Journal article
Health care workers’ perceptions and reported use of respiratory protective equipment: A qualitative analysis
American journal of infection control, Vol.47(10), pp.1162-1166
10/2019
DOI: 10.1016/j.ajic.2019.04.174
PMCID: PMC7115305
PMID: 31182235
Abstract
[Display omitted]
•Healthcare workers know and mostly follow respiratory protection protocols.•Social norms encourage protocol adherence during high-risk situations.•Diagnostic uncertainty and mistrust of protocols may lead to inappropriate use.•Clinical experience served as a personal protocol in cases of uncertainty.•Respiratory protective equipment nonadherence includes overuse.
Little is known about health care workers’ (HCW) perceptions of, or experiences using, respiratory protective equipment (RPE). We sought to characterize their perceptions and identify reasons underlying inappropriate use.
We conducted 12 focus groups with nurses and nursing assistants at 4 medical centers. We analyzed the thematic content of 73 discrete “stories” told by focus group participants.
We identified 5 story types surrounding RPE use: 1) policies are known and seen during work routines; 2) during protocol lapses, use is reinforced through social norms; 3) clinical experiences sometimes supersede protocol adherence; 4) when risk perception is high, we found concern regarding accessing RPE; and 5) HCWs in emergency departments were viewed as not following protocol because risk was ever-present.
HCWs were aware of the importance of RPE and protocols for using it, and these supported use when protocol lapses occurred. However, protocol adherence was undermined by clinical experience, perceived risk, and the distinct context of the emergency department where patients continually arrive with incomplete or delayed diagnoses.
Protocols, visual cues, and social norms contribute to a culture of safety. This culture can be undermined when HCWs experience diagnostic uncertainty or they mistrust the protocol and instead rely on their clinical experiences.
Details
- Title: Subtitle
- Health care workers’ perceptions and reported use of respiratory protective equipment: A qualitative analysis
- Creators
- Gemmae M Fix - Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VA Hospital, Bedford, MAHeather Schacht Reisinger - Comprehensive Access & Delivery Research & Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IAAnna Etchin - Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VA Hospital, Bedford, MASarah McDannold - Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VA Hospital, Bedford, MAAaron Eagan - VHA Office of Public Health, National Center for Occupational Health and Infection Control, Gainesville, FLKimberly Findley - VHA Office of Public Health, National Center for Occupational Health and Infection Control, Gainesville, FLAllen L Gifford - Center for Healthcare Organization and Implementation Research (CHOIR), Boston University School of Medicine, VA Boston Healthcare System, Boston, MAKalpana Gupta - Center for Healthcare Organization and Implementation Research (CHOIR), Boston University School of Medicine, VA Boston Healthcare System, Boston, MAD. Keith McInnes - Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VA Hospital, Bedford, MA
- Resource Type
- Journal article
- Publication Details
- American journal of infection control, Vol.47(10), pp.1162-1166
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.ajic.2019.04.174
- PMID
- 31182235
- PMCID
- PMC7115305
- ISSN
- 0196-6553
- eISSN
- 1527-3296
- Language
- English
- Date published
- 10/2019
- Academic Unit
- Center for Social Science Innovation; Internal Medicine
- Record Identifier
- 9984094550902771
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