The Effect of Training on Knowledge, Perception, and Practice of Healthcare Personnel on the Use of Respiratory Protective Equipment during COVID-19 Pandemic at a Private Hospital in the Northern part of Thailand.

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Chonwipha Chonwipha Teerasantipun, MD
Wittaya Pichetweerachai, MD
Nattaphol Pruetpongpun, MD
Kanokwan Suwannawat, RN
Warut Chaiwong, BSc, MPH
Chaiyos Kunanusont, MD, PhD


OBJECTIVES: To determine the effect of the respiratory protective training program of healthcare personnel (HCP) during the Coronavirus Disease 2019 (COVID-19) pandemic at a private hospital in the northern part of Thailand.

MATERIALS AND METHODS: This cross-sectional study was conducted with 89 healthcare personnel (HCP) of Bangkok Hospital Phitsanulok, who required wearing a tight-fitting respirator during their duties and attended respiratory protective equipment (RPE) video-based training program regarding the general principles of respirator usage and guidelines on safely re-using RPE. A questionnaire-based assessment of participants’ 3-month retention of knowledge and perception was conducted in April 2021. A qualitative fit test (QLFT) was used in terms of practice on RPE. The proportion of correct responses in the 3-month knowledge and perception score were compared with a pre-training test and an immediate post-training test using paired t-test. The same analysis was conducted with QLFT using McNemar’s test.

RESULT: Various types of RPE were used in each test depending on the supply. The most commonly used RPE was N95 (58.4%), the majority of N95 was 3MVLFEX 9105. Compared with the pretraining test, the proportion of correct responses in the immediate post-training test increased by 11% (p < 0.001; 95% CI 1.07-2.23). Similarly, in 3-month post-training, the percentage of correct response also increased from pre-training by 10.4% (p < 0.001; 95% CI 0.08-2.28). HCP had an excellent level of perception on using RPE during COVID-19. No significant change in perception was found between pretraining and both immediate and 3-months after training (p = 0.536 and p = 0.384 respectively) The pass rate significantly raised to 96.6% for an immediate post-training test (p < 0.001) and to 98.8% after 3-month (p < 0.001).

CONCLUSION: Training has played an important role to help HCP improve their knowledge and practice regarding the usage of RPE, but has no significant effect on perception. The assessment of knowledge, perception and practice retention of RPE usage after 3-month showed the positive impacts of video-based training groups on participants’ knowledge and practice. Further evaluations are needed on the interventions that enhance HPC perceptions and attitudes on safety behavior. Pre- and in-service training programs for frontline HPC during a Coronavirus 19 disease pandemic need to be considered by Thai Ministry of Public Health.


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Chonwipha Teerasantipun, MD C, Pichetweerachai, MD W, Pruetpongpun, MD N, Suwannawat, RN K, Chaiwong, BSc, MPH W, Kunanusont, MD, PhD C. The Effect of Training on Knowledge, Perception, and Practice of Healthcare Personnel on the Use of Respiratory Protective Equipment during COVID-19 Pandemic at a Private Hospital in the Northern part of Thailand. BKK Med J [Internet]. 2021 Sep. 29 [cited 2022 May 17];17(2):110. Available from:
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Occupational Safety and Health Administration. Guidance on preparing for workplaces for COVID-19. 2020 (Accessed May 27, 2020, at .)

World Health Organization. WHO calls for healthy, safe and decent working conditions for all health workers, amidst COVID-19 pandemic. 2020. (Accessed May 27, 2020, at

The Centre for Evidence-Based Medicine (CEBM). COVID-19 How many Healthcare workers are infected?. 2020. (Accessed May 27, 2020 at )

United States Department of Labor.1910.134 - Respiratory Protection. | Occupational Safety and Health Administration. 2011. (Accessed May 27, 2020, at )

United States Department of Labor. Hospital respiratory protection program toolkit: Resources for respirator program administrators. 2015. (Accessed May 27, 2020, at )

Centers for Disease Control and Prevention (CDC). Strategies for Optimizing the Supply of N95 Respirators: COVID-19. 2020. (Accessed May 27, 2020, )

Degesys NF, Wang RC, Kwan E, et al. Correlation Between N95 Extended Use and Reuse and Fit Failure in an Emergency Department. JAMA 2020;324(1):94-6.

