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Trained observers for donning doffing ppe cbrne collaborative[1]
- 1. Trained Observers for Donning/Doffing PPE 1 Reducing Serious Communicable Disease Threats Join the Move to Sustainable Safety: www.cbrnecc.ca
- 2. 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 2
- 3. THE CULTURE OF SAFETY 3
- 4. 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.aspx http://aubreydaniels.com/blog/2013/01/23/7-keys-for-creating-a-safety-culture/ 4
- 5. 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
- 6. 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 6CHECK OUT: http://gtresearchnews.gatech.edu/newsrelease/CREW.html
- 7. 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. 7
- 8. 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 8
- 10. 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
- 11. 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 11
- 12. Trained Observers for Donning 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? 12
- 13. Trained Observers for Donning 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? 13
- 14. Trained Observers for Donning 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? 14
- 15. Trained Observers for Donning 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? 15
- 16. Trained Observers for Donning 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? 16
- 17. 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 17
- 18. ORGANIZATIONAL SAFETY LEADERS Working with 18
- 19. 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. 19
- 20. 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 20
- 21. 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. 21
- 22. In the Setting of A Serious Communicable Disease Organizational Safety Leaders 22 • 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
- 23. FAILURE MODE AND EFFECTS ANALYSIS 23
- 24. 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 24
- 25. 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 25 CHECK OUT: http://www.ihi.org/resources/Pages/Tools/FailureModesandEffectsAnalys isTool.aspx
- 26. EXERCISING YOUR OBSERVER (FMEA) SKILLS DAILY 26
- 27. 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 27
- 28. 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 28
- 29. EXERCISE YOUR OBSERVER SKILLS 29
- 31. Failure Risk? Pre: PPE Vitals: Anticipate Correction • P120 • BP 160/100 • R 24 • O2Sat 95% • T 37.6 31
- 32. Failure Risk?: Pre-PPE Caution: If Drink 700 cc Correction 32
- 53. General Failure Risks • Contamination • Equipment: Improper use or Failure • Physiologic: Fatigue, Heat • Psychological: Claustrophobia 53
- 54. 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 54
- 55. 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. • Laurie.mazurik@cbrnecc.ca 55www.cbrnecc.ca
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