Source avec lien : Open Forum Infectious Diseases, 9(S2). 10.1093/ofid/ofac492.1046
Le personnel de santé (PSS) a été confronté à des défis liés aux équipements de protection individuelle (EPI) pendant la pandémie de COVID-19, notamment des pénuries d’approvisionnement, des articles EPI supplémentaires, des modèles différents et des protocoles/directives modifiés. Nous avons utilisé une approche fondée sur l’ingénierie des facteurs humains et l’ethnographie pour évaluer qualitativement les effets de ces défis sur les professionnels de la santé et leur utilisation de l’EPI pendant la pandémie.
Healthcare personnel (HCP) faced personal protective equipment (PPE)-related challenges during the COVID-19 pandemic including supply shortages, additional PPE items, different designs, and modified protocols (PR)/guidelines. We used a human factors engineering- and ethnography-informed approach to qualitatively assess the effects of these challenges on HCP and their PPE use during the pandemic.We observed PPE use (e.g., donning/doffing) by HCP caring for patients with COVID-19, those under investigation (PUI), and those with other conditions in 1 acute, 1 intermediate, and 1 intensive care unit at a large Midwestern academic hospital. We conducted mini-interviews with a subset of HCP to clarify observed behavior and identify PPE-related concerns. We captured observation, interview, and additional data (e.g., unit layouts, signage) in structured and unstructured notes. We transcribed and imported notes into MAXQDA and applied a deductive-inductive analytical approach.From April-July 2021, we observed 188 patient care episodes and conducted 47 mini-interviews. Observations included COVID-19 (n=102), PUI (n=4), and non-COVID-19 (n=82) rooms on varying isolation precautions. PRs related to masks and eye protection changed during the study period and particularly affected donning practices. Other barriers included time-intensive PRs, unclear PR communication, unfamiliar designs, lack of surfaces on which to set supplies while donning/doffing, and inconvenient PPE storage/cleaning locations. We observed recommendation/PR deviations related to PPE use (e.g., exposed wrists, unapproved/no eye protection), cleaning, and signage/storage (e.g., designated “clean” surfaces). HCP reported PPE extended use/reuse, provision of design options, and their own adaptations (e.g., “batching” tasks, modifying PPE) facilitated donning/doffing. New PPE requirements highlighted tensions between HCP comfort and safety; despite this, some wanted to include modified PRs in their routine infection prevention practices permanently.PPE use barriers and facilitators related to modified COVID-19 PRs have implications for the ongoing pandemic and future respiratory pathogen outbreaks.Loreen Herwaldt, MD, 3M: • 3M is providing products for one of Dr. Herwaldt’s research studies unrelated to the work reported here.|PDI Healthcare: PDI Healthcare has provided research funding to Dr. Herwaldt unrelated to the work reported in this abstract.