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Impact of Personal Protective Equipment Training on PPE Use among Healthcare Workers in Nigeria

Abstract

Personal protective equipment (PPE) is an important component of occupational health and infection prevention and control in healthcare settings. Healthcare workers may be exposed to infectious diseases, blood and body fluids, contaminated materials, chemicals, respiratory hazards, and other occupational risks during patient care. Appropriate use of PPE, including gloves, gowns, masks, respirators, eye protection, face shields, and other protective equipment, can reduce occupational exposure and contribute to safer healthcare environments. However, healthcare workers may not consistently use PPE correctly because of inadequate training, limited knowledge of PPE selection and indications, discomfort, shortages of equipment, poor availability, time pressure, and inadequate supervision. PPE training provides an opportunity to improve healthcare workers' knowledge and practical skills in selecting, donning, using, removing, disposing of, and maintaining appropriate protective equipment. Against this background, this study investigates the impact of personal protective equipment training on PPE use among healthcare workers in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Hierarchy of Controls. The Health Belief Model explains how healthcare workers' perceptions of occupational risk, perceived severity of exposure, perceived benefits of PPE use, perceived barriers, and cues to action may influence compliance with PPE practices. Social Cognitive Theory emphasizes observational learning, practical demonstration, behavioural reinforcement, feedback, and self-efficacy in developing appropriate occupational safety behaviours. The Hierarchy of Controls provides a framework for understanding PPE as an important protective measure within a broader occupational risk-control system and emphasizes the need to combine PPE with administrative and environmental controls. Collectively, these theoretical perspectives provide a suitable framework for explaining how PPE training may influence PPE use among healthcare workers in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise healthcare workers, including doctors, nurses, midwives, laboratory personnel, pharmacists, community health officers, healthcare assistants, environmental health personnel, and other relevant healthcare staff working in selected public and private healthcare facilities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, healthcare facilities, departments, and eligible healthcare workers. PPE training will be assessed using indicators such as training frequency, duration, training content, practical demonstrations, PPE selection, indications for use, donning and doffing procedures, disposal procedures, equipment maintenance, infection prevention and control principles, availability of training materials, supervised practice, competency assessment, and refresher training. PPE use will be assessed using indicators such as availability and accessibility of appropriate PPE, correct selection of PPE, consistent use during indicated procedures, correct donning and doffing techniques, appropriate disposal or reuse procedures where applicable, hand hygiene before and after PPE use, appropriate storage, compliance with facility PPE protocols, and observed correct use during patient-care activities. Data will be collected using structured questionnaires, PPE knowledge and practice assessment tools, direct workplace observation checklists, training attendance records, PPE inventory records, infection prevention and control records, and relevant healthcare facility documents. Descriptive statistics will be used to summarize participants' characteristics, occupational exposure risks, training participation, PPE availability, and PPE-use practices. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of PPE training on PPE use. Where a quasi-experimental design is adopted, PPE-use competency and compliance before and after implementation of the training intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that PPE training has a significant positive impact on PPE use among healthcare workers in Nigeria. Healthcare workers exposed to structured and practical PPE training are expected to demonstrate better compliance with recommended PPE practices than workers without comparable training. Training may improve workers' ability to identify occupational hazards, select appropriate PPE, correctly put on and remove protective equipment, and dispose of contaminated materials safely. Practical demonstrations and supervised exercises may strengthen workers' confidence and reduce errors associated with incorrect donning and doffing. Training may also improve awareness of the importance of PPE during procedures involving blood and body fluids, respiratory hazards, infectious patients, chemicals, and other occupational exposures. However, inadequate PPE supply, shortages of appropriate equipment, discomfort, heat, time constraints, heavy workloads, inadequate supervision, weak institutional safety policies, and inconsistent availability of different PPE types may limit the translation of training into routine practice. The study therefore expects accessible, practical, competency-based, and continuous PPE training, supported by adequate PPE availability and effective supervision, to contribute significantly to improved PPE use among healthcare workers in Nigeria. The study is expected to contribute to the literature on occupational health, PPE use, infection prevention and control, healthcare worker safety, occupational exposure prevention, workplace health education, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, hospitals, primary healthcare centres, healthcare professional bodies, occupational health practitioners, infection prevention and control committees, development partners, and policymakers regarding strategies for improving healthcare worker safety. The study will also provide evidence-based recommendations for strengthening competency-based PPE training, integrating regular PPE refresher training into healthcare worker continuing professional development, improving PPE supply and inventory systems, conducting routine workplace observation and competency assessments, strengthening infection prevention and occupational safety policies, and ensuring that healthcare facilities provide appropriate PPE for different occupational risks across Nigeria.

Keywords: Personal protective equipment training, PPE use, healthcare workers, occupational health, infection prevention and control, workplace safety, PPE compliance, occupational exposure, healthcare safety, Nigeria, public health.