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Increasing face-mask compliance among healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic

Published online by Cambridge University Press:  03 May 2021

Rupak Datta
Affiliation:
Hospital Epidemiology and Infection Prevention Program, Veterans Affairs Connecticut Healthcare System (VACHS), West Haven, Connecticut Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
Keith Glenn
Affiliation:
Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
Anthony Pellegrino
Affiliation:
Hospital Epidemiology and Infection Prevention Program, Veterans Affairs Connecticut Healthcare System (VACHS), West Haven, Connecticut
Jessica Tuan
Affiliation:
Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
Brian Linde
Affiliation:
Occupational Health Services, VACHS, West Haven, Connecticut Occupational and Environmental Medicine, Yale School of Medicine, New Haven, Connecticut
Jehanzeb Kayani
Affiliation:
Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
Kavin Patel
Affiliation:
Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
Lisbeysi Calo
Affiliation:
Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut
Louise Marie Dembry
Affiliation:
Hospital Epidemiology and Infection Prevention Program, Veterans Affairs Connecticut Healthcare System (VACHS), West Haven, Connecticut Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut Section of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
Ann Fisher
Affiliation:
Hospital Epidemiology and Infection Prevention Program, Veterans Affairs Connecticut Healthcare System (VACHS), West Haven, Connecticut Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
Corresponding
E-mail address:

Abstract

Objective:

Prior studies of universal masking have not measured face-mask compliance. We performed a quality improvement study to monitor and improve face-mask compliance among healthcare personnel (HCP) during the coronavirus disease 2019 (COVID-19) pandemic.

Design:

Mixed-methods study.

Setting:

Tertiary-care center in West Haven, Connecticut.

Patients:

HCP including physicians, nurses, and ancillary staff.

Methods:

Face-mask compliance was measured through direct observations during a 4-week baseline period after universal masking was mandated. Frontline and management HCP completed semistructured interviews from which a multimodal intervention was developed. Direct observations were repeated during a 14-week period following implementation of the multimodal intervention. Differences between units were evaluated with χ2 testing using the Bonferroni correction. Face-mask compliance between baseline and intervention periods was compared using time-series regression.

Results:

Among 1,561 observations during the baseline period, median weekly face-mask compliance was 82.2% (range, 80.8%–84.4%). Semistructured interviews were performed with 16 HCP. Qualitative analysis informed the development of a multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership. Among 2,651 observations during the intervention period, median weekly face-mask compliance was 92.6% (range, 84.6%–97.9%). There was no difference in weekly face-mask compliance between COVID-19 and non–COVID-19 units. The multimodal intervention was associated with an increase in face-mask compliance (β = 0.023; P = .002).

Conclusions:

Face-mask compliance remained suboptimal among HCP despite a facility-wide mandate for universal masking. A multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership was effective in increasing face-mask compliance among HCP.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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