The Impact of PPE Availability on Moral Distress Among EMTs During the COVID-19 Pandemic and Strategies: A Review and a Logic Model.

Background and Aims: The COVID-19 pandemic has placed an unprecedented strain on healthcare systems worldwide, with frontline healthcare workers, including Emergency Medical Technicians (EMTs), facing numerous challenges. One of the most significant issues has been the availability and adequacy of personal protective equipment (PPE). This study explores the relationship between PPE availability and moral distress among EMTs during the COVID-19 pandemic and proposes a logic model to address it. Methods: In this narrative review, a goal-based search was conducted in several databases, and related articles were selected, and the desired relationships and strategies were extracted from them. Finally, a logic model was presented. Results: Inadequate PPE availability on EMTs can lead to heightened moral distress, psychological strain, and ethical dilemmas, affecting their well-being and the quality of care they provide. To mitigate moral distress effectively, strategies such as ensuring a reliable PPE supply chain, efficient distribution systems, prioritizing PPE allocation, establishing clear protocols, promoting mental health support, and ethical decision-making are crucial. The logic model is drawn by establishing relationships between inputs, activities, outputs, and outcomes of the program. Conclusion: The availability of PPE is critical to the health and safety of EMTs during emergencies, especially pandemics. The proposed logic model can guide stakeholders to work together, address PPE availability and moral distress among EMTs, and improve well-being and quality of care.