Personal protective equipment simulation training is associated with lower COVID-19 infection among healthcare workers

ABSTRACT Objective To describe the personal protective equipment training strategies during the beginning of the pandemic and to investigate the association between training and COVID-19 infection among healthcare workers. Methods This cross-sectional study conducted between March and May 2020 included 7,142 healthcare professionals who were eligible for both online and face-to-face simulation-based training on personal protective equipment use. Simulation training attendance was assessed by reviewing the attendance list, and the COVID-19 sick leave records recovered from the institutional RT-PCR database used to grant sick leave. The association between personal protective equipment training and COVID-19 was investigated using logistic regression, adjusted for sociodemographic and occupational characteristics. Results The mean age was 36.9 years (± 8.3), and 72.6% of participants were female. A total of 5,502 (77.0%) professionals were trained: 3,012 (54.7%) through online training, 691 (12.6%) through face-to-face training, and 1,799 (32.7%) through both strategies. During the study period, 584 (8.2%) COVID-19 cases were diagnosed among these professionals. The number of positive RT-PCR tests was 180 (11.0%) for untrained professionals, 245 (8.1%) for those trained only online, 35 (5.1%) for those trained face-to-face, and 124 (6.9%) for those trained with both strategies (p<0.001). Participants who received face-to-face training had a 0.43 lower risk of contracting COVID-19. Conclusion Personal protective equipment training decreased the odds of COVID-19 among healthcare professionals, with face-to-face simulation-based training being most effective.

【摘要】
研究目的：旨在描述新冠疫情初期的个人防护装备（personal protective equipment）培训策略，并探讨医护人员接受该培训与新型冠状病毒肺炎（COVID-19）感染之间的关联。
研究方法：本横断面研究于2020年3月至5月期间开展，共纳入7142名符合纳入标准的医护人员，所有对象均可参与个人防护装备使用的线上及线下模拟实操培训。通过核查培训签到表评估模拟培训的参与情况，并从用于审批病假的机构实时荧光定量反转录聚合酶链反应（RT-PCR）数据库中调取新冠病毒感染相关病假记录。采用logistic回归分析探讨个人防护装备培训与新冠感染之间的关联，并对社会人口学特征及职业特征进行校正。
研究结果：本研究纳入对象的平均年龄为36.9岁（±8.3），其中72.6%为女性。总计5502名（77.0%）医护人员接受了培训：其中3012名（54.7%）仅参与线上培训，691名（12.6%）仅参与线下培训，1799名（32.7%）同时接受了两种培训方式。研究期间，共有584名（8.2%）医护人员被诊断为新型冠状病毒肺炎。未接受培训的医护人员中RT-PCR检测阳性率为11.0%（共180例），仅接受线上培训者为8.1%（共245例），仅接受线下培训者为5.1%（共35例），接受两种培训方式者为6.9%（共124例），组间差异具有统计学意义（p<0.001）。仅接受线下模拟培训的医护人员感染新冠的风险较未接受培训者降低43%。
研究结论：个人防护装备培训可降低医护人员感染新型冠状病毒肺炎的概率，其中线下模拟实操培训的防护效果最为显著。