Tokyo Medical and Dental University, Tokyo, Japan.
Tokyo Medical and Dental University, Tokyo, Japan.
J Am Med Dir Assoc. 2022 Jun;23(6):930-935.e2. doi: 10.1016/j.jamda.2022.02.012. Epub 2022 Feb 28.
To assess adherence to personal protective equipment (PPE) use among home care workers during usual care at the agency level during the COVID-19 pandemic in Japan and determine whether agency-level action toward infection prevention and control (IPC) is associated with adherence to PPE use.
A nationwide cross-sectional study.
Home care service agencies in Japan were randomly selected from all agencies nationwide.
An online survey was conducted between January and February 2021. The administrators at home care service agencies responded to the following items: adherence to PPE (disposable masks, gloves, and aprons) use during diaper change among their home care workers, agency-level actions toward IPC, including monitoring of infection outbreak among users, existing manual for IPC, training opportunities on IPC for care workers, and other agency and administrator characteristics.
Of the 1942 agencies, 197 were included in the analysis (response rate: 10.1%). Although 145 (73.6%) of the agencies always used both masks and gloves during diaper change, 32 (16.2%) agencies fully adhered to wearing masks, gloves, and aprons. Agencies monitoring infectious disease outbreaks among service users were more likely to adhere to PPE use (adjusted odds ratio: 5.97, 95% confidence interval: 1.30-27.31).
Low adherence to PPE use, especially apron use, during diaper change among home care service agencies during the COVID-19 pandemic in Japan was revealed, despite the widespread availability of a manual for IPC and/or training opportunities. To ensure safety and quality home care services for both users and home care workers, agencies should not simply create manuals or training systems as a structure; instead, they should implement effective processes for appropriate PPE use.
评估日本 COVID-19 大流行期间机构层面上门护理工作人员在常规护理中个人防护设备（PPE）使用的依从性，并确定机构层面的感染预防和控制（IPC）措施是否与 PPE 使用的依从性相关。
一项全国性的横断面研究。
从全国所有机构中随机选择日本的上门护理服务机构。
2021 年 1 月至 2 月进行了在线调查。上门护理服务机构的管理人员回答了以下问题：上门护理工人在更换尿布时对 PPE（一次性口罩、手套和围裙）的使用依从性、机构层面的 IPC 措施，包括对使用者感染爆发的监测、现有的 IPC 手册、对护理人员的 IPC 培训机会，以及其他机构和管理人员的特征。
在 1942 家机构中，有 197 家机构（应答率：10.1%）被纳入分析。虽然 145 家（73.6%）机构在更换尿布时始终同时使用口罩和手套，但 32 家（16.2%）机构完全遵守佩戴口罩、手套和围裙的规定。对服务使用者传染病爆发进行监测的机构更有可能遵守 PPE 使用规定（调整后的优势比：5.97，95%置信区间：1.30-27.31）。
尽管普遍提供了 IPC 手册和/或培训机会，但在日本 COVID-19 大流行期间，上门护理服务机构在更换尿布时 PPE 使用的依从性较低，尤其是围裙的使用。为了确保用户和上门护理工人的安全和高质量的上门护理服务，机构不仅应将创建手册或培训系统视为一种结构；相反，他们应实施有效的 PPE 使用流程。
