Understanding the Predictors that Contribute to Liberian Health Care Workers Feeling Protected From Ebola While at Work

Objective: To assess Liberian health care workers' feelings around safety in returning to work in the setting of the Ebola virus disease outbreak of 2014-2015 after receiving infection prevention and control (IPC) training. Methods: Academic Consortium Combating Ebola in Liberia (ACCEL) training surveys were done at 21 public, Liberian hospitals to understand health care workers' attitudes surrounding Ebola and whether they felt safe while at work based on multiple factors. Logistic regression was used for analysis. Results: We found that health care workers feeling safe at work during the Ebola outbreak was primarily predicted by the number of IPC/Ebola trainings received pre-ACCEL interventions. Health care workers felt increasingly safer and motivated to return to work as trainings approached 3 (OR 8, p-value < 0.001); however, more than 3 trainings resulted in decreased safety and motivation. In addition, health care workers who reported washing their hands before and after patient contact were 3.4 times more likely to understand how to protect themselves from Ebola. Conclusions: These results help to better understand the utility of repeated trainings on health care worker practice attitudes and the importance of IPC policies within hospitals, such as hand hygiene promotion and education, when coordinating humanitarian efforts.