Factors affecting healthcare workers’ compliance with social and behavioural infection control measures during emerging infectious disease outbreaks: Rapid evidence review

Abstract

The 2019-2020 outbreak of novel coronavirus has raised concerns about nosocomial transmission; that is, transmission within healthcare settings. Research from previous outbreaks of emerging infectious diseases suggests a major cause of nosocomial transmission is healthcare professionals' poor compliance with recommended personal protective behaviours. This rapid evidence review explored existing literature on emerging infectious disease outbreaks to identify factors associated with compliance with social and behavioural infection control measures among healthcare staff. 56 papers were reviewed and several positive associations were found: Staff working in emergency or intensive care settings appeared more likely to comply with recommendations than those in other settings, and there was some evidence that contact with confirmed cases could improve compliance. There was some evidence that staff with higher levels of anxiety and higher concern about the risk of infection were more likely to comply with recommended behaviour, and that monitoring from superiors could improve compliance. Several negative associations were also found. Observed non-compliance of colleagues could hinder compliance. Staff identified many barriers to compliance related to personal protective equipment, including availability; perceived difficulty and effectiveness; inconvenience; discomfort; and a negative impact on patient care. There appeared to be many issues regarding the communication and ease of understanding of infection control guidance. Based on the results of this review we recommend provision of training and education tailored for different occupational roles within the healthcare setting; managerial staff 'leading by example'; ensuring adequate resources for infection control; and timely provision of practical evidence-based infection control guidelines.

Adherence towards COVID-19 mitigation measures and its associated factors among Gondar City residents: A community-based cross-sectional study in Northwest Ethiopia

“…This finding is in contrast with a study conducted in United States [33] which revealed that as individual's perception of risk increases, they highly engage in risk prevention behaviors. Additionally, this finding is also in contrast with a study done in United Kingdom [34] and Slovenia [35] which showed that desensitization to risk or genuine reductions in risk might lead to reduction in mitigation measures utilization.…”

Adherence to protective measures among health care workers in the UK; a cross-sectional study

“…15 Such fatalism may be higher in those with increased exposure to the illness at work. Despite previous mixed evidence for the influence of training on adherence to infection control measures, 6 we found that adherence to PPE use was higher in those who had received health and safety training during the COVID-19 pandemic and who had higher perceived information sufficiency. Thinking that colleagues and line managers took PPE seriously was also associated with increased complete adherence to use of PPE.…”

“…A recent rapid review of adherence to infection control measures during emerging infectious disease outbreaks (56 papers, two relating to COVID-19) found evidence that better adherence was associated with higher perceived effectiveness of infection control measures, higher perceived risk of the illness. 6 Poor adherence was associated with concerns about shortages of PPE, inadequate guidance for use of PPE, perceived negative impact of PPE on a HCWs ability to communicate with patients, and seeing other colleagues not adhering to PPE.…”

Compliance with personal protective equipment use among non-medical healthcare professionals during Covid-19 pandemic

“…They reported several symptoms associated with the use of PPE, such as dehydration, skin desquamation, shortness of breath, sweating, dizziness, headaches, and skin rashes. The use of PPE may decrease healthcare service quality, making it challenging to communicate with patients due to muffled speech, inability to establish non-verbal cues with patients, and making them less 'visible' to their patients (Brooks et al, 2020).…”

“…An environmental factor that influenced the compliance in using PPE found in this study was the co-worker's role in reminding PPE. Brooks et al (2020) conducted a meta-analysis of 36 studies to identify factors associated with compliance with social and behavioral infection control measures among healthcare staff. This study showed noncompliant colleagues or managers were associated with non-compliant employees.…”