trained observers for donning doffing ppe cbrne collaborative[1]
TRANSCRIPT
Trained Observers forDonning/Doffing PPE
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Reducing Serious Communicable Disease Threats
Join the Move to Sustainable Safety: www.cbrnecc.ca
At the end of this session you will understand:
• The Culture of Safety
• What Trained Observers watch for in Donning/Doffing
• Why Organizational Safety Leaders need your input
• Failure Mode and Effect Analysis (FMEA)
• How you can use your Observer (FMEA) Skills Daily
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THE CULTURE OF SAFETY
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The Culture of Safety
• Safety is everyone’s responsibility
• Openly sharing information without reprisal is essential
• LISTENING is the first step in mitigating risks
CHECK OUT: http://www.ihi.org/resources/Pages/Changes/DevelopaCultureofSafety.aspxhttp://aubreydaniels.com/blog/2013/01/23/7-keys-for-creating-a-safety-culture/ 4
Language is Important
• United Airlines discovered that crew “hierarchy” can lead to important information being missed, with sometimes fatal results
CHECK OUT: http://en.wikipedia.org/wiki/Crew_resource_management 5
Language is Important
• When black box tapes of the air crash were reviewed, it was noted there were times the Co-pilot expressed concerns to the Pilot, which could have prevented the crash
6CHECK OUT: http://gtresearchnews.gatech.edu/newsrelease/CREW.html
CUUS
United Airlines created CUUS - 4 critical words – which - if used - translate to
“STOP AND LISTEN. We have a potential problem.”
• I am Concerned
• I am Uncomfortable
• This is Unsafe
• I am Scared
If anyone uses this language, it is important to immediately STOP AND LISTEN.
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You will know you have a Culture of Safety when you:
• Openly share ideas
• Listen to each other
• Think innovatively about safety
• Develop ways together to reduce risk and prevent failure
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TRAINED OBSERVERS FOR DONNING/DOFFING PPE
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What is a Trained Observer?
That’s a great question!
In general terms, Trained Observers are people trained to “observe a situation” and “rate it” using:
• written description
• photographs, or
• other visual scales such as drawings or videos
10http://www.urban.org/toolkit/data-methods/ratings.cfm
Trained Observers for Donning/Donning of PPE
This Trained Observer will watch others:
1. Prepare to Don PPE
2. Don their PPE
3. Doff Their PPE
AND correct any risks or failures they observe in the process
To do this Trained Observers will use:
• Written aids such as check lists
• Photo or visual aids
• Rating scales
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Trained Observers forDonning and Doffing of PPE
• Observe others using a checklist to ensure the donning-doffing process is done correctly
• Do not perform hands-on tasks to assist (unless an emergency)
• Is there a Trained Observer in this picture?
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Trained Observers forDonning and Doffing of PPE
• The Trained Observer must verbally confirm each step with the person being observed
• Is there a Trained Observer in this picture?
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Trained Observers forDonning and Doffing of PPE
• If staff need hands-on assistance, a “buddy” should help and the Trained Observer remains a 3rd
person
• Is there a Trained Observer in this picture?
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Trained Observers forDonning and Doffing of PPE
• Over time, as staff gain experience, they will be able to don and doff by themselves.
• To reach this level requires almost daily practice ( rare).
• The buddy could potentially become a Trained Observer under those conditions
• Is there a potential Trained Observer in this picture?
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Trained Observers forDonning and Doffing of PPE
• The Safest Model for a Trained Observer in the Donning and Doffing of PPE is using 3 people– Two Buddies in PPE to assist
each other as needed.
– One Trained Observer
• Is there a Trained Observer in this picture?
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To Support the Trained Observer
Institutions/Agencies must have:
• Checklists for donning and doffing their specific PPE
• Simple protocols for documentation
• Training sessions to develop/maintain the Trained Observer Skills
• A Safety Leader if assistance is needed
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ORGANIZATIONAL SAFETY LEADERS
Working with
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Organizational Safety Leaders
• The Role of a Safety Leader is to monitor workplace activities to ensure workers comply with company policies and government safety regulations
• This includes organizational policy development, safety inspections and training.
