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Anaesthetists' current practice and perceptions of aerosol-generating procedures: a mixed-methods study
Anaesthesia ( IF 10.7 ) Pub Date : 2022-07-21 , DOI: 10.1111/anae.15803
A J Shrimpton 1 , C E D Osborne 1 , J M Brown 2 , T M Cook 3 , C Penfold 4 , L Rooshenas 5 , A E Pickering 1
Affiliation  

The evidence base surrounding the transmission risk of ‘aerosol-generating procedures’ has evolved primarily through quantification of aerosol concentrations during clinical practice. Consequently, infection prevention and control guidelines are undergoing continual reassessment. This mixed-methods study aimed to explore the perceptions of practicing anaesthetists regarding aerosol-generating procedures. An online survey was distributed to the Membership Engagement Group of the Royal College of Anaesthetists during November 2021. The survey included five clinical scenarios to identify the personal approach of respondents to precautions, their hospital's policies and the associated impact on healthcare provision. A purposive sample was selected for interviews to explore the reasoning behind their perceptions and behaviours in greater depth. A total of 333 survey responses were analysed quantitatively. Transcripts from 18 interviews were coded and analysed thematically. The sample was broadly representative of the UK anaesthetic workforce. Most respondents and their hospitals were aware of, supported and adhered to UK guidance. However, there were examples of substantial divergence from these guidelines at both individual and hospital level. For example, 40 (12%) requested respiratory protective equipment and 63 (20%) worked in hospitals that required it to be worn whilst performing tracheal intubation in SARS-CoV-2 negative patients. Additionally, 173 (52%) wore respiratory protective equipment whilst inserting supraglottic airway devices. Regarding the use of respiratory protective equipment and fallow times in the operating theatre: 305 (92%) perceived reduced efficiency; 376 (83%) perceived a negative impact on teamworking; 201 (64%) were worried about environmental impact; and 255 (77%) reported significant problems with communication. However, 269 (63%) felt the negative impacts of respiratory protection equipment were appropriately balanced against the risks of SARS-CoV-2 transmission. Attitudes were polarised about the prospect of moving away from using respiratory protective equipment. Participants' perceived risk from COVID-19 correlated with concern regarding stepdown (Spearman's test, R = 0.36, p < 0.001). Attitudes towards aerosol-generating procedures and the need for respiratory protective equipment are evolving and this information can be used to inform strategies to facilitate successful adoption of revised guidelines.

中文翻译:

麻醉师目前的实践和对气溶胶生成程序的看法:一项混合方法研究

围绕“产生气溶胶的程序”的传播风险的证据基础主要是通过临床实践中气溶胶浓度的量化而发展起来的。因此,感染预防和控制指南正在不断重新评估。这项混合方法研究旨在探讨执业麻醉师对气溶胶生成程序的看法。2021 年 11 月,向皇家麻醉师学院的会员参与小组分发了一项在线调查。该调查包括五个临床场景,以确定受访者的个人预防措施、他们医院的政策以及对医疗保健提供的相关影响。选择了一个有目的的样本进行访谈,以更深入地探索他们的看法和行为背后的原因。对总共 333 份调查答复进行了定量分析。对 18 份访谈的文字记录进行了编码和主题分析。该样本广泛代表了英国麻醉师队伍。大多数受访者和他们的医院都知道、支持并遵守英国指南。然而,在个人和医院层面上都存在与这些指南存在重大差异的例子。例如,40 人(12%)要求呼吸防护设备,63 人(20%)在要求在对 SARS-CoV-2 阴性患者进行气管插管时佩戴呼吸防护设备的医院工作。此外,173 人 (52%) 在插入声门上气道装置时佩戴了呼吸防护设备。关于手术室呼吸防护设备的使用和休息时间:305 (92%) 认为效率降低;376 (83%) 认为对团队合作有负面影响;201 (64%) 担心环境影响;255 人 (77%) 报告了严重的沟通问题。然而,269 人 (63%) 认为呼吸防护设备的负面影响与 SARS-CoV-2 传播的风险相平衡。对于不再使用呼吸防护设备的前景,人们的态度两极分化。参与者对 COVID-19 的感知风险与对降级的担忧相关(Spearman 检验,R = 0.36,p < 0.001)。人们对产生气溶胶的程序的态度和对呼吸防护设备的需求正在发生变化,这些信息可用于为策略提供信息,以促进成功采用修订后的指南。201 (64%) 担心环境影响;255 人 (77%) 报告了严重的沟通问题。然而,269 人 (63%) 认为呼吸防护设备的负面影响与 SARS-CoV-2 传播的风险相平衡。对于不再使用呼吸防护设备的前景,人们的态度两极分化。参与者对 COVID-19 的感知风险与对降级的担忧相关(Spearman 检验,R = 0.36,p < 0.001)。人们对产生气溶胶的程序的态度和对呼吸防护设备的需求正在发生变化,这些信息可用于为策略提供信息,以促进成功采用修订后的指南。201 (64%) 担心环境影响;255 人 (77%) 报告了严重的沟通问题。然而,269 人 (63%) 认为呼吸防护设备的负面影响与 SARS-CoV-2 传播的风险相平衡。对于不再使用呼吸防护设备的前景,人们的态度两极分化。参与者对 COVID-19 的感知风险与对降级的担忧相关(Spearman 检验,R = 0.36,p < 0.001)。人们对产生气溶胶的程序的态度和对呼吸防护设备的需求正在发生变化,这些信息可用于为策略提供信息,以促进成功采用修订后的指南。269 人 (63%) 认为呼吸防护设备的负面影响与 SARS-CoV-2 传播的风险相平衡。对于不再使用呼吸防护设备的前景,人们的态度两极分化。参与者对 COVID-19 的感知风险与对降级的担忧相关(Spearman 检验,R = 0.36,p < 0.001)。人们对产生气溶胶的程序的态度和对呼吸防护设备的需求正在发生变化,这些信息可用于为策略提供信息,以促进成功采用修订后的指南。269 人 (63%) 认为呼吸防护设备的负面影响与 SARS-CoV-2 传播的风险相平衡。对于不再使用呼吸防护设备的前景,人们的态度两极分化。参与者对 COVID-19 的感知风险与对降级的担忧相关(Spearman 检验,R = 0.36,p < 0.001)。人们对产生气溶胶的程序的态度和对呼吸防护设备的需求正在发生变化,这些信息可用于为策略提供信息,以促进成功采用修订后的指南。对 COVID-19 的感知风险与对降级的担忧相关(Spearman 检验,R = 0.36,p < 0.001)。人们对产生气溶胶的程序的态度和对呼吸防护设备的需求正在发生变化,这些信息可用于为策略提供信息,以促进成功采用修订后的指南。对 COVID-19 的感知风险与对降级的担忧相关(Spearman 检验,R = 0.36,p < 0.001)。人们对产生气溶胶的程序的态度和对呼吸防护设备的需求正在发生变化,这些信息可用于为策略提供信息,以促进成功采用修订后的指南。
更新日期:2022-07-21
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