Frontline healthcare workers’ experiences with personal protective equipment during the COVID-19 pandemic in the UK: a rapid qualitative appraisal

  1. Katarina Hoernke
  2. Nehla Djellouli
  3. Lily Andrews
  4. Sasha Lewis-Jackson
  5. Louisa Manby
  6. Sam Martin
  7. Samantha Vanderslott
  8. Cecilia Vindrola-Padros

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Abstract

To 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.

Design

A 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).

Participants

Interview 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.

Results

A 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.

Conclusion

This 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.

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  1. Version published to 10.1136/bmjopen-2020-046199
  2. ScreenIT

    SciScore for 10.1101/2020.10.12.20211482: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Participants were approached by clinical leads in their Trusts to gather verbal consent for the research team to contact them via email.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and limitations: To our knowledge, this is the first qualitative study reporting frontline HCWs’ experiences with PPE during the COVID-19 pandemic in the UK. It offers first-hand experiences from the perspective of HCWs and contributes to the ongoing research on PPE for frontline HCWs during the COVID-19 pandemic.9 Interviews were carried out before, during and after the peak of the pandemic, which allowed for experiences to be captured in real-time. However, with the pandemic still evolving, this study will have missed insights since the end of the data collection period. Potential reporting bias should also be considered. Participants may not have been comfortable sharing the full details of their experiences related to PPE during the COVID-19 pandemic, as it became a sensitive and political issue. Participants’ perceived ability to discuss the topic could have been influenced by reports of HCWs being told not to speak to journalists or post on social media about PPE shortages.66 The lack of face-to-face contact during interviews limited our ability to pick up on non-verbal cues. Prioritising good rapport with participants was a priority amongst the interview team. This analysis includes data from the initial data collection period, which was limited in its representation of BAME, lower seniority and community HCWs’ experiences. As data collection has progressed, purposive sampling diversified the sample of participants in the wider study.17 Triangulating intervie...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.10.12.20211482v1 on medRxiv