Practices and Perceptions of Face Mask Use in a Pediatric Health System During the COVID-19 Pandemic

• Published in: Respiratory care Vol. 66; no. 7; pp. 1096 - 1104
• Main Authors: Willis, L Denise, Lovenstein, Austin, Spray, Beverly J, Honeycutt, Michele, Walden, Marlene
• Format: Journal Article
• Language: English
• Published: United States Daedalus Enterprises, Inc 01-07-2021; Daedalus Enterprises Inc
• Subjects: Care and treatment; Child; Children; COVID-19; Epidemics; Health aspects; Health care industry; Humans; Hygiene; Masks; Original Research; Pandemics; Patients; Pediatrics; Perception; SARS-CoV-2; United States; United States; COVID-19; face mask; SARS-CoV-2; personal protective equipment; hospital staff; coronavirus; survey; face covering; universal masking; pediatric
• ISSN: 0020-1324; 1943-3654
• DOI: 10.4187/respcare.08944

Face coverings are recommended to help mitigate the spread of COVID-19. Guidelines regarding face mask use have evolved from the time when COVID-19 first emerged. Practices for face mask use in the United States vary widely.
Clinical and nonclinical staff from a pediatric health care system were invited to complete a survey regarding perceptions and practices of face mask use during the COVID-19 pandemic. Overall results were analyzed, and subgroup analyses were conducted to compare clinical and nonclinical staff, and clinical staff who do and do not provide direct patient care.
The response rate was approximately 24% (1,128 of 4,698). Most respondents were clinical staff who provide patient care. A surgical/procedure mask was most often worn for patient care by 72% (
< .001). Most respondents (70%) reported wearing a cloth mask when not in the hospital (
< .001). Cloth masks were worn for a mean of 3.4 ± 3.9 d before washing. Frequent hand hygiene before putting on the mask, before removing, and after removing was reported as 56%, 44%, and 62%, respectively. The most common challenges reported were glasses fogging (69%), skin irritations (45%), and headaches (31%). Qualitative data revealed themes of feeling unsafe, beliefs and practices about COVID-19 and masks, mandates and enforcement of wearing masks, availability of personal protective equipment, and care delivery challenges.
Practices and perceptions of face masks varied among staff in a pediatric health care system. Some staff did not feel that masks are effective in preventing virus spread, and others did not feel safe in performing job duties. Hand hygiene for mask handling was not practiced consistently. A large number of staff reported having experienced challenges or health issues when wearing a mask. Clinical staff who provide direct patient care reported more issues than both nonclinical and clinical staff who do not provide care.