Trained observers for donning doffing ppe cbrne collaborative[1]

Trained Observers forDonning/Doffing PPE

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Reducing Serious Communicable Disease Threats

Join the Move to Sustainable Safety: www.cbrnecc.ca

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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/

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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

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Language is Important

• When black box tapes from air crashes were reviewed, it was noted there were times the Co-pilot expressed concerns to the Pilot, that could have prevented the crash

CHECK OUT: http://gtresearchnews.gatech.edu/newsrelease/CREW.html

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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

http://www.urban.org/toolkit/data-methods/ratings.cfm

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Trained Observers for Donning/Donning of PPE

This Trained Observer will watch others:1. Prepare to Don PPE 2. Don their PPE3. Doff Their PPEAND correct any risks or failures they observe in the processTo 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 donning-doffing, using a check list to insure it 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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• The Trained Observer must verbally confirm each step with the person being observed


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• If staff need hands-on assistance, a “buddy” should help and the Trained Observer remains a 3rd person


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• 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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• 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


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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 LEADERSWorking 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 DiseaseOrganizational 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 DiseaseOrganizational 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 DiseaseOrganizational Safety Leaders

• 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

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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

CHECK OUT: http://www.ihi.org/resources/Pages/Tools/FailureModesandEffectsAnalys

isTool.aspx

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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?


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Failure Risk?


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Failure Risk?


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Failure Risk?


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Failure Risk?


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Failure Risk?


http://www.ecdc.europa.eu/ 39

Failure Risk?


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Failure RISK?



Failure Risk?


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Failure Risk?



Failure Risk?


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Failure Risk?



Failure Risk?


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Failure Risk?


http://www.ecdc.europa.eu/

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Failure Risk?


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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

http://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.

• [email protected]

www.cbrnecc.ca

mailto:[email protected]

mailto:[email protected]

Trained observers for donning doffing ppe cbrne collaborative[1]

Healthcare

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