Health workers report errors in infection prevention during height of COVID-19
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Key takeaways:
- A third of registered nurses and around one-quarter of physicians reported at least one PPE error in the previous 2 weeks.
- Survey respondents reported adhering to hand hygiene guidelines only 40% of the time.
In a survey of health care personnel, one-third of registered nurses and more than one-quarter of physicians reported making at least one error in adhering to guidance for personal protective equipment in the previous 2 weeks.
Nurses and physicians were far more likely to report nonadherence than other personnel, and respondents with a higher risk for exposure to SARS-CoV-2 were close to six times more likely to report errors, researchers reported.
Study observers also reported that personnel adhered to hand and glove hygiene protocols less than half the time.
“While error rates varied by job type, what this study really shows is that all three groups of health care personnel were at risk of SARS-CoV-2 exposure and were making errors in adherence to infection prevention protocols during the height of the pandemic,” Emily J. Haas, PhD, a research health scientist at the CDC’s National Institute for Occupational Safety and Health and National Personal Protective Technology Laboratory, said in a press release issued by the Association for Professionals in Infection Control and Epidemiology (APIC).
Haas and colleagues analyzed responses to surveys from 191 health care personnel at the University of North Carolina Medical Center collected between July 2020 and January 2021. Participants were asked to report their experiences and SARS-CoV-2 exposure and their adherence to infection prevention protocols at the hospital. In addition, study researchers observed health care staff to gather other data.
The researchers grouped personnel into three categories — physicians, advanced practice providers, physician assistants and nurse practitioners (45% of participants); registered nurses (27%); and other personnel, such as therapists, dieticians and food and environmental services personnel (28%).
Nearly all participants reported “reliable access” to personal protective gear, including gowns, gloves, eye shields and face masks.
According to the study, job role was associated with both a risk for SARS-CoV-2 exposure and potential for nonadherence to protocols. Among the three groups, 57.4% of registered nurses completed tasks that risked exposure to the virus, compared with 29% of physicians and 38% of other personnel.
Within the groups, 33.3% of registered nurses reported at least one error in the previous 2 weeks compared with 26.5% of physicians and 9.6% of other personnel. Personnel more likely to be exposed to the virus were 5.74 times more likely to report at least one infection prevention protocol error in the previous 2 weeks.
The most frequently misperformed precaution was hand hygiene. Study observers reported that hand and glove protocols were followed roughly 40% of the time in COVID-19 wards.
“This is a clear demonstration that we need to improve engagement in our training for emergency preparedness and to create a more strategic response that will help our health care workers stay safe, even in times of extreme stress,” Haas said.
APIC president Patricia Jackson, RN, MA, CIC, FAPIC, said infection preventions can use the findings “in their education and outreach to strengthen preparedness for future outbreaks and to improve the safety of the day-to-day delivery of health care.”
“This study adds to our understanding of healthcare personnel compliance with infection prevention protocols during COVID-19 and highlights improvement opportunities,” Jackson said.
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