Fatores associados à adesão e uso de equipamentos de proteção individual entre profissionais vinculados a programas de residência na área da saúde no combate à pandemia de COVID-19

Abstract

The objective was to analyze the factors associated with the use and adherence to PPE by postgraduate professionals linked to residency programs in the health area in the fight against the covid-19 pandemic. This is a cross-sectional study, conducted by the STROBE and CHERRIES guides, carried out in Brazil, from August 2020 to March 2021 with professionals linked to Health Residency Programs. The validated instrument E.P.I. was used for data collection. APS. which was made available on the free KoboToolbox platform. To analyze the use off PPE, the E.P.I. instrument was used APS adapted for residents. Statistical analysis was performed using the Statistical Package for the Social Sciences. The total number of points achieved in each domain of the instrument was considered adequate use of PPE and, to estimate adherence, an individual calculation was carried out per participant (number of domains that showed adequate use/total number of domains answered x 100). The cutoff point that served as a basis to represent adherence to the use of PPE was greater than and/or equal to 75%. For association analysis, the Chi-Square or Fisher's exact tests were used, with significance adopted at p≤0.05. To analyze the prevalences related to the adequate use of PPE and the factors age, area of concentration, length of experience and performance of training activities, the 95% Confidence Interval (95% CI) was used. The research was approved by the Human Research Ethics Committee of the Federal University of Juiz de Fora, under Opinion no. 4,363,912 and financed by the National Council for Scientific and Technological Development (Process no. 401457/2020-6). 227 residents participated in the study. Appropriate use was identified: for hat, 51.5%; apron/coat, 51.5%; and face shield/glasses in 49.1%. There was an association between age and the surgical mask (p=0.04) and glasses/face shield (p=0.05) domains. The area of concentration of the residency program was associated with the appropriate use of a cap (p=0.01) and the appropriate use of a surgical mask (p=(0.02). The time spent in the program was not significant for any domain. Training activities were associated with the appropriate use of N95 masks (p=≤0.001) and surgical masks (p=0.02). Adherence to the appropriate use of PPE ranged from 0 (21.1%) to 67% (3.5%).It is concluded that age, area of concentration of the program and performance of training activities are associated with the appropriate use of PPE. It is noteworthy that no resident adhered to the appropriate use of PPE. Given this evidence, it is recommended to strengthen the topic of biosafety in all health residency programs in Brazil. Furthermore, it is recommended the development and implementation of training on PPE ≥ 75%. for different professional categories, the use of clinical simulations on donning and doffing. Organization of action plans for adherence to PPE and their management. Reinforce the use of standard precautions, aerosols and droplets, establishing an identification flow, evaluating factors that hinder adherence to PPE, as well as maintaining periodic training activities and in accordance with the needs of the moment experienced and carrying out monitoring, evaluation and continuous reassessment of actions.