Use of personal protective equipment in Canadian pediatric emergency departments

Reid SM, Ken J, Farion KJ, Suh KN, Audcent T, Barrowman NJ, Plint AC. Department of Pediatrics, University of Ottawa, Ottawa, ON

Introduction: This study examined the attitudes, knowledge, self reported behaviors and perceived barriers to compliance with infection control practices and the use of personal protective equipment (PPE) in Canadian pediatric emergency departments (EDs).

Methods: A self-administered survey tool consisting of 21 questions was developed and validated de novo for this study. The survey was mailed to all individuals listed on the Pediatric Emergency Research Canada Database of physicians practising pediatric emergency medicine in Canada.

Results: There were 187 physicians surveyed and 125 (67%) responded. Respondents had a median 9 years of experience (range 0–32 yr) and 50 respondents (41%) had completed a pediatric emergency medicine fellowship. Fifty-four percent reported that they had either never received PPE training or had not been trained in the previous 2 years. Respondents scored a mean of 4.92 out of 11 questions correct (SD 1.66) on knowledge-based questions although 53% reported being very or somewhat comfortable with their knowledge of transmission-based isolation practices. Only 11% reported always or usually wearing a mask when assessing febrile respiratory patients. For scenarios assessing self-reported use of PPE, respondents reported correct PPE use in a mean of 1.01 out of 6 scenarios (SD 0.95). There was no statistically significant correlation between knowledge and reported use of PPE (p = 0.08). Respondents report they would be more likely to use PPE appropriately if patients were clearly identified prior to physician assessment, equipment was easily accessible, and PPE was made a priority in their ED.

Conclusion: Knowledge and self reported adherence to recommended infection control practices among Canadian pediatric emergency physicians is suboptimal. Early identification of patients requiring PPE, more convenient access to PPE, and improved education regarding isolation and PPE practices may improve adherence to these important guidelines.

Keywords: personal protective equipment, infection control, pediatrics