The Use of Personal Protective Equipment among Frontline Nurses in a Nationally Designated COVID-19 Hospital during the Pandemic

Abstract

Background The appropriate use of personal protective equipment (PPE) can significantly reduce the risk of infection associated with caring for patients. This study aimed to investigate the knowledge, awareness, and behaviors related to the PPE usage among frontline nurses in a nationally designated coronavirus disease 2019 (COVID-19) hospital during the COVID-19 pandemic. Materials and Methods The study was performed in two phases: (1) a questionnaire survey to assess the knowledge, awareness, and behaviors related to PPE use, and (2) in-depth personal interviews to elaborate the survey findings. The questionnaires were distributed to all 121 registered nurses in three isolation wards and an intensive care unit which dedicated for patients with COVID-19 and 102 nurses completed survey (84.3% response rate). In-depth interviews were conducted with a total of 7 nurses. Results Among the survey participant, 100% stated that they knew how to protect themselves while providing nursing care and 93.1% stated that they knew the recommended PPE by task. Most survey participant mainly wore gloves, face shield, N95 or equivalent respirator, and a long-sleeved gown, but one-third of the participants sometimes used coveralls instead of long-sleeved gown. In-depth interviews, the importance of timely updated and specific guidelines for selecting the appropriate type of PPE was highlighted. The adequate supply of PPE, convenience at work, and the role of responsible leadership mainly determined behaviors related to the PPE. Conclusion As new information on COVID-19 continues to emerge, the up-to-date and specific PPE guideline with evidence should be prepared. The spread of accurate information, the role of accountable leadership, and the active communication under positive organizational culture are important for the proper use of PPE.

Emergency nurses' attitudes, perceptions about personal protective equipment and willingness to care for COVID‐19 patients: A descriptive, cross‐sectional study

“…Among the personal protective equipment, nurses perceived goggles as creating the most discomfort. In a previous study (Min et al, 2021), more than half of frontline nurses reported discomfort from wearing goggles and did not help prevent COVID‐19 infection. Goggles created discomfort when working with patients due to obscured vision from its fogging, which was stressful for nurses (Kim & Lee, 2016).…”

“…However, donning personal protective equipment for a long period can be cumbersome and uncomfortable and result in headaches, overheating, trouble with verbal communication, impaired visibility and back pain related to powered air‐purifying respirators use (Loibner et al, 2019; Ong et al, 2020). Although research has established the association between inadequate personal protective equipment use and increased risk of COVID‐19 infection (Nguyen et al, 2020), perceived discomfort from personal protective equipment may discourage health care workers' willingness to work during the COVID‐19 pandemic (Min et al, 2021).…”

“…In South Korea, the COVID-19 outbreak began in January 2020, earlier than in the United States and Europe (Min et al, 2021). During the early stages of the COVID-19 pandemic, the Korean government issued personal protective equipment guidelines for health care workers based on their guidelines established during the 2015 Middle East Respiratory Syndrome (MERS) coronavirus outbreak.…”

Differences in strategies for prevention of COVID-19 transmission in hospitals: nationwide survey results from the Republic of Korea

“…We found that most hospitals provided coveralls as PPE for healthcare workers managing confirmed COVID-19 cases. A Korean study showed that even though most healthcare workers knew that the Korea Disease Control and Prevention Agency (KDCA) guidelines allowed healthcare workers to choose either coveralls or long-sleeved gowns, many healthcare workers did not use long-sleeved gowns [ 28 ]. This might be attributable to confusion among healthcare workers about COVID-19 transmission due to the initial KDCA recommendation about PPE; at the beginning of the pandemic, KDCA recommended using coveralls during managing COVID-19 patients [ 29 ].…”

Adaptations in vascular access procedures as an initiative to protect healthcare workers throughout the COVID‐19 pandemic

“…Personal protective equipment (PPE) is essential in the protection and spread of the COVID‐19 virus as SARS‐CoV‐2 is transmitted through respiratory droplets and close contact (Park, 2020 ). At the beginning of the pandemic, there was much discussion as to what the proper and most protective forms of PPE were (Hussain et al, 2020 ; Min et al, 2021 ). This uncertainty, although unavoidable, likely created a delayed response time to patient care, as more time was needed between patients to assure proper PPE and safety protocols could be followed by HCWs.…”