Dataset Information

Learning from healthcare workers' experiences with personal protective equipment during the COVID-19 pandemic in Aotearoa/New Zealand: a thematic analysis and framework for future practice.

ABSTRACT:

Objectives

Safety and welfare are critical as pandemic-related demands on the healthcare workforce continue. Access to personal protective equipment (PPE) has been a central concern of healthcare workers throughout the COVID-19 pandemic. Against the backdrop of an already strained healthcare system, our study aimed to explore the experiences of healthcare workers with PPE during the first COVID-19 surge (February-June 2020) in Aotearoa/New Zealand (NZ). We also aimed to use these findings to present a strengths-based framework for supporting healthcare workers moving forward.

Design

Web-based, anonymous survey including qualitative open-text questions. Questions were both closed and open text, and recruitment was multimodal. We undertook inductive thematic analysis of the dataset as a whole to explore prominent values related to healthcare workers' experiences.

Setting

October-November 2020 in New Zealand.

Participants

1411 healthcare workers who used PPE during surge one of the COVID-19 pandemic.

Results

We identified four interactive values as central to healthcare workers' experiences: transparency, trust, safety and respect. When healthcare workers cited positive experiences, trust and safety were perceived as present, with a sense of inclusion in the process of stock allocation and effective communication with managers. When trust was low, with concerns over personal safety, poor communication and lack of transparency resulted in perceived lack of respect and distress among respondents. Our proposed framework presents key recommendations to support the health workforce in terms of communication relating to PPE supply and distribution built on those four values.

Conclusions

Healthcare worker experiences with PPE access has been likened to 'the canary in the coalmine' for existing health system challenges that have been exacerbated during the COVID-19 pandemic. The four key values identified could be used to improve healthcare worker experience in the future.

SUBMITTER: Wild CEK

PROVIDER: S-EPMC9577277 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Learning from healthcare workers' experiences with personal protective equipment during the COVID-19 pandemic in Aotearoa/New Zealand: a thematic analysis and framework for future practice.

Wild Cervantée E K CEK Wells Hailey H Coetzee Nicolene N Grant Cameron C CC Sullivan Trudy A TA Derraik José G B JGB Anderson Yvonne C YC

BMJ open 20221014 10

<h4>Objectives</h4>Safety and welfare are critical as pandemic-related demands on the healthcare workforce continue. Access to personal protective equipment (PPE) has been a central concern of healthcare workers throughout the COVID-19 pandemic. Against the backdrop of an already strained healthcare system, our study aimed to explore the experiences of healthcare workers with PPE during the first COVID-19 surge (February-June 2020) in Aotearoa/New Zealand (NZ). We also aimed to use these finding ...[more]

PMID: 36241354

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Project description:BackgroundThe COVID-19 pandemic has highlighted personal protective equipment (PPE) supply, distribution, and disposal issues worldwide. Calls to conserve PPE stocks and increase supply resulted in the rapid development of potential disinfection methods, with the possibility of improvements in medical waste reduction. However, how receptive health-care workers are to PPE reuse remains unknown. We aimed to examine the views of health-care workers who used PPE during the first COVID-19 wave in Aotearoa New Zealand, in relation to acceptability of PPE disinfection and reuse.MethodsIn this multi-methods survey, health-care workers in New Zealand, were invited via a multimodal recruitment strategy to complete a survey regarding use of PPE during the first COVID-19 wave. Gender question options were male, female, gender diverse, or prefer not to say. Demographic differences in self-reported PPE reuse and acceptability were examined. The survey included closed (single-response, multi-response, ranking, and Likert-scale questions) and open-text questions. Any open-text comments were analysed with thematic analysis. The survey was built and deployed using Qualtrics software.Findings1411 health-care workers completed the survey between Oct 7 and Nov 30, 2020. 1397 participants had gender data available (1140 [82%] female and 257 [18%] male) and 995 (74%) of 1347 were of New Zealand European ethnicity. PPE reuse was common and reported by 628 (45%) of the 1411 participants, with 396 (63%) of the 628 reporting reusing PPE multiple times in 1 day. Acceptability of the concept of PPE disinfection for potential reuse was high overall (1196 [85%] of 1411) but varied depending on the type of PPE. Thematic analysis confirmed that PPE reuse was already occurring and respondents recognised the potential benefits of reduced medical wastage and increased PPE supply. Important caveats for consideration included the availability of scientific evidence, level of negotiated risk, and trust in the organisation undertaking PPE disinfection, with clear communication about decontamination processes being crucial to acceptability.InterpretationPPE reuse occurred frequently during the first wave of COVID-19 in New Zealand. Although support for the disinfection of PPE for reuse was high, the success of any future programmes to reuse PPE will require meaningful engagement and clear communication with health-care workers. Further research into PPE disinfection safety and logistics is warranted, alongside the development of standard operating procedures and clearly communicated policies for the end user, should this more sustainable health-care practice be planned for adoption in certain settings.FundingNew Zealand Ministry of Business, Innovation and Employment (COVID-19 Innovation Acceleration Fund) and the Medical Assurance Society Foundation.

