Adherence to Personal Protective Equipment Guidelines During the COVID-19 Pandemic Among Healthcare Personnel in the United States

Mehran Karvar, MD
Department of Surgery
Division of Plastic Surgery
Poster Overview

A critical focus of the U.S. national response to COVID-19 pandemic is the protection of nearly 18 million frontline healthcare personnel (HCP). HCP adherence to Centers for Disease Control and Prevention (CDC) guidelines on the use of proper personal protective equipment (PPE) has remained a key concern throughout the ongoing COVID-19 crisis, particularly because effective prophylaxis and treatments have yet to become widely available. As such, through an online anonymous survey, we aimed to identify adherence to CDC guidelines for PPE use among HCP in the United States in different clinical scenarios. A questionnaire was designed and distributed among statewide healthcare institutions in June to July 2020. Respondents from 8 states (Washington, Texas, South Carolina, Oregon, Louisiana, Colorado, California, and Arizona) were included in the final data analysis. HCP adherence to the PPE guidelines in different clinical scenarios varied widely. Doctors demonstrated greatest adherence in the majority of scenarios. Overall, complete adherence of HCP to PPE recommendations in five clinical scenarios in the eight states was low (<40%). It is critical to identify reasons of this low adherence through further studies to provide pinpoint strategies for enhancing HCP safety.

Scientific Abstract

The use of personal protective equipment (PPE) is the main source of protection for healthcare personnel (HCP) during the ongoing COVID-19 crisis. Through an online survey, we aimed to identify adherence to PPE guidelines, as defined by the Centers for Disease Control and Prevention (CDC), among different HCP professions in the United States. The scenarios ranged from “communal hospital space” to settings that required HCP to “carry out aerosol-generating procedures”. The questionnaire was distributed among statewide healthcare institutions and to HCP using the snowball sampling technique from June to July, 2020. Totally, 436 responses from eight states (Washington, Texas, South Carolina, Oregon, Louisiana, Colorado, California, and Arizona) were included in the study. HCP adherence to the PPE guidelines under the five clinical scenarios varied widely. Among different professions, doctors demonstrated greatest adherence in four out of five scenarios, except for “patient contact when COVID-19 suspected,” in which nurses showed more compliance. Collectively, HCP complete adherence to all PPE recommendations was low (<40%). Further research is promptly required to identify the underlying reasons and provide effective solutions.

Clinical Implications
Low, variable adherence to PPE guidelines among frontline HCP included in this study can endanger their safety through the ongoing COVID-19 crisis. This study demonstrates the critical need to further identify the reasons underlying this variability.
Research Areas
Authors
Mehran Karvar, M.D., Ayushi Aggarwal, Oliver A. Darwish, Chenhao Ma, M.D., Valentin Haug, M.D., Mengfan Wu, M.D., Ph.D., Dennis P. Orgill, M.D., Ph.D., Adriana C. Panayi, M.D.
Principal Investigator
Adriana C. Panayi, M.D.

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