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 Table of Contents  
PAPERS PRESENTED AT THE XVII ANNUAL CONFERENCE OF HOSPITAL INFECTION
Year : 2021  |  Volume : 9  |  Issue : 3  |  Page : 91-94

Knowledge and practices of health-care workers regarding face mask in hospital


Department of Infection Control, U.N Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India

Date of Submission16-Apr-2022
Date of Acceptance01-May-2022
Date of Web Publication22-Jul-2022

Correspondence Address:
Dr. Rupali Patil
B 301, Signor Sky, Ghodasar, Ahmedabad, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpsic.jpsic_12_22

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  Abstract 


Aim and Objective: The aim of the study is to know the knowledge and practices of health-care workers regarding surgical face mask.
Materials and Methods: This is a cross-sectional study. Mask plays a pivot role in the protection of health-care workers (HCWs) from acquiring respiratory infections, special during coronavirus-2019 outbreak. A self-constructed questionnaire that contains 10 question and answer (Q/A) regarding surgical face mask. These Q/A are for knowledge assessment of staff. We also conduct an observational survey which includes 6 points about practices of HCWs regarding face mask. The strata of personnel were included doctors, nurses, paramedical and others staff. Questions related to knowledge were in the form of multiple-choice questions with one correct answer. The knowledge–practices score was turn converted into percentage before the analysis of results – >80% score for good, 60%–80% moderate and <60% poor level knowledge.
Results: Completed questionnaires were sent for statistical analysis. In our study, totally 109 HCWs were participated. In which (12) 11% doctors, (76) 70% nursing staff, (21) 19% paramedical staff covered. Out of which 95 (87%) were female and 14 (13%) were male. Most staff had work experience of 2–5 years. 74% staff were younger less than 30 years. Around 63% of participants knew about correct way of wearing a surgical face mask, 90% knew that there were 3 layers, 62% knew middle layer act as barrier, 64% knew the maximum duration of wearing it, 75% knew that cloth mask was not as effective as surgical mask. 88% knew that surgical mask can be reused. 87% knew surgical face mask discarded in yellow bag. 97% knew metal strip to fit nose. Majority 95% believe that mask is required in this situation. In practices, we observed 71% staff worn surgical mask, out of which 84% staff worn it correct way blue front. 9% staff worn filtering face piece type of mask, 20% staff worn cloth mask. 15% staff nose was not covered, 2.8% staff mouth was not covered, 28% staff metal strip was not pressed/fitted and 25% staff not tied their mask properly. During observation, three staff touched the front surface of mask.
Conclusion: Knowledge and practices of HCWs regarding the use of surgical face mask were found to be good-to-moderate level.

Keywords: COVID-19, face mask, practices of health-care workers


How to cite this article:
Maradia M, Patil R, Gajjar S. Knowledge and practices of health-care workers regarding face mask in hospital. J Patient Saf Infect Control 2021;9:91-4

How to cite this URL:
Maradia M, Patil R, Gajjar S. Knowledge and practices of health-care workers regarding face mask in hospital. J Patient Saf Infect Control [serial online] 2021 [cited 2022 Aug 18];9:91-4. Available from: https://www.jpsiconline.com/text.asp?2021/9/3/91/351731


  Introduction Top


Surgical masks are widely used in health-care setting. Respirators are also used in health-care setting. It is important that employers and workers understand the differences between them. A surgical mask is primarily used to protect patients and health-care workers (HCWs) from people who may have a respiratory infection or to protect sterilised or disinfected medical devices and supplies. Surgical mask have three layers as you can see in [Figure 1].
Figure 1: Surgical face mask with layers

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Wearing face mask may limit exposure to respiratory droplets and large particles and may help prevent those who have COVID-19 from spreading the virus. According to the report of Centers for Disease Control and Prevention (CDC) reports that HCWs account for at least 11% of reported severe acute respiratory syndrome coronavirus 2 infections.[1],[2]

COVID-19 is an ongoing pandemic for which appropriate infection prevention and control measures need to be adopted. HCWs' adherence to prevention and control measures is affected by their knowledge, attitudes and practices (KAP) towards mask during COVID-19 even during body fluid exposure in hospital.[3]

The World Health Organization (WHO) states that incorrect use and disposal of this mask may actually increase the rate of transmission.[4] If you wear a mask, then you must know how to use it and discard it properly. Identifying knowledge and practices regarding face mask are very important to identify gaps and intervene them to control the spread of infection. For which appropriate infection prevention and control measures need to be adopted.[5] HCWs' adherence to prevention and control measures is affected by their KAP towards COVID-19. In this study, we assessed the KAP among HCWs towards the COVID-19 during the ongoing pandemic.

