| Adherence to SP |
Adherence to PP [med] = 4.69
67% of participants stated that they follow PP with all patients, regardless of diagnosis. |
“The implementation of standard precautions constituted the main measure to prevent the transmission of COVID-19 among patients and healthcare professionals and was adopted in care to all patients, minimizing exposure to respiratory pathogens, including COVID-19.” G46, Hospital C – Head of nursing at the Surgical Center
“I think that the pandemic improved our reflection on the importance of standard precautions in our daily work.” G6, Hospital D – Head of the Surgery Unit and Material and Sterilization Center |
| Use of PPE |
Apron: 66% always use it when there is a possibility of getting blood or other secretions on their clothes.
Gloves: 88% always use them when there is a possibility of contact with blood or other secretions.
Protective glasses or face shield: 50% always use them when there is a possibility of blood or other secretions splashing into the eyes.
Mask: 89% always use it when there is a possibility of blood or other secretions splashing into the mouth. |
“The workers, faced with the pandemic, understood the need of using PPE to protect themselves. Obvious protections were not taken seriously during daily activities, by some, before the pandemic”. G32, Hospital B – Occupational Health and Safety Service
“Adherence to the use of PPE is based on a good job at raising awareness. This is now being done. Healthcare professionals are finally wearing PPE without us having to beg for it.” G53, Hospital D – Risk Management Unit
“I have adopted PPE more consciously.” TE48, Hospital A – ICU
“The upside to all this was and is daily learning that came with the pandemic and the reinforcement of existing practices, with a more conscious adoption. For example, PPE. ” E133, Hospital C – Psychiatry |
| Hand hygiene |
75% always washed their hands after removing disposable gloves. |
“The professionals learned to value precautions to protect themselves and patients, trying to prevent outbreaks and, above all, they learned to use PPE. There has never been so much talk about hand hygiene.” G13, Hospital A - Hospital Infection Control Service |
| Care for materials and the environment |
86% considered all materials in contact with saliva from patients to be contaminated. |
“My work environment serves COVID and non-COVID patients, and it is very important for the environment not to be contaminated. We keep an eye on everyone who leaves the room and does not care for the environment.” E123, Hospital C – Hemodynamics |
| Family |
Significant association between adherence to SP and “having children” (p = 0.014). |
“The frightening possibility of contracting it and transmitting it to other people, whether patients, family, and friends, has shaped many attitudes. Daily practices regarding the use of PPE were widely followed.” E156, Hospital A – COVID UNIT |
| Work in the COVID area |
Greater adherence to SP in the COVID area (p < 0.001).
Professionals who worked in the “COVID area” had a perception of fewer “obstacles to following SP” and a better assessment of the “safety climate” and “PPE availability”. |
“It is a place with a greater probability of contracting the disease, but safer in terms of protection, as we protect ourselves more with PPE.” TE15, Hospital A – COVID UNIT
“In the COVID area, employees dress appropriately. However, in the non-COVID area, there is some relaxation in the use of precautionary measures.” G28, Hospital C – Nursing Education Service
“... compliance within the COVID ICU is visibly greater considering the professional’s protection bias.” G9 – Hospital D – Head of the Intensive Care Unit |
| Perception of protection effectiveness |
86% of professionals believe they can reduce the risk of acquiring COVID-19 at work if they follow standard precautions. |
“I believe that healthcare professionals wearing everything correctly have a reduced risk of acquiring the virus at work, we definitely take better care of ourselves.” M92, Hospital B – Pediatrics |
| Risk perception |
6% of participants do not feel exposed to contracting COVID-19 at work.
“Risk perception” is higher among nursing professionals (p < 0.001) and in the group of participants who had symptoms suggestive of COVID-19 (p < 0.001). |
“The pandemic caused fear among professionals, leading many to use PPE appropriately. However, there are moments of denial, in which professionals ignore the indicated protection measures.” G27, Hospital C – Head of the Psychiatric Nursing Service
“It is difficult to understand why some people do not want to accept that the virus is lethal and often do not follow the protection standards.” TE111, Hospital B – Outpatient Unit |
| Obstacles to SP adherence |
24% stated that the accumulation of daily activities frequently interferes with their ability to follow the SP.
Around 20% stated that they cannot get used to using PPE when carrying out some tasks and believe that following the SP makes work more difficult. |
“Face shield distorts the vision and interferes with tracheal intubation.” M47, Hospital C – Surgical Center
“Pressure for agility in service that is not always possible having to follow clothing protocols.” TE48, Hospital A – ICU
“Sometimes it is difficult to equip myself quickly when an emergency that requires speed arises.” M118, Hospital D – Emergency Room
“It is very difficult to hear each other with a mask and face shield. We have to scream and that makes the work much more exhausting.” M48, Hospital C – ICU |
| Workload |
A total of 35% of the participants stated that there is always much work to be done.
Physicians had a greater perception of “workload” compared to nursing professionals (p = 0.002). |
“In relation specifically to the hospital, having to perform activities that in other institutions are nursing responsibilities (such as collecting nasopharyngeal swab, ECG, measuring vital signs of patients with respiratory symptoms), which makes work even more exhausting.” M4, Hospital D – Emergency Room |
| Safety climate |
Safety climate was the scale with lowest score (Md = 3.83).
68% completely agree that they have support from their supervisor to follow the SP.
16% completely agree that in their institution senior management is personally involved in security activities.
Hospital C had the best “safety climate” assessment (4.17) and Hospital D had the worst (3.25) (p < 0.001).
Physicians (p = 0.009) and CLT professionals (p < 0.001) had a better assessment of this item. |
“A bit flawed on the part of managers, who DO NOT work in care and have a slightly distorted perception of work routines.” TE80, Hospital D – ICU
“I realize that the institution just wants ‘labor’, it is not truly concerned with the employee’s (physical and mental) health.” TE20, Hospital D – COVID UNIT
“I feel the Hospital is very committed to the safety of all its professionals. It meets all our protective needs.” E102, Hospital C - General Ward
“Since the pandemic started, we all received orientation from the management. And this made us very confident to deal with all situations in the face of the pandemic.” TE84, Hospital C - ICU
“Effective, correct guidelines. The managers collaborated with the team, questioning what the best evidence for team safety was.” TE146, Hospital C – COVID UNIT
“When the pandemic began, support from the institution was focused on intensive care units, as if it were the only means of transmission. I did not feel safe. Afterwards, with the emergence of cases and contamination in the units, the processes improved.” E133, Hospital C – Psychiatry |
| PPE availability |
48% of all participants stated that their work unit has all the necessary equipment and material to protect against COVID-19.
Physicians (p = 0.04) had a more positive perception of “PPE availability”. |
“...when the pandemic began, the correct number of PPE was not available for the entire team and N95 masks were initially being dispensed only for medical, physiotherapy, and nursing teams, and not for nursing technicians, which caused discomfort...” E2, Hospital A – Surgical Center
“I think everything possible was done. Sometimes we have PPE of questionable quality, such as disposable aprons, but there was never a lack of material, which I consider an achievement worth highlighting.” M91, Hospital B – ICU |
| Biosafety training/qualification |
Having received biosafety guidance/training with a focus on preventing transmission of the new coronavirus was associated with higher levels of adherence to SP (p = 0.018). |
“There was greater concern for obtaining knowledge and searching for suitable material.” G11, Hospital D – Hospital Infection Control Service
“What we have in a positive way are enlightening live streams regarding the subject.” E16, Hospital A – Outpatient Ward |
