Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is one of the worst flu pandemic in human history. The WHO declared pandemic has spread across all continents and sickened a large number of people.

Containment of this disease has been a major problem despite the numerous protocols advanced by various regulatory bodies. These guidelines and protocols include those by the WHO, Centres for Disease Control, ICMR, International Labour Organization, and European Agency for Safety and Health to prevent infections among healthcare and non- health care workers [ 1].

These guidelines includes wearing of face masks, maintaining social distancing, hand hygiene using sanitizer, vaccination, following travel advisories, case notification and management. Among the critical components of infection and prevention control (IPC) during the management of COVID-19 is the mandatory use of PPE by healthcare workers (HCWs) [ 2].

In the health care setting, personal protective equipment is mainly used to protect the health care personnel from the exposure of pathogens especially Health Care Acquired Infections (HAIs). The use of PPE is essential in Infection Control (IC) [ 3].

With the emergence of the new global pandemic, healthcare workers often find it difficult to use PPE, especially in summer seasons and in areas where air conditioners are unavailable or shut down due to fear of spread of infection [ 4]^,. The investigators had witnessed the challenges and benefits of using PPE during COVID 19 pandemic. Nurses, as being the frontline warriors of COVID 19 have also shared the difficulties experienced by PPE use in current crisis situation. There were reports that many hospital authorities have discriminatory approaches towards nurses, denying them PPE to shield themselves from the deadly pandemic. Hence the investigators felt the need of conducting the study on perceptions of nursing personnel regarding challenges in PPE usage.

A study to assess the perceptions of nursing personnel regarding challenges in usage of PPE during COVID 19 pandemic in hospitals, India.

Identify the perceptions of nursing personnel on usage of PPE.

Find out the association between physical symptoms of nursing personnel owing to usage of PPE during COVID 19 pandemic & their selected personal variables.

There is significant association between severity of physical symptoms owing to PPE usage & selected personal variables of nursing personnel at 0.05 level of significance.

The study used a descriptive survey design to assess the perceptions on challenges in the usage of PPE among nursing personnel. The study population consists of nursing personnel working in Government and private Hospitals, who had used PPE in the care of COVID 19 patients. The data collection tool consisted of personal data sheet, three point rating scale to measure the perceptions of nursing personnel on usage of PPE during COVID 19 pandemic and Check list to measure the physical symptoms experienced by nursing personnel owing to PPE. The tools were converted into “Google forms”and data collection was done by web based methods. A total of 134 participants were included in the study. Electronic consent was obtained for the consenting process. The period of data collection was from April to June 2021.

Frequency and percentage distribution of demographic variables were analysed. Among the nursing personnel under study, 88(65.7%) were in the age group of 21 to 30 years, 112 (83.6%) were females, most 115(85.5%) of them were staff nurses, more than half 56(41.8%) of them were working in wards. Out of the sample, 85(63.4%) nursing personnel were working in government sector and 82(61.2%) had more than 5 years’ experience.

Table 1 depicts the frequency and percentage distribution of perceptions on challenges regarding PPE usage it includes challenges related to personal needs, patient care and administration.

Table 2 shows that the most important challanges encountered by the nursing personnel regarding PPE usage were: difficulty in meeting basic needs such as food and fluids, difficulty in elimination needs, inability to relax, difficulty to meet hygienic needs and feeling disconnected with friends and family during working hours.

Table 3 reveals the physical symptoms experienced by the nursing personnel while using PPE. The most common physical symptoms reported by nurses were; heat stress 124(92.5%), head ache120(89.6%), exhaustion 117(87.3%), dryness in throat 116(86.6%) and excessive thirst 115(85.8%).

TheTable table 4 explicit that the nursing personnel 41(30.6%) had mild symptoms, 54(40.3%) had moderate symptoms and 39(29.1%) had severe symptoms experienced owing to PPE usage.

There were no significant association between physical symptoms of nursing personnel and selected personal variables at 0.05 level of significance. Hence null hypothesis was accepted and research hypothesis was rejected.

Nurses play a key role in the containment of Covid 19 pandemic. The use of personal protective equipment protects them from the greater risks of the ongoing pandemic. The most common challenges experienced by the nurses were; difficulty to meet basic needs such as food and fluids, elimination needs, hygienic needs. Majority of the nurses reported that they are not able to relax. Other perceived challenges reported were; feeling disconnected with friends and family during working hours and difficulty in the application of therapeutic touch in patient care. The common physical symptoms reported by nurses were; heat stress 124(92.5%), head ache120 (89.6%), exhaustion 117(87.3%) dryness in throat (86.6%) and excessive thirst 115(85.5).

Results of the present study were consistent with a cross-sectional study conducted among 150 frontline nurses in ICUs of COVID hospital [ 5], North India. The most common adverse health effects expressed by them were headache (73.4%), extreme sweating (59.6%), and difficulty in breathing (36.7%); 91.7% complained about the fogging of the goggle. Majority of frontline nurses expressed nasal bridge scarring (76.64%) and indentation and pain on the back of the ears (66.42%) as the adverse skin reactions after wearing N95 masks. The common skin problems identified due to double gloving of latex gloves were excessive skin soakage with sweat (70.07%) and skin chapping (19%). Heat and moisture generated inside the PPE after the prolonged period make nurses more dis-comfortable, with sweating profusely, restlessness, headache, weakness, and giddiness [ 6].