Barriers to the Use of PPE to Prevent Pertussis Exposures in a Pediatric Primary Care Network.

TitleBarriers to the Use of PPE to Prevent Pertussis Exposures in a Pediatric Primary Care Network.
Publication TypeJournal Article
Year of Publication2015
AuthorsFierro JL, Middleton M, Smallwood AN, Rettig S, Feudtner C, Coffin SE, Feemster KA
JournalJ Pediatric Infect Dis Soc
Volume4
Issue1
Pagination49-56
Date Published03/2015
ISSN2048-7207
Abstract

BACKGROUND: The resurgence of pertussis is contributing to mounting healthcare worker (HCW) exposures, especially within pediatric outpatient settings. Infection prevention and control (IPC) guidelines for ambulatory sites exist, but are not uniformly implemented. Our aim was to identify facilitators and barriers to the use of IPC practices to prevent pertussis transmission in ambulatory pediatric settings.

METHODS: HCWs at 18 of 25 (72%) clinics in a pediatric ambulatory network completed a theory-based questionnaire about pertussis and personal protective equipment (PPE). The questionnaire contained randomly distributed versions of two vignettes to create an experimental design assessing barriers to PPE use.

RESULTS: Three hundred forty-three of 467 (73%) HCWs completed the survey: 234 (68%) clinical and 109 (32%) nonclinical. Seventy-one percent of clinical HCWs reported wearing PPE when caring for a patient with suspected pertussis; only 27% used PPE for patients with any respiratory symptoms. Among clinical HCWs, reported PPE use when caring for patients with suspected pertussis was independently associated with attitudes toward PPE (odds ratio [OR] 5.4, 95% confidence interval [CI] 1.8, 16.6), knowledge and skills (OR 4.6, 95% CI 1.4, 15.2), and lack of perceived barriers (OR 3.2, 95% CI 1.3, 7.9). HCWs who did not perceive PPE use as a norm were less likely to report using PPE (OR 0.2, 95% CI 0.1, 0.6) or distributing masks to patients with cough (OR 0.02, 95% CI 0.00, 0.2). Reported PPE use was not influenced by perceived infection risk or mask accessibility.

CONCLUSION: Our results identified barriers to PPE use and targets for education to prevent pertussis transmission in ambulatory pediatric settings.

DOI10.1093/jpids/piu033
Alternate JournalJ Pediatric Infect Dis Soc
PubMed ID26407357