Document Type : Original Article
Authors
- . Maneesh Sharma
- . Divita Sharma 1
- . Ashok Kumar Sharma 2
- . Aroop Mohanty 3
- . Meenakshi Khapre 1
- . C. Vasantha Kalyani
1 Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
2 Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
3 Department of Microbiology, All India Institute of Medical Sciences, Gorakhpur, Uttarakhand, India
Abstract
BACKGROUND: To reduce the likelihood of transmission of infection to health‑care workers (HCWs),
personal protective equipment is used. However, wearing personal protective equipment (PPE)
increases the risk of heat stress and loss of dexterity, leads to poor compliance to PPE. To address
the issues of poor compliance to PPE, it was necessary to gain a deeper understanding about the
factors that influence compliance. Thus this qualitative study was planned to explore barriers faced
by HCWs while using PPE during a pandemic situation in a tertiary care hospital, Uttarakhand, India.
MATERIALS AND METHODS: A exploratory qualitative study was undertaken among health care
workers involved in the care of COVID patients. FGDs were done and an unstructured interview guide
with open‑ended questions was used which helped to explore the factors which can be potential
barriers to the HCWs while working wearing PPE.
RESULTS: Organizational and individual factors acting as barriers such as unavailability of essential
personal protective equipment, a disharmonious work environment, lack of comfort, inadequate size,
and quality of PPE were identified as the major barriers in the present study.
CONCLUSION: Future efforts to optimize PPE use should focus on to adequate supplies both in
quality and quantity can help in avoidance of such barriers. Resources should be prioritized with the
needs of the HCWs in the times of pandemic. Regular training and feedbacks are necessary for the
satisfaction of HCWs and improving PPE compliance.
Keywords
1. Patidar K, Sharma M, Gautam A, Sharma DK, Jain J.
COVID‑19 knowledge and perception among budding nurses:
A questionnaire based survey. Int J Nur Res 2020;6:1‑7.
2. Singh V, Supehia S, Gupta PK, Narula H, Sharma M, Devi K,
et al. Effectiveness of video modules in infection control trainings
during COVID19 pandemic: A quasiexperimental study in tertiary
care institute. J Educ Health Promot 2020;55:56.
3. Melo Dde S, Silva e Souza AC, Tipple AF, das Neves ZC,
Pereira MS. Nurses’ understanding of standard precautions at a
public hospital in Goiania – GO, Brazil. Rev Lat Am Enfermagem
2006;14:720‑7.
4. Honda H, Iwata K. Personal protective equipment and improving
compliance among healthcare workers in high‑risk settings. Curr
Opin Infect Dis 2016;29:400‑6.
5. Sawada SI, Kuklane K, Wakatsuki K, Morikawa H.
New development of research on personal protective
equipment (PPE) for occupational safety and health. Ind Health
2017;55:471‑2.
6. Davey SL, Lee BJ, Robbins T, Randeva H, Thake CD. Heat stress
and PPE during COVID‑19: Impact on healthcare workers’
performance, safety and well‑being in NHS settings. J Hosp Infect
2021;108:185‑8.
7. Casanova LM, Rutala WA, Weber DJ, Sobsey MD. Effect of
single‑versus double‑gloving on virus transfer to health care
workers’ skin and clothing during removal of personal protective
equipment. Am J Infect Control 2012;40:369‑74.
8. Harrod M, Petersen L, Weston LE, Gregory L, Mayer J,
Samore MH, et al. Understanding workflow and personal
protective equipment challenges across different healthcare
personnel roles. Clin Infect Dis 2019;69:S185‑91.
9. Barker AK, Brown K, Siraj D, Ahsan M, Sengupta S, Safdar N.
Barriers and facilitators to infection control at a hospital in
northern India: A qualitative study. Antimicrob Resist Infect
Control 2017;6:35.
10. Neves HC, Souza AC, Medeiros M, Munari DB, Ribeiro LC,
Tipple AF. Safety of nursing staff and determinants of adherence
to personal protective equipment. Rev Lat Am Enfermagem
2011;19:354‑61.
11. Srivastava A, Thomson SB. Framework analysis: A qualitative
methodology for applied policy research. Jornal of Administration
and Governance 2009: 4(2):72‑79.
12. Hu X, Zhang Z, Li N, Liu D, Zhang L, He W, et al. Self‑reported
use of personal protective equipment among Chinese critical
care clinicians during 2009 H1N1 influenza pandemic. PLoS One
2012;7:e44723.
13. Loibner M, Hagauer S, Schwantzer G, Berghold A, Zatloukal K.
Limiting factors for wearing personal protective equipment (PPE)
in a health care environment evaluated in a randomised study.
PLoS One 2019;14:e0210775.
14. Tamene A, Afework A, Mebratu L. A qualitative study of barriers
to personal protective equipment use among laundry workers in
government hospitals, Hawassa, Ethiopia. J Environ Public Health
2020;1‑8.
15. KumarMS, Goud BR, Joseph B. Astudy of occupational health and
safety measures in the laundry department of a private tertiary
care teaching hospital, Bengaluru. Indian J Occup Environ Med
2014;18:13‑20.
16. Patel A, D’Alessandro MM, Ireland KJ, Burel WG, Wencil EB,
Rasmussen SA. Personal protective equipment supply chain:
Lessons learned from recent public health emergency responses.
Health Secur 2017;15:244‑52.
17. Safdar N, Sengupta S, Musuuza JS, Juthani‑Mehta M, Drees M,
Abbo LM, et al. Status of the prevention of multidrug‑resistant
organisms in international settings: A survey of the society for
healthcare epidemiology of America Research Network. Infect
Control Hosp Epidemiol 2017;38:53‑60