PPE Champion Training€¦ · Acquisition of COVID-19 in healthcare settings 72.52% of cases were...
Transcript of PPE Champion Training€¦ · Acquisition of COVID-19 in healthcare settings 72.52% of cases were...
PPE Champion Training
Welcome to PPE Champion Training
• Thank you for coming on board to adopt the PPE Champion role within your clinical area/s
• All of the PPE resources referred to in this training can be found on the Western Health COVID-19 Microsite https://coronavirus.wh.org.au/ppe/
• There is a dedicated section of the microsite for PPE Champions https://coronavirus.wh.org.au/ppe/ppe-champions/
Context of the PPE Champion role
Reference: Department of Health and Human Services https://www.dhhs.vic.gov.au/victorian-healthcare-worker-covid-19-data
189 Total number of Western Health staff tested positive (7/10/2020)
3Number of Western Health staff on
leave for COVID-19 (7/10/2020)
Healthcare worker cases over time
Reference: Department of Health and Human Services https://www.dhhs.vic.gov.au/victorian-healthcare-worker-covid-19-data
Healthcare worker cases by occupation
4.62% medical practitioners40.04% nurses or midwives 49.88% aged care or disability workers 3.40% other healthcare workers
Reference: Department of Health and Human Services https://www.dhhs.vic.gov.au/victorian-healthcare-worker-covid-19-data
Source of infections in healthcare workers over time
Reference: Department of Health and Human Services https://www.dhhs.vic.gov.au/victorian-healthcare-worker-covid-19-data
Acquisition of COVID-19 in healthcare settings
72.52% of cases were acquired in a healthcare setting14.52% were not acquired in a healthcare setting12.95% of cases are either still under investigation or the source of infection is unable to be determined
25 August 2020117 healthcare workers hospitalized12 were admitted to intensive care One death, a nurse from the disability sector
Reference: Department of Health and Human Services https://www.dhhs.vic.gov.au/victorian-healthcare-worker-covid-19-data
PPE Champion Pilot and Scaling
Scale PPE Champion role
to Western Health
Evaluation to refine role
Pilot role with small group of
PPE Champions on high risk and
aged care wards
- Seek to understand root cause of HCW infections- Focus on PPE - Mapping of PPE strategies to date
- Progress- Gaps- Priorities
- PPE Champion pilot and scaling
PPE Champion Role Overview
- The role will be shaped and refined over time (with your help)
- All new PPE Champions are up skilled in PPE proficiency
- Aim of the role To support staff to wear their PPE safely 100% of the time
- Key objectives of the role:
- Building staff capability to wear PPE safely
- Being a ‘go to person’ for PPE related issues & enquiries
- Building a positive PPE culture
Up skilling in PPE
To adopt the role of a PPE Champion please:
- Complete the Standard & Transmission Based Precautions Welearn online module available here: https://welearn.wh.org.au/course/view.php?id=361
- Attend PPE Champion training (this session) delivered by the COVID and Infection Prevention teams
- Complete a PPE Skill Assessment - Observation of you donning; doffing; fit checking your PPE, with a member of the
Infection Prevention CNC team or a ‘Gold Standard PPE Champion’. https://coronavirus.wh.org.au/wp-content/uploads/2020/09/Western-Health-PPE-Skill-Assessment-Tool.pdf
- Ideally your PPE skill assessment will occur within your usual clinical context and tasks, however if this is not possible a simulated environment will suffice.
- Please contact Lauren ([email protected]) to book this in.