Aim and objective

The aim of the study is to know the knowledge and practices of HCWs regarding surgical face mask especially during COVID-19 pandemic.


  Materials and Methods Top


This is cross-sectional study. The study was conduct in the month of June 2021 in clinical area of tertiary care hospital, Ahmedabad, Gujarat.

Study design and setting

A self-constructed questionnaire which contains 10 question and answer (Q/A) regarding surgical face mask. Questions were made according to WHO and CDC guideline for correct use of face mask.[3] These Q/A are for knowledge assessment of staff. We also conduct observational survey which includes 8 points about practices of HCWs regarding face mask. The strata of personnel were included doctors, nurses, paramedical and others staff. Question related to knowledge was in the form of multiple-choice questions with one correct answer.

Data collection and management

We distribute a hard copy of knowledge assessment form in differ clinical area. For their practices, we audit 8 points related to face mask at that time. The knowledge–practices score was turn converted into percentage before analysis of results. The knowledge–practices score was turn converted into percentage before analysis of results – >80% score for good, 60%–80% moderate and <60% poor level knowledge.

Inclusion and exclusion criteria

The study included health-care workers who were willing to give informed consent and was available at the time of the study.


  Results Top


Completed questionnaires were sent for statistical analysis. In this study, totally 109 HCWs were participated in which (12) 11% doctors, (76) 70% nursing staff and (21) 19% paramedical staff covered.

As shown in [Figure 2], out of 109 staff, 95 (87%) were female and 14 (13%) were male. Most staff had work experience of 2–5 years. 74% staff were younger less than 30 years.
Figure 2: HCW participate in survey. HCW: Healthcare workers

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As shown in [Table 1], around 63% of participants knew about correct way of wearing surgical face mask, 90% knew that there were 3 layers, 62% knew middle layer act as barrier, 64% knew the maximum duration of wearing it, 75% knew that cloth mask was not as effective as surgical mask. 88% knew that surgical mask can be reused. 87% knew surgical face mask discarded in yellow bag. 97% knew metal strip to fit nose. Majority 95% believe that mask is required in this situation.
Table 1: Knowledge assessment for correct use of face mask by health-care worker

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As shown in [Table 2], in practices, we observed 71% staff worn surgical mask, out of which 84% staff worn it correct way blue front. 9% staff worn filtering face-piece type of mask, 20% staff worn cloth mask. 15% staff nose was not covered, 2.8% staff mouth was not covered, 28% staff metal strip was not pressed/fitted and 25% staff not tied their mask properly. During observation, three staffs touched front surface of mask.
Table 2: Practice assessment for correct use of face mask by health-care workers

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  Discussion Top


Face masks are essential personal protective equipment in health-care setting which protect HCW and patients from transmission of infection. Face mask used as a protective barrier to reduce the risk of transmission of microorganisms between patients, HCWs and the environment.[6] Knowledge and practices about the use of face mask are essential for health-care provider. In this study, 69% of participants HCW were wearing a proper surgical face mask [Figure 3]; and 80% obtained a good score by answering the questions correctly. In the study, Seid Yimer and Gebrehana Belay, Ethopia in 2021, knowledge and practice of health-care providers regarding proper face mask utilisation were 65.8% and 59.5%, respectively.[7] In our study, 90% HCWs knew that surgical face masks have three layers and worn for up to 8 h. (In study Seid Yimer and Gebrehana Belay, Ethopia, respectively 62.6% and 78.4%). These results may be because of continuous training regarding face mask given to HCW during COVID-19. In this study, there was higher nursing staff participant (76) 70%. As in our institute, major working force is nurses. This attributes higher female staff in our institute. In this study, 95 (87%) were female and 14 (13%) were male. Most staff had work experience of 2–5 years. 74% staff were younger less than 30 years.
Figure 3: Overall practices of face mask by HCWs. HCWs: Healthcare workers

