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Infection precaution adherence varies by potential exposure risks to SARS-CoV-2 and job role: Findings from a US medical center - 18/03/24

Doi : 10.1016/j.ajic.2023.10.010 
Emily J. Haas, PhD a, , Kaitlin Kelly-Reif, PhD b, Mihili Edirisooriya, PhD a, Laura Reynolds, MPH, BSN, RN c, Cherese N. Beatty Parker, MPH d, Deanna Zhu e, David J. Weber, MD, MPH, FIDSA, FSHEA, FRSM e, f, Emily Sickbert-Bennett, PhD, MS, CIC, FSHEA e, f, Ross M. Boyce, MD MSc f, Emily J. Ciccone, MD, MHS f, Allison E. Aiello, PhD d
a National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Pittsburgh, PA 
b Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, OH 
c Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV 
d Department of Epidemiology and Robert N. Butler Columbia Aging Center, Columbia University, New York, NY 
e Department of Infection Prevention, University of North Carolina Medical Center, Chapel Hill, NC 
f Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC 

Address correspondence to Emily J. Haas, 626 Cochrans Mill Rd., Pittsburgh, PA 15236.626 Cochrans Mill Rd.PittsburghPA15236

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Abstract

Background

Infection precautions (IP) facilitate standardized and safe patient care. Research has demonstrated several barriers to IP adherence among health care personnel (HCP) but potential exposure risk to SARS-CoV-2 and job role has not been considered.

Methods

Researchers used self-reported baseline surveys with 191 HCPs at a university medical center to examine factors that may have affected IP adherence (eg, personal protective equipment [PPE] and hand hygiene errors) over the 2 weeks prior to the survey. Chi-square tests were used to determine if differences existed first, among job role and IP adherence, and second, the potential risk of exposure to SARS-CoV-2 and IP adherence. A binary logistic regression estimated if PPE nonadherence was associated with COVID-19 stress, job role, and potential exposure risk to SARS-CoV-2.

Results

PPE nonadherence varied by job role. Those in the Other group (ie, nonphysician/non-nursing HCP) reported significantly fewer errors (9.6%) compared to Physicians (26.5%) and Registered Nurses (33.3%). Hand/glove hygiene errors between COVID-19 patient rooms varied by job role. Respondents who had higher risks of exposure to SARS-CoV-2 were 5.74 times more likely to experience errors.

Conclusions

The results provide implications for adopting systems-level approaches to support worker knowledge and engagement across job roles to improve IP adherence.

El texto completo de este artículo está disponible en PDF.

Highlights

HCP self-reported and were observed to make PPE errors during the COVID-19 pandemic.
Less common HCP roles need training and education during a public health emergency.
The combination of repetitive job tasks and demands may contribute to PPE errors.
A systems-level approach to support HCP knowledge may improve adherence behavior.

El texto completo de este artículo está disponible en PDF.

Key Words : COVID-19, Health care personnel, Job task exposure, Personal protective equipment, Socio-technical systems


Esquema


 Conflicts of interest: AEA reports consulting with Analysis Group Inc.
 Ethics approval and consent to participate: This study was reviewed, and determined that the risk involved was no more than minimal by the blinded IRB (Protocol #20-0942). All individuals provided informed consent prior to participation.
 Availability of data and materials: Data are not publicly available due to the potential for individual identification. For questions regarding the use of the data or for those interested in working with the data, please contact Allison E. Aiello at aea27@cumc.columbia.edu.


© 2023  Publicado por Elsevier Masson SAS.
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