Anaesthetists' current practice and perceptions of aerosol-generating procedures: a mixed-methods study.

Area of Science:

• Anesthesiology and critical care medicine
• Infection prevention and control
• Respiratory medicine

Background:

• Evidence on aerosol-generating procedures (AGPs) transmission risk is evolving.
• Infection prevention and control guidelines require continuous reassessment.
• Anaesthetists' perceptions of AGPs and associated risks are crucial for guideline adherence.

Purpose of the Study:

• To explore anaesthetists' perceptions of aerosol-generating procedures (AGPs).
• To understand individual and hospital-level adherence to UK AGP guidelines.
• To assess the impact of AGP precautions on healthcare provision and team dynamics.

Main Methods:

• A mixed-methods study combining online surveys and semi-structured interviews.
• Online survey distributed to UK anaesthetists (n=333) with clinical scenarios.
• Thematic analysis of 18 interviews to explore perceptions and behaviours in depth.

Main Results:

• Most anaesthetists and hospitals adhered to UK guidance, but divergences were noted.
• Significant use of respiratory protective equipment (RPE) occurred even for non-SARS-CoV-2 negative patients during tracheal intubation (20%).
• RPE use and fallow times negatively impacted efficiency (92%), teamwork (83%), and communication (77%), yet 63% felt the balance with SARS-CoV-2 risk was appropriate.

Conclusions:

• Anaesthetists' attitudes towards AGPs and RPE are evolving, influenced by perceived COVID-19 risk.
• Divergence from guidelines highlights the need for clear communication and support.
• Findings can inform strategies for successful adoption of revised AGP guidelines and RPE use.