Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-28T03:46:20.204Z Has data issue: false hasContentIssue false
  • English
  • Français

Increasing face-mask compliance among healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic

Part of: SARS-CoV-2/COVID-19

Published online by Cambridge University Press:  03 May 2021

Rupak Datta Open the ORCID record for Rupak Datta [Opens in a new window] ,
Keith Glenn ,
Anthony Pellegrino ,
Jessica Tuan ,
Brian Linde ,
Jehanzeb Kayani ,
Kavin Patel ,
Lisbeysi Calo ,
Louise Marie Dembry  and
Ann Fisher
Rupak Datta*
Affiliation:
Hospital Epidemiology and Infection Prevention Program, Veterans Affairs Connecticut Healthcare System (VACHS), West Haven, Connecticut Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
Keith Glenn
Affiliation:
Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
Anthony Pellegrino
Affiliation:
Hospital Epidemiology and Infection Prevention Program, Veterans Affairs Connecticut Healthcare System (VACHS), West Haven, Connecticut
Jessica Tuan
Affiliation:
Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
Brian Linde
Affiliation:
Occupational Health Services, VACHS, West Haven, Connecticut Occupational and Environmental Medicine, Yale School of Medicine, New Haven, Connecticut
Jehanzeb Kayani
Affiliation:
Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
Kavin Patel
Affiliation:
Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
Lisbeysi Calo
Affiliation:
Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut
Louise Marie Dembry
Affiliation:
Hospital Epidemiology and Infection Prevention Program, Veterans Affairs Connecticut Healthcare System (VACHS), West Haven, Connecticut Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut Section of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
Ann Fisher
Affiliation:
Hospital Epidemiology and Infection Prevention Program, Veterans Affairs Connecticut Healthcare System (VACHS), West Haven, Connecticut Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
*
Author for correspondence: Rupak Datta, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Prior studies of universal masking have not measured face-mask compliance. We performed a quality improvement study to monitor and improve face-mask compliance among healthcare personnel (HCP) during the coronavirus disease 2019 (COVID-19) pandemic.

Design:

Mixed-methods study.

Setting:

Tertiary-care center in West Haven, Connecticut.

Patients:

HCP including physicians, nurses, and ancillary staff.

Methods:

Face-mask compliance was measured through direct observations during a 4-week baseline period after universal masking was mandated. Frontline and management HCP completed semistructured interviews from which a multimodal intervention was developed. Direct observations were repeated during a 14-week period following implementation of the multimodal intervention. Differences between units were evaluated with χ2 testing using the Bonferroni correction. Face-mask compliance between baseline and intervention periods was compared using time-series regression.

Results:

Among 1,561 observations during the baseline period, median weekly face-mask compliance was 82.2% (range, 80.8%–84.4%). Semistructured interviews were performed with 16 HCP. Qualitative analysis informed the development of a multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership. Among 2,651 observations during the intervention period, median weekly face-mask compliance was 92.6% (range, 84.6%–97.9%). There was no difference in weekly face-mask compliance between COVID-19 and non–COVID-19 units. The multimodal intervention was associated with an increase in face-mask compliance (β = 0.023; P = .002).

Conclusions:

