Adherence to protective measures among healthcare workers in the UK: a cross-sectional study

  1. Louise E Smith
  2. Danai Serfioti
  3. Dale Weston
  4. Neil Greenberg
  5. G James Rubin

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Abstract

Healthcare workers (HCWs) are frontline responders to emergency infectious disease outbreaks such as COVID-19. To avoid the rapid spread of disease, adherence to protective measures is paramount. We investigated rates of correct use of personal protective equipment (PPE), hand hygiene and physical distancing in UK HCWs who had been to their workplace at the start of the COVID-19 pandemic and factors associated with adherence.

Methods

We used an online cross-sectional survey of 1035 UK healthcare professionals (data collected 12–16 June 2020). We excluded those who had not been to their workplace in the previous 6 weeks, leaving us with a sample size of 831. Respondents were asked about their use of PPE, hand hygiene and physical distancing in the workplace. Frequency of uptake was reported descriptively; adjusted logistic regressions were used to separately investigate factors associated with adherence to use of PPE, maintaining good hand hygiene and physical distancing from colleagues.

Results

Adherence to personal protective measures was suboptimal (PPE use: 80.0%, 95% CI 77.3 to 82.8; hand hygiene: 67.8%, 95% CI 64.6 to 71.0; coming into close contact with colleagues: 74.7%, 95% CI 71.7 to 77.7). Adherence to PPE use was associated with having received training about health and safety in the workplace for COVID-19, greater perceived social pressure to adopt the behaviour and availability of PPE. Non-adherence was associated with fatalism about COVID-19 and greater perceived difficulty of adopting protective measures. Workplace design using markings to facilitate distancing was associated with adherence to physical distancing.

Conclusions

Uptake of personal protective behaviours among UK HCWs at the start of the pandemic was variable. Factors associated with adherence provide insight into ways to support HCWs to adopt personal protective behaviours, such as ensuring that adequate PPE is available and designing workplaces to facilitate physical distancing.

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  1. Version published to 10.1136/emermed-2021-211454
  2. ScreenIT

    SciScore for 10.1101/2020.07.24.20161422: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethics: Ethical approval for this study was granted by the King’s College London Research Ethics Committee (reference: LRS-19/20-19184).
    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:
    However, due to space limitations in the survey, we were unable to ask about the perceived effectiveness of handwashing. Further observational research investigating rates of adherence to and factors associated with hand hygiene in HCWs is urgently needed. Only one-quarter of HCWs reported physically distancing the most recent time they were at work. While we cannot rely on self-reported data to accurately measure rates of adherence, these findings emphasise how difficult physical distancing is between HCWs in the workplace. Clear environmental cues, design of the workplace to enable physical distancing and perceived ease of keeping a 2-metre distance were strongly associated maintaining physical distancing. Patterns of adherence to physical distancing in the workplace were similar to those for adherence to use of PPE, with lower fatalism about catching COVID-19, higher perceived social norms and greater perceived effectiveness of physical distancing being associated with increased adherence. Adherence to physical distancing measures in the UK general population during the pandemic is also associated with greater perceived social norms and effectiveness of physical distancing.9 Re-designing areas so that it is easy to maintain physical distancing, and using clear markings to promote physical distancing are likely to promote adherence. This study has several limitations. First, rates of adherence should be viewed cautiously due to use of self-report data, which may be influenc...

    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

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  3. Version published to 10.1101/2020.07.24.20161422v1 on medRxiv