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. 2021 Feb 25:8:2049936121998562.
doi: 10.1177/2049936121998562. eCollection 2021 Jan-Dec.

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

Mariachiara Ippolito  1 , Mahesh Ramanan  2 , Davide Bellina  1 , Giulia Catalisano  1 , Pasquale Iozzo  3 , Andrea Di Guardo  1 , Alessandra Moscarelli  1 , Giacomo Grasselli  4 , Antonino Giarratano  1 , Matteo Bassetti  5 , Alexis Tabah  6 , Andrea Cortegiani  7
Affiliations

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

Mariachiara Ippolito et al. Ther Adv Infect Dis. .

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.

Keywords: COVID-19; Italy; PPE-SAFE; personal protective equipment; survey.

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Conflict of interest statement

Conflict of interest statement: Outside the submitted work, MB has participated in advisory boards and/or received speaker honoraria from Achaogen, Angelini, Astellas, Bayer, Basilea, Biomerieux, Cidara, Gilead, Menarini, MSD, Nabriva, Paratek, Pfizer, Roche, Melinta, Shionogi, Tetraphase, VenatoRx and Vifor and has received study grants from Angelini, Basilea, Astellas, Shionogi, Cidara, Melinta, Gilead, Pfizer and MSD, AC has received honoraria for lectures from Thermofisher and Pfizer. All the other authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Personal protective equipment used for routine care in Italy. The chart shows the frequencies distribution of routinely used personal protective equipment in Italy. PAPR, powered air purifying respirators; PPE, personal protective equipment.
See this image and copyright information in PMC

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