Friday, January 4, 2013

Healthcare Worker Perception of Risk Predicts Use of Personal Protective Equipment

What motivates healthcare workers to wear personal protective equipment (masks, gowns, gloves, goggles)? Here is a related article in the American Journal of Infection Control.

The investigators used a questionnaire of perceptions and intentions to use infection control measures. Questionnaires were completed by 74 HCWs at 2 hospitals. HCWs also indicated a 1-meter transmission risk zone and their perceived transmission risk zone. 

When contact with a patient was expected, and a minimum 1-meter transmission risk zone was perceived (AOR, 9.8; P = .022) mask use was predicted. 

This finding is not unusual. I have frequently noticed that HCWs will cut corners on donning gowns and gloves for pathogens such as MRSA, VRE or C.difficile. Why? Probably because the perceived risk of infection to the HCW is low. 

Much has been published about the importance of safety checklists in medicine. Here is an an excellent book on the subject titled The Checklist Manifesto. Compliance with safety checklists in operating rooms and hospital wards has no doubt increased yet still falls short of the compliance and rigor observed for safety checklists by airline pilots. 

The reasons for this may be multiple but I suspect that the perception of risk is still very much at play. Pilots have as much to lose as their passengers in the event of an airline mishap, thereby driving up compliance with aviation safety checklists. 

The risks of adverse outcomes are not equally shared between HCWs and their patients, likely impacting compliance with safety checklists.