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Thirty-one per cent of participants obtained an overall moderate-to-poor score regarding the correct usage of a surgical face mask. The correct way to wear a surgical mask is by wearing the coloured side facing out which is independent of your health status. The outer blue-coloured layer is hydrophobic or is a fluid-repelling layer, and its main function is to prevent micro-organisms from sticking to it, whereas the white inner one is a hydrophilic layer that absorbs moisture from we breathe out. If you wear it the other way round, the moisture from the air will stick onto it, thus making it easier for germs to stay there. There is a middle layer that actually filters the micro-organism.[8]

Cloth mask were commonly used by HCWs in hospital before COVID-19 pandemic. Though always surgical mask are worn by HCWs before surgical asepsis. In this study, around 75% HCWs agreed that cloth mask is not as effective as a regular surgical mask which was comparable with study Kumar et al. in 2020.[9] 88% HCWs knew that surgical face mask cannot be re-used. 88% knew the correct maximum duration of using it. Other studies like Kumar et al. in 2020[9] also highlighted similar findings concluding that cloth mask, re-use and extended use of mask makes it ineffective.

The WHO established a colour-coded bin system for proper disposal of biomedical waste in hospitals.[10] In our study, 87% proper discarding of mask knew by HCW which was good compare to other studies.


  Conclusion Top


Knowledge and practices of HCWs regarding use of surgical face mask were found to be good-to-moderate level. In addition to using the appropriate mask, frequent hand hygiene and respiratory hygiene should always be performed. PPE should be discarded in an appropriate waste container after use. Always maintain standard precaution in hospital.

Acknowledgement

We would like to thank all the HCWs for their voluntary participation in the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Face Mask, Including Surgical Mask, and Respirators for COVID. Available from: https://www.fda.gov/medicaldevices. [Last accessed on 2021 Sep 15].  Back to cited text no. 1
    
2.
CDC COVID-19 Response Team. Characteristics of health care personnel with COVID-19 United States, February 12-April 9, 2020. MMWR Morb Mortal Wkly Rep 2020;69:477-81.  Back to cited text no. 2
    
3.
World Health Organization. Rational use of Personal Protective Equipment (PPE) for Coronavirus Disease (COVID-19): Interim Guidance; 2020. Available from: https://apps.who.int/iris/handle/10665/331498. [Last accessed on 2020 Jul 06].  Back to cited text no. 3
    
4.
Kiani MA, Bahreyni Toosi SMH, Badiei Aval S, Gholian-Avval M, Zakerian M, Hoseini SJ, et al. Is home Care a Successful Strategy in COVID-19? A Valuable Experience from Iran. International Journal of Pediatrics, 2021;9:12843-54.  Back to cited text no. 4
    
5.
Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis. Journal of Hospital Infection, 2021;108:120-34.  Back to cited text no. 5
    
6.
Honarbakhsh M, Jahangiri M, Ghaem H. Knowledge, perceptions and practices of healthcare workers regarding the use of respiratory protection equipment at Iran hospitals. J Infect Prev 2018;19:29-36.  Back to cited text no. 6
    
7.
Seid Yimer T, Gebrehana Belay H. Knowledge and practice of health care providers towards proper face mask utilization to minimize the extent of COVID-19 infection in amhara region referral hospitals, Ethiopia. J Multidiscip Healthc 2021;14:1583-91.  Back to cited text no. 7
    
8.
Show Your Colours: Only One Way to Wear Surgical Masks Correctly, with the Coloured Side Out; 2020. Available from: https://www.thestar.com.my/news/nation/2020/01/28/show-your-colours-only-one-way-to-wear-surgical-masks-correctly-wit. [Last accessed on 2020 Feb 23].  Back to cited text no. 8
    
9.
Kumar J, Katto MS, Siddiqui AA, Sahito B, Jamil M, Rasheed N, et al. Knowledge, attitude, and practices of healthcare workers regarding the use of face mask to limit the spread of the new coronavirus disease (COVID-19). Cureus 2020;12:e7737.  Back to cited text no. 9
    
10.
Chartier Y, Emmanuel J, Pieper U, Prüss A, Rushbrook P, Stringer R, et al. Safe management of wastes from health-care activities. Safe management of wastes from health-care activities., (Ed. 2) 2014.  Back to cited text no. 10
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2]



 

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