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In the Setting of A Serious Communicable Disease
Organizational Safety Leaders oversee:
• Risk based Selection of PPE
• Screening Staff for suitability to use PPE
• Development of Donning and Doffing Protocols
• Setting up Serious Communicable Disease Units and Teams
• Training Teams including Trained Observers for PPE
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In the Setting of A Serious Communicable Disease
Organizational Safety Leaders
Must work with others to establish protocols for the safe management of:
• Lab specimens
• Waste
• Patient movement within the hospital
• Diagnostic Imaging
• Visitors
• Etc.
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In the Setting of A Serious Communicable Disease
Organizational Safety Leaders
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• Must be strong promoters of the Culture of Safety
• Remain current and continually monitor health and safety guidance as it evolves
• Work with staff to find even better ways to improve safety
FAILURE MODE AND EFFECTS ANALYSIS
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Failure Mode and Effects Analysis(FMEA)
FMEA is a systematic, proactive method for evaluating a process to:
• Identify where and how it might fail
• Assess the relative impact of different failures
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Failure Mode and Effects Analysis(FMEA)
• The Ultimate Goal of FMEA is identifying risk/failures and PROACTIVELY correcting them
• This is the main role of a Trained Observer
25CHECK OUT:
http://www.ihi.org/resources/Pages/Tools/FailureModesandEffectsAnalysisTool.aspx
EXERCISING YOUR OBSERVER (FMEA) SKILLS DAILY
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Exercising your Observer (FMEA) Skills Daily
• Hand-washing
• Seal checks of your N95
• Proper Glove removal
• Waste disposal
• All of the above are Donning-Doffing Steps you do daily
• Practice them as if you were dealing with a patient with a Serious Communicable Disease
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Exercising your Trained Observer (FMEA) Skills Daily
Review online protocols or the training materials of others to:
• Identify the risk
• Consider the impact of the failure
• Think proactively of correction
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EXERCISE YOUR OBSERVER SKILLS
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Failure RISK?
Anticipate Correction
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Failure Risk?
Pre: PPE Vitals: Anticipate Correction
• P120
• BP 160/100
• R 24
• O2Sat 95%
• T 37.6
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Failure Risk?: Pre-PPE
Caution: If Drink 700 cc Correction
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Failure Risk?
Anticipate Correction
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Failure Risk?
Anticipate Correction
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Failure Risk?
Anticipate Correction
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Failure Risk?
Anticipate Correction
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Failure Risk?
Anticipate Correction
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Failure Risk?
Anticipate Correction
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Failure Risk?
Anticipate Correction
39http://www.ecdc.europa.eu/
Failure RISK?
Anticipate Correction
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Failure Risk?
Anticipate Correction
41http://www.ecdc.europa.eu/
Failure Risk?
Anticipate Correction
42http://www.ecdc.europa.eu/
Failure Risk?
Anticipate Correction
43http://www.ecdc.europa.eu/
Failure Risk?
Anticipate Correction
44http://www.ecdc.europa.eu/
Failure Risk?
Anticipate Correction
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Failure Risk?
Anticipate Correction
46http://www.ecdc.europa.eu/
Failure Risk?
Anticipate Correction
47http://www.ecdc.europa.eu/
Failure Risk?
Anticipate Correction
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Failure Risk?
Anticipate Correction
49http://www.ecdc.europa.eu/
Failure Risk?
Anticipate Correction
50http://www.ecdc.europa.eu/
Failure Risk?
Anticipate Correction
51http://www.ecdc.europa.eu/
Failure Risk?
Anticipate Correction
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General Failure Risks
• Contamination
• Equipment: Improper use or Failure
• Physiologic: Fatigue, Heat
• Psychological: Claustrophobia
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Safety belongs to all of US
• The CBRNE Collaborative is a Public Health Agency of Canada Project, sponsored by the Canadian Safety and Security Program.
• It is managed by Sunnybrook Research Academy (Toronto).
• Check us out at:
www.cbrnecc.ca
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The Trained Observer Slide Presentation
• Was Created by Dr. Laurie Mazurik, Staff Emergency Physician at Sunnybrook Health Science Centre Toronto, CANADA
• Her experience with SARS in 2003, ignited a passion to support better training for HCW in personal protection and emergency preparedness.
55www.cbrnecc.ca