Building Staff Capability to Wear PPE Safely
PPE spotting & coaching
- Observing staff (all disciplines) donning, doffing & fit checking their PPE and providing in the moment feedback to build PPE proficiency
1. Correct PPE items worn
2. Bare below the elbow
3. Donning order correct i.e. hand hygiene; gown; mask; eye protection; hand hygiene; gloves
4. Fit check steps correct i.e. gentle inhale; gentle exhale
5. Doffing order correct i.e. gloves; hand hygiene; gown; hand hygiene; eye protection; hand hygiene; mask; hand hygiene
6. Risk of self contamination does not occur e.g. touching front of mask
7. PPE is disposed in clinical waste bin
- PPE Champions representing wards/ clinical areas can dedicate regular time to using the ‘PPE spotting & coaching tool’ available here: https://coronavirus.wh.org.au/wp-content/uploads/2020/09/PPE-Spotting-and-Coaching-Tool-16.9.2020.xlsx
- Be strategic about when you complete the tool – break time; start/ end of a shift
- Aim to collect at least 15 (smaller teams) – 25 (larger teams/ wards) observations (different people) each week (the more data the more meaning we can deduct)
- At the end of each week submit completed tools to Lauren ([email protected]) for data entry. We will return run charts to you so that you can start to track trends
Building Staff Capability to Wear PPE Safely
Run chart examples from FH Trends toward improvement!↙
↙ Opportunity to target improvement!
6859
7176
93100
67 7178
64
0
20
40
60
80
100
2. Bare below the elbow (%)
100
20
0
80
100 100
67
100 100 100
0102030405060708090
100
5. Doffing order correct (%)
100 100 100 100 100 100 100 100 100 100 100
0102030405060708090
100
7. PPE is disposed in clinical waste
Goal achieved!↙
Building Staff Capability to Wear PPE Safely
Using data to drive improvement
Building Staff Capability to Wear PPE Safely
PPE Skill Assessments
- Offer staff a PPE Skill Assessment, as an opportunity to review and build skill. The PPE Skill Assessment tool template is available here: https://coronavirus.wh.org.au/wp-content/uploads/2020/09/Western-Health-PPE-Skill-Assessment-Tool.pdf
- To administer the PPE Skill Assessment - 1:1 within usual practice. You may need to administer the tool over a few occasions to
observe all relevant items. Be strategic about when you administer the tool
- Alternatively you can set up a simulated environment. There are sufficient supplies of PPE to use for the purpose of practice – except N95 masks. Expired N95 masks are available to use for training - contact the nursing education team to access
- If using a simulated environment consider using a buddy approach to assessment and training (approach used by PPE Champions in Williamstown)
- Provide targeted education to the staff member to build their capability and obtain PPE proficiency.
- Submit completed tools to Lauren ([email protected]) for data entry
Building Staff Capability to Wear PPE Safely
Setting up the environment to optimise PPE skill
- Putting up laminated PPE related posters (e.g. how to don; doff; fit check)
- Participating in the scaling of mirrors at donning/ doffing stations
- Look for gaps and opportunities for improvement e.g. where to clean face shields
- Facilitate improvements in the environment
Nameeta with the new signage put up at the PPE doffing station
Nameeta from WACU & Lower GEM
New donning & doffing stations on FH 3B & Level 3 Acute Allied Health office
Building a Positive PPE Culture
You may build a positive PPE Culture through:
- Best practice role modeling - Eliciting and modeling best practice PPE technique and infection control
- Delivering training & promotional activities - Encourage staff to complete the ‘Standard & Transmission Based Precautions’
Welearn module https://welearn.wh.org.au/course/view.php?id=361
- Offer training & promotional activities to create the conditions for cultural and behavioural change (e.g. information sessions, emails, posters). Consider being strategic
- Building a buddy culture - Building a buddy culture where staff are empowered to speak up, act proactively and
offer to be a buddy or seek a buddy to support safe PPE donning, doffing and fit checking e.g. role model, promote during PPE Skill Assessments where staff are buddied up, set up donning & doffing stations as ‘buddy checkpoints’ (posters, mirror, supply)
- Communicating in a way that builds skill & growth- Rather than staff feeling like they have made a mistake, rather building a culture where it
is ok not to know all of the answers and we are all learning and improving.