Project description:In this paper, we examine the cost effectiveness of investment in personal protective equipment (PPE) for protecting health care workers (HCWs) against two infectious diseases: Ebola virus and methicillin-resistant Staphylococcus aureus (MRSA). This builds on similar work published for COVID-19 in 2020. We developed two separate decision-analytic models using a payer perspective to compare the costs and effects of multiple PPE use scenarios for protection of HCW against Ebola and MRSA. Bayesian multivariate sensitivity analyses were used to consider the uncertainty surrounding all key parameters for both diseases. We estimate the cost to provide adequate PPE for a HCW encounter with an Ebola patient is $13.04, which is associated with a 97% risk reduction in infections. The mean incremental cost-effectiveness ratio (ICER) is $3.98 per disability-adjusted life year (DALY) averted. Because of lowered infection and disability rates, this investment is estimated to save $132.27 in averted health systems costs, a financial ROI of 1,014%. For MRSA, the cost of adequate PPE for one HCW encounter is $0.88, which is associated with a 53% risk reduction in infections. The mean ICER is $362.14 per DALY averted. This investment is estimated to save $20.18 in averted health systems costs, a financial ROI of 2,294%. In terms of total health savings per death averted, investing in adequate PPE is the dominant strategy for Ebola and MRSA, suggesting that it is both more costly and less clinically optimal to not fully invest in PPE for these diseases. There are many compelling reasons to invest in PPE to protect HCWs. This analysis examines the economic case, building on previous evidence that protecting HCWs with PPE is cost-effective for COVD-19. Ebola and MRSA scenarios were selected to allow assessment of both endemic and epidemic infectious diseases. While PPE is cost-effective for both conditions, compared to our analysis for COVID-19, PPE is relatively more cost-effective for Ebola and relatively less so for MRSA. Further research is needed to assess shortfalls in the PPE supply chain identified during the COVID-19 pandemic to ensure an efficient and resilient supply in the face of future pandemics.

Project description:ObjectivesTo report frontline healthcare workers' (HCWs) experiences with personal protective equipment (PPE) during the COVID-19 pandemic in the UK. To understand HCWs' fears and concerns surrounding PPE, their experiences following its guidance and how these affected their perceived ability to deliver care during the COVID-19 pandemic.DesignA rapid qualitative appraisal study combining three sources of data: semistructured in-depth telephone interviews with frontline HCWs (n=46), media reports (n=39 newspaper articles and 145 000 social media posts) and government PPE policies (n=25).ParticipantsInterview participants were HCWs purposively sampled from critical care, emergency and respiratory departments as well as redeployed HCWs from primary, secondary and tertiary care centres across the UK.ResultsA major concern was running out of PPE, putting HCWs and patients at risk of infection. Following national level guidance was often not feasible when there were shortages, leading to reuse and improvisation of PPE. Frequently changing guidelines generated confusion and distrust. PPE was reserved for high-risk secondary care settings and this translated into HCWs outside these settings feeling inadequately protected. Participants were concerned about differential access to adequate PPE, particularly for women and Black, Asian and Minority Ethnic HCWs. Participants continued delivering care despite the physical discomfort, practical problems and communication barriers associated with PPE use.ConclusionThis study found that frontline HCWs persisted in caring for their patients despite multiple challenges including inappropriate provision of PPE, inadequate training and inconsistent guidance. In order to effectively care for patients during the COVID-19 pandemic, frontline HCWs need appropriate provision of PPE, training in its use as well as comprehensive and consistent guidance. These needs must be addressed in order to protect the health and well-being of the most valuable healthcare resource in the COVID-19 pandemic: our HCWs.

Dataset Information

Learning from healthcare workers' experiences with personal protective equipment during the COVID-19 pandemic in Aotearoa/New Zealand: a thematic analysis and framework for future practice.

Objectives

Design

Setting

Participants

Results

Conclusions

Publications

Learning from healthcare workers' experiences with personal protective equipment during the COVID-19 pandemic in Aotearoa/New Zealand: a thematic analysis and framework for future practice.

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