• Molly Harrod, Lauren E Weston, Lynn Gregory, Laura Petersen, Jeanmarie Mayer, Frank A Drews, and Sarah L Krein.
• VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI. Electronic address: Molly.Harrod@va.gov.
• Am J Infect Control. 2020 Apr 1; 48 (4): 410-415.

BackgroundHealth care personnel (HCP) use of personal protective equipment (PPE) reduces infectious disease transmission. However, PPE compliance remains low. The objective of this study was to better understand how HCP perceptions factor into PPE decision making as well as how organizational processes and the environment impact behavior.MethodsThis qualitative study used observation and focus groups at 2 medical centers. Data were analyzed using thematic analysis.ResultsThe decision to use PPE and to follow precaution practices was influenced by risk perception as well as organizational and environmental factors. Perceived risk, related to certain organisms and work tasks, was considered by HCP when deciding to use PPE. Organizational processes, such as policies that were not applied uniformly, and environmental factors, such as clean versus contaminated space, also played a role in HCP PPE use.DiscussionBecause HCP seemed focused on organisms and work tasks, education on specific organisms and helping HCP think through their workflow may be more effective in conveying the importance of PPE in reducing transmission. Additionally, isolation practices should be compared across disciplines to ensure they complement, rather than contradict, one another. Assessment of the environment may help protect HCP and patients from infectious organisms.ConclusionPreventing the spread of infectious organisms should not depend solely on PPE use, but should also be recognized as an organizational responsibility.Published by Elsevier Inc.

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