Adherence to Personal Protective Equipment Use in Home-Care Service Agencies During COVID-19 in Japan: A Cross-Sectional Survey

Noriko Morioka; Masayo Kashiwagi; Jun Hamano

doi:10.1016/j.jamda.2022.02.012

Adherence to Personal Protective Equipment Use in Home-Care Service Agencies During COVID-19 in Japan: A Cross-Sectional Survey

J Am Med Dir Assoc. 2022 Jun;23(6):930-935.e2. doi: 10.1016/j.jamda.2022.02.012. Epub 2022 Feb 28.

Authors

Noriko Morioka¹, Masayo Kashiwagi², Jun Hamano³

Affiliations

¹ Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: morioka.gh@tmd.ac.jp.
² Tokyo Medical and Dental University, Tokyo, Japan.
³ University of Tsukuba, Ibaraki, Japan.

Abstract

Objectives: To assess adherence to personal protective equipment (PPE) use among home care workers during usual care at the agency level during the COVID-19 pandemic in Japan and determine whether agency-level action toward infection prevention and control (IPC) is associated with adherence to PPE use.

Design: A nationwide cross-sectional study.

Setting and participants: Home care service agencies in Japan were randomly selected from all agencies nationwide.

Methods: An online survey was conducted between January and February 2021. The administrators at home care service agencies responded to the following items: adherence to PPE (disposable masks, gloves, and aprons) use during diaper change among their home care workers, agency-level actions toward IPC, including monitoring of infection outbreak among users, existing manual for IPC, training opportunities on IPC for care workers, and other agency and administrator characteristics.

Results: Of the 1942 agencies, 197 were included in the analysis (response rate: 10.1%). Although 145 (73.6%) of the agencies always used both masks and gloves during diaper change, 32 (16.2%) agencies fully adhered to wearing masks, gloves, and aprons. Agencies monitoring infectious disease outbreaks among service users were more likely to adhere to PPE use (adjusted odds ratio: 5.97, 95% confidence interval: 1.30-27.31).

Conclusions and implications: Low adherence to PPE use, especially apron use, during diaper change among home care service agencies during the COVID-19 pandemic in Japan was revealed, despite the widespread availability of a manual for IPC and/or training opportunities. To ensure safety and quality home care services for both users and home care workers, agencies should not simply create manuals or training systems as a structure; instead, they should implement effective processes for appropriate PPE use.

Keywords: Infection prevention and control; home-care aide; home-care service; personal protective equipment.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / prevention & control
Cross-Sectional Studies
Health Personnel
Home Care Services*
Humans
Japan / epidemiology
Pandemics / prevention & control
Personal Protective Equipment