Honarbakhsh M, Jahangiri M, Ghaem H. Knowledge, perceptions and practices of healthcare workers regarding the use of respiratory protection equipment at Iran hospitals. J Infect Prev 2018;19(1):29-36.

United States Department of Labor. 1910.134 App C - OSHA Respirator Medical Evaluation Questionnaire(Mandatory). Occupational Safety and Health Administration. (Accessed May 27, 2020, at )

Summacheeva Foundation. Respirator Medical Evaluation Questionnaire [in Thai]. 2018:1-12. (Accessed May 2 7, 202 0, at )

United States Department of Labor. Safety and Health Topics | Respiratory Protection - General Guidance |Occupational Safety and Health Administration. (Accessed May 27, 2020, at )

Centers for Disease Control and Prevention (CDC). The Need for Fit Testing During Emerging Infectious Disease Outbreaks. 2020. (Accessed May 27, 2020, at )

United States Department of Labor. 1910.134 App A - Fit Testing Procedures (Mandatory). Occupational Safety and Health Administration. (Accessed May 27, 2020, )

Burke LA, Ray R. Re-setting the concentration levels of students in higher education: an exploratory study. Teach High Educ 2008;13(5):571–82.

Stuart J, Rutherford RJ. Medical student concentration during lectures. Lancet 1978;2(8088):514-6.

Martin BO, Kolomitro K, Lam TCM. Training Methods: A review and analysis. Hum Resour Dev Rev 2014;13(1):11-35.

Ahmed N, Shakoor M, Vohra F, et al. Knowledge, Awareness and Practice of Health care Professionals  amid SARSCoV- 2, Corona Virus Disease Outbreak. Pak J Med Sci 2020;36(COVID-19-S4):S49-S56.

Hughes P, Ferrett E. Introduction to health and safety in construction: for the NEBOSH national certificate in construction health and safety. 5th Edition by Routledge, Taylor&Francis Group. London and New York. 2016.

Eccles M, Grimshaw J, Walker A, et al. Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. J Clin Epidemiol 2005;58(2):107–12.

Govender K, Rangiah C, Ross A, et al. Retention of knowledge of and skills in cardiopulmonary resuscitation among healthcare providers after training. SA Fam Pract 2010;52(5):459–62.

Sankar J, Vijayakanthi N, Sankar MJ, et al. Knowledge and skill retention of in-service versus preservice nursing professionals following an informal training program in pediatric cardiopulmonary resuscitation: A repeated-measures quasi-experimental study. Biomed Res Int 2013;2013:1-7.

Osei-Ampofo M, Tafoya MJ, Tafoya CA, et al. Skill and knowledge retention after training in cardiopulmonary ultrasound in Ghana: an impact assessment of bedside ultrasound training in a resource-limited setting. Emerg Med J 2018;35(11):704-7.

Wu S, Li R, Su W, et al. Is knowledge retained by healthcare providers after training? A pragmatic evaluation of drug-resistant tuberculosis management in China. BMJ Open. 2019;9(3):e024196.

Ekpreechakul T, Saiphiroonthong W, Chaiwong W, et al. Quantitative fit tests of selected respirators for health care workers caring for patients with confirmed or suspected COVID-19. BKK Med J 2020;16(2):196-9.

Wardhan R, Brennan MM, Brown HL, et al. Does a Modified Adhesive Respirator Improve the Face Seal for Health Care Workers Who Previously Failed a Fit Test?: A Pilot Study During the Coronavirus Disease 2019 Pandemic. A Pract 2020;14(8):e01264.

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