P2-N95 Mask Use During the COVID- 19 Pandemic - Experiences and Perceptions of Nurses Who Suffered Adverse Effects

Introduction: The use of P2/N95 masks was mandatory for nurses during the COVID-19 pandemic. The prolonged and generalised use of these masks has been previously associated with adverse side effects. The aim of this study was to explore the experiences and perceived personal and care delivery impacts of P2/N95 mask use among nurses who reported side-effects. Methods: A qualitative exploratory descriptive design was used. Nurses were recruited from a major tertiary public health service in Melbourne, Australia. Interview data were analysed thematically. Results: Overall, the participants (n=12) reported consistent experiences about the physical discomfort and injuries caused by the use of P2/N95 mask and their impact on patient care. Four themes emerged: ‘adverse health impacts’, ‘perceived occupational challenges caused by scarcity of P2/N95 masks’, ‘impact of wearing P2/N95 masks on patient care and work practices’, and ‘positive adaptive strategies of nurses using P2/N95 masks to improve patient care’. Conclusion: Nurses reported the use of P2/N95 masks resulted in significant adverse health outcomes and affected their ability to deliver high quality patient care. These reported effects were found to be more pronounced among nurses with chronic skin conditions and sensitive skin. The findings of this study highlight the importance of creating awareness about skin reactions and pressure injuries associated with P2/N95 mask use among nurses. Furthermore, the findings underscore the importance of identifying the underlying mechanisms causing skin reactions and facial pressure injuries, including the long-term effects of prolonged mask use on nurses' skin.