Healthcare professionals’ perceptions of critical care resource availability and factors associated with mental well-being during COVID-19: Results from a US survey

Sharma, Monisha; Creutzfeldt, Claire J; Lewis, Ariane; Patel, Pratik V; Hartog, Christiane; Jannotta, Gemi E; Blissitt, Patricia; Kross, Erin K; Kassebaum, Nicholas; Greer, David M; Curtis, J Randall; Wahlster, Sarah

BACKGROUND: Assessing the impact of COVID-19 on intensive care unit (ICU) providers’ perceptions of resource availability and evaluating factors associated with emotional distress/burnout can inform interventions to promote provider well-being. METHODS: Between April 23-May 7, 2020, we electronically administered a survey to physicians, nurses, respiratory therapist (RTs) and advanced practice providers (APPs) caring for COVID-19 patients in the US. We conducted multivariate regression to assess associations between concerns, reported lack of resources and three outcomes: emotional distress/burnout (primary outcome), and two secondary outcomes: 1) fear that hospital is unable to keep providers safe, and 2) concern about transmitting COVID-19 to family/community. RESULTS: We included 1,651 respondents from all 50 states; 47% nurses, 25% physicians, 17% RTs, 11% APPS. Shortages of intensivists and ICU nurses were reported by 12% and 28% of providers, respectively. The largest supply restrictions reported were for powered air purifying respirators (PAPRs); (56% reporting restricted availability). Provider concerns included worries about transmitting COVID-19 to family/community (66%), emotional distress/burnout (58%), and insufficient personal protective equipment (PPE) (40%). After adjustment, emotional distress/burnout was significantly associated with insufficient PPE access (aRR: 1.43, 95% CI: 1.32 - 1.55), stigma from community (aRR: 1.32, 95% CI: 1.24 - 1.41), and poor communication with supervisors (aRR:1.13, 95% CI: 1.06 - 1.21). Insufficient PPE access was the strongest predictor of feeling that the hospital is unable to keep providers safe and worries about transmitting infection to families/communities. CONCLUSION: Addressing insufficient PPE access, poor communication from supervisors, and community stigma may improve provider mental well-being during the COVID-19 pandemic.