Being a ‘Go To Person’ for PPE Related Issues & Enquiries
To be a ‘go to person’ you can:
- Disseminate PPE related updates (e.g. updates received from the PPE Core Group, COVID-19 team, Infection Prevention team)
- Be a point of contact within your clinical area for staff to ask questions or raise issues relating to PPE
- Actively seeking to problem solve PPE related issues or find the answer to PPE related enquiries through the microsite
- Collaborate with others – consider linking with others to support resolution of issues/ to overcome barriers, such as Infection Prevention, COVID-19 team, OH&S and the PPE Access Team
Time Allocation to the Objectives of the Role
Building staff capability to wear PPE safely
- Dedicated time dependent on the needs of your clinical area
- Time needed will vary between clinical areas and will change over time
- May need to ramp up in context of outbreak within your clinical area
Being a ‘go to person’ for PPE related issues & enquiries
- Always, ongoing
Building a positive PPE culture
- Always, ongoing
PPE Champion Sticker/ Badge
Infection Prevention and Control
How Infections Spread in the Healthcare Setting
Infectious Agent
Contact Airborne
Indirect
Droplet
DirectDroplet nuclei
(Suspended in air)
Equipment &
EnvironmentHands
Injection
Ingestion
Route of Transmission
Route of transmission is likely to
be droplet spread through close
contact with infected individuals
R0 2.5-3, similar to (1918
Pandemic was 2.8), compare with
Chickenpox (3.7-5) and Measles
(12-18)
Demonstrating transmission
https://youtu.be/VK2vpOh5wws
https://youtu.be/GSPv04IJvpI
What are the Symptoms of COVID-19?
• Incubation period is 2-7 days after exposure (maximum 14, peak 5-7)
• This is similar to flu
• Majority have a fever and dry cough (rapid onset)
• Symptoms last 5-6 days
• Severe illness starts day 7
• Shortness of breath
• Lung inflammation
• Pneumonia
Symptom Proportion of cases
Fever > 37.5oC 88%
Dry Cough 68%
Fatigue 38%
Sputum 33%
Shortness of breath
19%
Muscle/joint pain
15%
Sore throat 14%
Headache 14%
PPE Up Skilling
• Selecting the right Personal Protective Equipment- Western Health COVID-19 PPE Guideline V9
- PPE during Covid Tier system
• Safely donning, doffing and fit checking PPE in the right order (https://coronavirus.wh.org.au/ppe/)
- Donning & doffing
- Surgical Mask
- Cupped P2/ N95 mask
- Duckbill P2/ N95 masks
- Facial Hairstyles and Filtering Face piece Respirators
- Standard precautions donning & doffing video
- N95 donning and doffing video
• Maintaining good habits while wearing PPE - Lighting up the virus
- Every day things we need to do differently in a COVID-19 world https://coronavirus.wh.org.au/wp-content/uploads/2020/08/PPE-Everyday-things-that-we-need-to-do-differently-in-a-COVID-19-world-6.8.2020.pdf
- Facial pressure injuries and skin issues from PPE
- Safety with patient personal hygiene care during COVID-19
Facial Pressure Injuries
P2/N95 Respirator Masks
• Protective dressings are NOTto be used on the face under P2/N95 respirator masks as they may impair the seal and not provide protection
Plastic aprons for Standard Precautions
Plastic aprons are recommended to be worn by all healthcare workers when:
• Close contact with the patient, materials or equipment that may lead to contamination of skin, uniforms, or other clothing with infectious organisms (known and unknown)
• There is a risk of contamination with blood and body substances, secretions, and excretions (excluding sweat).
Bare Below the Elbows
• What is Bare Below the Elbows (BBE)? It is an initiative aiming to improve the effectiveness of hand hygiene performed by health care workers
• Who should be BBE? – all staff undertaking direct patient contact or patient environment
• When should I be BBE?
• With direct patient care
• When in contact with the patient environment (patient zone)
• When working in the clinical area (healthcare zone)
Contacts:
Infection Prevention• Maureen Canning
[email protected]• Richard Bartolo
[email protected]• Anie Edward
[email protected]• Infection Control (WH)
PPE Champion role• Lauren Guy
For further information
CORONAVIRUS.WH.ORG.AU/PPE