hospitals. We performed a retrospective cohort evaluation using two-time points: (i) February-March 2020 (pre-pandemic period); and (ii) January-March 2021 (intra-pandemic period). Self-reported frequency of appropriate PPE use was measured by a Likert scale. We used multivariable logistic regression to identify factors associated with no increase in self-reported PPE use. Of 343 HCP, the proportion of participants reporting 'always' using PPE rose from 66% during the pre-pandemic period to 80% during the pandemic. Factors associated with HCP who did not increase in PPE use included having high baseline reported PPE, being a non-registered HCP (e.g. nurse assistants, dental assistants, porters), being male, and having a low perceived risk of becoming infected with any respiratory virus while working in the hospital. PPE education, training, and risk communication content should target all cadres of HCP, regardless of registered/non-registered status, with a focus on behavior change for improved prevention and control of SARS-CoV-2 and other respiratory viruses in healthcare settings.

Recognizing Local Champions in Infection Prevention and Control.

Recognizing Local Champions in Infection Prevention and Control.

Personal protective equipment simulation training is associated with lower COVID-19 infection among healthcare workers.

To describe the personal protective equipment training strategies during the beginning of the pandemic and to investigate the association between training and COVID-19 infection among healthcare workers. This cross-sectional study conducted between March and May 2020 included 7,142 healthcare professionals who were eligible for both online and face-to-face simulation-based training on personal protective equipment use. Simulation training attendance was assessed by reviewing the attendance list, and the COVID-19 sick leave records recovered from the institutional RT-PCR database used to grant sick leave. The association between personal protective equipment training and COVID-19 was investigated using logistic regression, adjusted for sociodemographic and occupational characteristics. The mean age was 36.9 years (± 8.3), and 72.6% of participants were female. A total of 5,502 (77.0%) professionals were trained: 3,012 (54.7%) through online training, 691 (12.6%) through face-to-face training, and 1,799 (32.7%) through both strategies. During the study period, 584 (8.2%) COVID-19 cases were diagnosed among these professionals. The number of positive RT-PCR tests was 180 (11.0%) for untrained professionals, 245 (8.1%) for those trained only online, 35 (5.1%) for those trained face-to-face, and 124 (6.9%) for those trained with both strategies (p<0.001). Participants who received face-to-face training had a 0.43 lower risk of contracting COVID-19. Personal protective equipment training decreased the odds of COVID-19 among healthcare professionals, with face-to-face simulation-based training being most effective.

Knowledge about COVID-19 and correct mask use in workers at a Peruvian university during the pandemic

The COVID-19 pandemic led to massive use of personal protective equipment (PPE). However, evidence on the frequency of appropriate use is sparse. In this study, we evaluated the level of knowledge about COVID-19 and biosafety measures, and the frequency of correct use of masks in workers at a university in Lima, Peru. Cross-sectional study conducted in a population of 109 workers of a private university who were physically onsite. We used a structured questionnaire to measure knowledge of COVID-19, together with use of and training in PPE. In addition, we explored factors associated with the correct use of masks and an adequate level of knowledge about COVID-19 and related biosafety measurSpain. Results were expressed as prevalence, using student's T-test and Pearson chi-square tests. We evaluated 82 workers, 35.4% of whom showed an adequate level of knowledge about COVID-19 and biosafety measurSpain. Younger participants and those who regularly washed their hands at work had an adequate level of knowledge, with 90.2% of these reporting correct use of their masks. Workers in general service areas or with a low level of education reported less frequent correct use of their mask compared to those who did not have these characteristics. Conclusion: We found a low level of knowledge about COVID-19 and biosafety measures among the workers of a private university; a higher level of education was associated with a greater prevalence of correct mask use. Training programs by work areas are needed, to improve biosafety practices among workers.