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Ippolito M, Ramanan M, Bellina D, Catalisano G, Iozzo P, Di Guardo A, Moscarelli A, Grasselli G, Giarratano A, Bassetti M, Tabah A, Cortegiani A. Personal protective equipment use by healthcare workers in intensive care unit during the early phase of COVID-19 pandemic in Italy: a secondary analysis of the PPE-SAFE survey. Ther Adv Infect Dis 2021; 8:2049936121998562. [PMID: 33717482 PMCID: PMC7922607 DOI: 10.1177/2049936121998562] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/01/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Italy was the first Western country to be heavily affected by COVID-19. Healthcare workers (HCWs) were exposed to a high risk of occupational infection, partially due to insufficient personal protective equipment (PPE) supplies. This study aimed to describe the practices, availability, training, confidence in PPE use and the adverse effects due to extended PPE use, as reported by HCWs in Italy. We also aimed to provide a comparison between Italian data and those from other countries. METHODS This study was a secondary analysis of a previously published international study, the PPE-SAFE Survey, conducted in April 2020. Data were analysed from the original study database. RESULTS We analysed the responses from 380 healthcare workers based in Italy, out of the 2711 respondents to the international survey. Among the Italian respondents, FFP2 and FFP3 respirators or equivalent were the most used masks for routine tasks (respectively 188/380, 50%; and 163/380, 43%). The median time of wearing PPE without taking a break was 5 h [interquartile range (IQR) 4-6], with statistically significant difference from other countries [median 4 h (IQR 2-5) p < 0.0001]. In Italy, 249 out of 380 (65%) HCWs had never performed a formal fit test for a N95 mask or equivalent and 91/380 (24%) never had a partner for donning and doffing procedures. Most of the respondents (299/380, 79%) had received formal training in PPE use at any time. CONCLUSION Most of the surveyed Italian HCWs reported working at above usual capacity, long shifts with PPE without breaks and routine use in intensive care unit of aerosol protection (e.g. FFP2/FFP3), hazmat suits and face shields/visors. The correct adherence to safety procedures (e.g. donning/doffing in pairs, performing fit test) has substantial scope for improvement in the future.
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Affiliation(s)
- Mariachiara Ippolito
- Department of Surgical, Oncological and Oral
Science (Di.Chir.On.S.), University of Palermo, Palermo, Sicilia,
Italy
| | - Mahesh Ramanan
- Intensive Care Units, Caboolture and Prince
Charles Hospitals, School of Medicine, University of Queensland, The George
Institute for Global Health, University of New South Wales, Sydney,
Queensland, Australia
| | - Davide Bellina
- Department of Surgical, Oncological and Oral
Science (Di.Chir.On.S.), University of Palermo, Palermo, Sicilia,
Italy
| | - Giulia Catalisano
- Department of Surgical, Oncological and Oral
Science (Di.Chir.On.S.), University of Palermo, Palermo, Sicilia,
Italy
| | - Pasquale Iozzo
- Department of Anaesthesia, Intensive Care and
Emergency, Policlinico Paolo Giaccone, University of Palermo, Palermo,
Sicilia, Italy
| | - Andrea Di Guardo
- Department of Surgical, Oncological and Oral
Science (Di.Chir.On.S.), University of Palermo, Palermo, Sicilia,
Italy
| | - Alessandra Moscarelli
- Department of Surgical, Oncological and Oral
Science (Di.Chir.On.S.), University of Palermo, Palermo, Sicilia,
Italy
| | - Giacomo Grasselli
- Dipartimento di Anestesia, Rianimazione ed
Emergenza-Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore
Policlinico, Milan, Lombardia, Italy
| | - Antonino Giarratano
- Department of Surgical, Oncological and Oral
Science (Di.Chir.On.S.), University of Palermo, Palermo, Sicilia,
Italy
- Department of Anaesthesia, Intensive Care and
Emergency, Policlinico Paolo Giaccone, Palermo, Italy
| | - Matteo Bassetti
- Infectious Diseases Clinic of the San
Martino-IST University Hospital, University of Genoa, Genova, Liguria,
Italy
| | - Alexis Tabah
- Intensive Care Unit, Faculty of Medicine,
Redcliffe Hospital, University of Queensland, Saint Lucia, Queensland,
Australia
| | - Andrea Cortegiani
- Department of Surgical, Oncological and Oral
Science (Di.Chir.On.S.), University of Palermo, Italy. Departement of
Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Via
del Vespro 129, 90127, Palermo, Italy
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