Khyber Medical University, Peshawar, Pakistan.
Gandhara University, Peshawar, Pakistan.
BMC Health Serv Res. 2023 Nov 15;23(1):1256. doi: 10.1186/s12913-023-10048-y.
The COVID-19 pandemic has revealed vulnerabilities in healthcare systems worldwide, emphasizing the importance of healthcare worker safety through adequate utilization of personal protective equipment (PPE). This study aims to assess the impact of pre-pandemic PPE training on the practices and other associated factors among frontline healthcare workers during the COVID-19 pandemic in Pakistan and provide insights into the implications of such training programs for future initiatives.
A cross-sectional study from May 9th to June 5th, 2020 was conducted among the frontline healthcare workers against COVID-19 in Pakistan, utilizing an online structured questionnaire shared via WhatsApp and Facebook by using purposive sampling. Statistical analyses, including chi-square tests for proportion and logistic regression for the association while multi-logistic regression for potential confounders, were performed using SPSS version 22.
A total of 453 healthcare staff participated, with 68.9% (n = 312) reporting no prior PPE training and 31.1% (n = 141) having received training. Significant associations were found between prior training and healthcare group distribution (p = 0.006), with doctors exhibiting the highest proportion of training 82 (37.61%), followed by nurses 50 (27.32%) and paramedics 9 (17.31%). Those who didn't receive any prior training in PPEs showed a higher perceived professional risk of 216 (69.23%) compared to those who received prior PPE training 96 (30.77%, p-value 0.005). Similarly, a higher frequency 137 (63.72%) of Perceived Personal risk was observed in those who didn't receive training, labeled as "high risk" compared to those who were trained 78 (36.28%, P value 0.02). Multi-logistic regression analysis identified paramedics as 0.26 times less likely to have received prior PPE training (Adjusted OR 0.26, 95% CI 0.10-0.65, p = 0.01) compared to medical doctors. Healthcare workers in tertiary care hospitals were 0.46 times less likely to undergo PPE training (Adjusted OR 0.46, 95% CI 0.25-0.87,p = 0.01) compared to those working at COVID-19 facilities/hospitals/quarantine centers. Likewise, individuals who doffed disposable gowns [Adjusted OR 3.86, (95% CI, 1.23-12.08, p = 0.02] were 3.86 times more interested in getting prior training in PPE compared to those who don't have skills to wear them.
Our findings highlight that healthcare levels, type of healthcare, and doffing skills are important predictors of whether healthcare workers have taken prior training in PPE. These findings imply developing effective training programs for healthcare workers to ensure safety while providing care during pandemics like COVID-19.
COVID-19 大流行揭示了全球医疗体系的脆弱性，强调了通过充分利用个人防护设备（PPE）来确保医护人员安全的重要性。本研究旨在评估巴基斯坦 COVID-19 大流行期间，医护人员在大流行前接受 PPE 培训对其实践和其他相关因素的影响，并为未来的培训计划提供启示。
2020 年 5 月 9 日至 6 月 5 日，利用 WhatsApp 和 Facebook 共享的在线结构化问卷，对巴基斯坦 COVID-19 一线医护人员进行了横断面研究，采用目的抽样法。使用 SPSS 版本 22 进行统计分析，包括比例的卡方检验和关联的逻辑回归，以及潜在混杂因素的多逻辑回归。
共有 453 名医护人员参与，其中 68.9%（n=312）报告未接受过 PPE 培训，31.1%（n=141）接受过培训。培训前与医护人员分组分布呈显著相关（p=0.006），医生接受培训的比例最高，为 82 人（37.61%），其次是护士 50 人（27.32%）和护理人员 9 人（17.31%）。那些没有接受过任何 PPE 培训的人认为自己的职业风险更高，有 216 人（69.23%），而接受过 PPE 培训的人有 96 人（30.77%，p 值 0.005）。同样，未接受培训的人认为自己的个人风险更高，有 137 人（63.72%）被标记为“高风险”，而接受过培训的人有 78 人（36.28%，P 值 0.02）。多逻辑回归分析发现，与医生相比，护理人员接受过 PPE 培训的可能性低 26%（调整后的 OR 0.26，95% CI 0.10-0.65，p=0.01）。与在 COVID-19 设施/医院/隔离中心工作的医护人员相比，在三级保健医院工作的医护人员接受 PPE 培训的可能性低 46%（调整后的 OR 0.46，95% CI 0.25-0.87，p=0.01）。同样，与没有脱卸一次性长袍技能的人相比，脱卸一次性长袍的人[调整后的 OR 3.86，（95% CI，1.23-12.08，p=0.02]更有兴趣接受 PPE 培训。
我们的研究结果表明，医护人员的医护水平、医护类型和脱卸技能是他们是否接受过 PPE 培训的重要预测因素。这些发现意味着需要为医护人员制定有效的培训计划，以确保在 COVID-19 等大流行期间提供护理时的安全。