Face-mask compliance remained suboptimal among HCP despite a facility-wide mandate for universal masking. A multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership was effective in increasing face-mask compliance among HCP.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 5 , May 2022 , pp. 616 - 622
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Chu, DK, Akl, EA, Duda, S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet 2020;395:1973–1987.CrossRefGoogle ScholarPubMed
Furukawa, NW, Brooks, JT, Sobel, J. Evidence supporting transmission of severe acute respiratory syndrome coronavirus 2 while presymptomatic or asymptomatic. Emerg Infect Dis 2020;26:e201595.CrossRefGoogle ScholarPubMed
He, X, Lau, EHY, Wu, P, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med 2020;26:672–675.CrossRefGoogle ScholarPubMed
Arons, MM, Hatfield, KM, Reddy, SC, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Engl J Med 2020;382:2081–2090.CrossRefGoogle Scholar
Kimball, A, Hatfield, KM, Arons, M, et al. Asymptomatic and presymptomatic SARS-CoV-2 infections in residents of a long-term care skilled nursing facility—King County, Washington, March 2020. Morbid Mortal Wkly Rep 2020;69:377–381.CrossRefGoogle Scholar
Scientific brief: SARS-CoV-2 and potential airborne transmission. Centers for Disease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-sars-cov-2.html. Accessed November 18, 2020.Google Scholar
Interim infection prevention and control recommendations for healthcare personnel during the coronavirus disease (2019) COVID-19 pandemic. Centers for Disease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html. Accessed November 18, 2020.Google Scholar
Seidelman, JL, Lewis, SS, Advani, SD, et al. Universal masking is an effective strategy to flatten the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) healthcare worker epidemiologic curve. Infect Control Hosp Epidemiol 2020;41:1466–1467.CrossRefGoogle ScholarPubMed
Wang, X, Ferro, EG, Zhou, G, Hashimoto, D and Bhatt, DL. Association between universal masking in a healthcare system and SARS-CoV-2 positivity among healthcare workers. JAMA 2020;324:703–704.CrossRefGoogle Scholar
Rhee, C, Baker, M, Vaidya, V, et al. Incidence of nosocomial COVID-19 in patients hospitalized at a large US academic medical center. JAMA Netw Open. 2020;3:e2020498.CrossRefGoogle Scholar
Advani, S, Smith, B, Lewis, S, Anderson, D, Sexton, D. Universal masking in hospitals in the COVID-19 era: is it time to consider shielding? Infect Control Hosp Epidemiol 2020;41:1066–1067.CrossRefGoogle ScholarPubMed
Richterman, A, Meyerowitz, EA, Cevik, M. Hospital-acquired SARS-CoV-2 infection: lessons for public health. JAMA 2020. doi: 10.1001/jama.2020.21399.CrossRefGoogle Scholar
Klompas, M, Morris, CA, Sinclair, J, Pearson, M, Shenoy, ES. Universal masking in hospitals in the COVID-19 era. N Engl J Med 2020;382(21):e63.CrossRefGoogle ScholarPubMed
Wong, SC, Lam, GK, AuYeung, CH, et al. Absence of nosocomial influenza and respiratory syncytial virus infection in the coronavirus disease 2019 (COVID-19) era: implication of universal masking in hospitals. Infect Control Hosp Epidemiol 2021;42:218–221.CrossRefGoogle ScholarPubMed
Kingston, L, O’Connell, NH, Dunne, CP. Hand hygiene–related clinical trials reported since 2010: a systematic review. J Hosp Infect 2016;92:309–320.CrossRefGoogle ScholarPubMed
Gould, DJ, Moralejo, D, Drey, N, Chudleigh, JH, Taljaard, M. Interventions to improve hand hygiene compliance in patient care. Cochrane Database Syst Rev 2017;9:CD005186.Google ScholarPubMed
Ruiz-Fernández, MD, Ramos-Pichardo, JD, Ibáñez-Masero, O, et al. Compassion fatigue, burnout, compassion satisfaction and perceived stress in healthcare professionals during the COVID-19 health crisis in Spain. J Clin Nurs 2020;29:4321–4330.CrossRefGoogle ScholarPubMed
Renardy, M, Eisenberg, M, Kirschner, D. Predicting the second wave of COVID-19 in Washtenaw County, MI. J Theor Biol 2020;507:110461.CrossRefGoogle ScholarPubMed
Standards for Quality Improvement Reporting Excellence, SQUIRE 2.0. Equator Network website. https://www.equator-network.org/reporting-guidelines/squire/. Accessed November 19, 2020.Google Scholar
Sinkowitz-Cochran, RL, Garcia-Williams, A, Hackbarth, A, et al. Evaluation of organizational culture among different levels of healthcare staff participating in the Institute for Healthcare Improvement’s 100,000 Lives campaign. Infect Control Hosp Epidemiol 2012;33:135–143.CrossRefGoogle ScholarPubMed
Wise, ME, Weber, SG, Schneider, A, et al. Hospital staff perceptions of a legislative mandate for methicillin-resistant Staphylococcus aureus screening. Infect Control Hosp Epidemiol 2011;32:573–578.CrossRefGoogle ScholarPubMed
Borkan, J. Immersion/crystallization. In: Crabtree, B, Miller, W, eds. Doing Qualitative Research, 2nd ed. Thousand Oaks, CA: Sage, 1999:179–194.Google Scholar
Armstrong, RA. When to use the Bonferroni correction. Ophthalmic Physiol Opt 2014;34:502–508.CrossRefGoogle ScholarPubMed
Connecticut COVID-19 response, daily data report. Connecticut government website. https://portal.ct.gov/coronavirus/covid-19-data-tracker. Accessed November 23, 2020.Google Scholar
Smiddy, MP, Murphy, OM, Savage, E, et al. Efficacy of observational hand hygiene audit with targeted feedback on doctors’ hand hygiene compliance: a retrospective time series analysis. J Infect Prev 2019;20:164–170.CrossRefGoogle ScholarPubMed
Madden, JM, Soumerai, SB, Lieu, TA, Mandl, KD, Zhang, F, Ross-Degnan, D. Effects of a law against early postpartum discharge on newborn follow-up, adverse events, and HMO expenditures. N Engl J Med 2002;347:2031–2038.CrossRefGoogle ScholarPubMed
Huang, SS, Yokoe, DS, Hinrichsen, VL, et al. Impact of routine intensive care unit surveillance cultures and resultant barrier precautions on hospital-wide methicillin-resistant Staphylococcus aureus bacteremia. Clin Infect Dis 2006;43:971–978.CrossRefGoogle ScholarPubMed
Glied, SA, Hartz, J, Giorgi, G. Consider it done? The likely efficacy of mandates for health insurance. Health Affairs 2007;26:1612–1621.CrossRefGoogle ScholarPubMed
Advani, S, Yarrington, ME, Smith, BA, Anderson, DJ, Sexton, DJ. Are we forgetting the “universal” in universal masking? Current challenges and future solutions. Infect Control Hosp Epidemiol 2020. doi: 10.1017/ice.2020.333.CrossRefGoogle Scholar
Fakih, MG, Sturm, LK, Fakih, RR. Overcoming COVID-19: addressing the perception of risk and transitioning protective behaviors to habits Infect Control Hosp Epidemiol 2021;42:489–490.CrossRefGoogle ScholarPubMed
Gostin, LO, Cohen, IG, Koplan, JP. Universal masking in the United States: the role of mandates, health education, and the CDC. JAMA 2020;324:837–838.CrossRefGoogle ScholarPubMed
Schwartz, JL. Evaluating and deploying COVID-19 vaccines—the importance of transparency, scientific integrity, and public trust. N Engl J Med 2020;383:1703–1705.CrossRefGoogle ScholarPubMed
Mello, MM, Silverman, RD, Omer, SB. Ensuring uptake of vaccines against SARS-CoV-2. N Engl J Med 2020;383:1296–1299.CrossRefGoogle ScholarPubMed
Supplementary material: File

Datta et al. supplementary material

Datta et al. supplementary material

Download Datta et al. supplementary material(File)
File 15 KB