Infection prevention behaviors and perceptions of nurses in a medical intensive care unit.

Objective: During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, recommended infection prevention practices for preventing transmission in acute healthcare settings included, at a minimum, universal source control with masking and eye protection within six feet of others and using a respirator when caring for individuals with COVID-19. Methods: A mixed methods study consisting of observations and self-reported infection prevention behaviors among critical care nurses identified high adherence to mask use in a medical intensive care unit (ICU) during the COVID-19 pandemic. Results: Surveyed nurses reported more barriers to proper use eye protection than with masking. We observed nurses wearing required eye-protection only 20% of the time when within 6 feet of others. Use of eye protection increased in the presence of patients while decreasing near other healthcare workers. In self-reported assessments, these nurses described decreased protective behaviors at work and at home after vaccination for COVID-19. However, self-reported masking in public remained high and was not impacted by vaccination status. Finally, nurses most frequently perceived high transmission risk of SARS-CoV-2 in the community and patient care settings, with lowest risk from co-workers and household members. Conclusions: Perceived risks of exposure to SARS-CoV-2 likely impact infection prevention behaviors. Differences in perceived risk between patient and peer groups provide insight into strategies for improving infection prevention behaviors in both pandemic and endemic multidrug-resistant organism settings.