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Anaesthetists' current practice and perceptions of aerosol-generating procedures: a mixed-methods study.
Shrimpton, A J; Osborne, C E D; Brown, J M; Cook, T M; Penfold, C; Rooshenas, L; Pickering, A E.
  • Shrimpton AJ; Anaesthesia, Pain and Critical Care Sciences, School of Physiology, Pharmacology and Neuroscience, University of Bristol, UK.
  • Osborne CED; Anaesthesia, Pain and Critical Care Sciences, School of Physiology, Pharmacology and Neuroscience, University of Bristol, UK.
  • Brown JM; Department of Anaesthesia and Intensive Care Medicine, North Bristol NHS Trust, Bristol, UK.
  • Cook TM; Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital NHS Trust, Bath, UK.
  • Penfold C; NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, UK.
  • Rooshenas L; Bristol Medical School, Bristol Population Health Science Institute, University of Bristol, UK.
  • Pickering AE; Anaesthesia, Pain and Critical Care Sciences, School of Physiology, Pharmacology and Neuroscience, University of Bristol, UK.
Anaesthesia ; 77(9): 959-970, 2022 09.
Article in English | MEDLINE | ID: covidwho-1948977
ABSTRACT
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Personal Protective Equipment / COVID-19 Type of study: Clinical Practice Guide Limits: Humans Language: English Journal: Anaesthesia Year: 2022 Document Type: Article Affiliation country: Anae.15803

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Personal Protective Equipment / COVID-19 Type of study: Clinical Practice Guide Limits: Humans Language: English Journal: Anaesthesia Year: 2022 Document Type: Article Affiliation country: Anae.15803