Adherence to safety precautions in the operation theatre among anaesthesiologists in the COVID era

Background and Aims: The COVID-19 pandemic led to significant infections among healthcare workers and deaths warranting the need for personal protective equipment. This study aimed to estimate the proportion of anaesthesiologists adhering to safety precautions and to evaluate their adherence patterns, difficulties faced and coping mechanisms in the operation theatre during the pandemic. Methods: This was a multicentric mixed methods study conducted among anaesthesiologists from two tertiary care hospitals. A paper-based questionnaire was given to all participants. The first part consisted of 21 questions regarding safety measures and extent of adherence. The second part was a response sheet regarding the various difficulties faced and coping mechanisms adopted. Following this, an in-depth interview was conducted to understand the same. The proportion of anaesthesiologists in different categories of adherence, patterns of adherence, difficulties faced, and coping mechanisms were computed and compared. Thematic framework analysis was done for in-depth interview. Results: Sixty participants were included. The adherence levels for N95 masks and face shields were higher. Most participants practised frequent handwashing and took showers after work. Fogging, difficulty in communication, marks on the face were the commonly faced difficulties. Self reassurance, adjusting the fit of masks/face shields, or taking breaks were the coping mechanisms mostly followed. Themes generated from in-depth interview include waning of caution, adaptation through innovative methods and stress due to uncertainty. Conclusion: The N95 mask was the most preferred safety precaution. Ease of use and safety were important considerations for adherence. Physical and mental acclimatisation and improved knowledge of disease played a vital role.