Personal Protective Equipment during the COVID-19 pandemic and operative time in cesarean section: retrospective cohort study* (original) (raw)
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Emergent Procedure Training in the 21st Century
Emergency Medicine - An International Perspective, 2012
Procedural competency is a substantial part of the emergency physician's (EP) skill set. Emergency Medicine (EM) is unique in that the practicing EP must be comfortable with a wide array of procedures that have the following features: 1) They span the entire human body and cross many disciplines in medicine and surgery; 2) There are both invasive and non-invasive procedures; 3) They occur at unpredictable frequencies and never on a schedule; 4) They often need to performed under significant time-pressure; and 5) The patients they need to be performed on are often critically ill and unstable. The Model of the Clinical Practice of Emergency Medicine (EM Model) serves as the guide for the content expertise that EPs are expected to have as active practitioners in the specialty. The EM Model was first developed in 2001 by the Core Content Task Force II and involved the collaboration of six EM organizations: the American Board of Emergency Medicine (ABEM), the American College of Emergency Physicians (ACEP), the Council of Emergency Medicine Residency Directors (CORD), the Emergency Medicine Residents' Association (EMRA), the Residency Review Committee for Emergency Medicine (RRC-EM), and the Society for Academic Emergency Medicine (SAEM).(1) It has undergone biannual revisions with the most recent revision in 2009. The EM Model specifies the types of procedures representative of the domain of emergency medicine (Table 1).(2) These include procedures such as: airway techniques, anesthetic techniques, bedside and procedural ultrasonography, obstetrics, resuscitation, head and neck procedures, thoracic procedures, skeletal procedures, vascular access, wound management, genitourinary procedures, gastrointestinal procedures, lumbar puncture, and others.
The Bangkok Medical Journal, 2021
To determine the effect of the respiratory protective training program of healthcare personnel (HCP) during the Coronavirus Disease 2019 (COVID-19) pandemic at a private hospital in the northern part of Thailand. MATERIALS AND METHODS: This cross-sectional study was conducted with 89 healthcare personnel (HCP) of Bangkok Hospital Phitsanulok, who required wearing a tight-fitting respirator during their duties and attended respiratory protective equipment (RPE) video-based training program regarding the general principles of respirator usage and guidelines on safely re-using RPE. A questionnaire-based assessment of participants' 3-month retention of knowledge and perception was conducted in April 2021. A qualitative fit test (QLFT) was used in terms of practice on RPE. The proportion of correct responses in the 3-month knowledge and perception score were compared with a pre-training test and an immediate post-training test using paired t-test. The same analysis was conducted with QLFT using McNemar's test. RESULT: Various types of RPE were used in each test depending on the supply. The most commonly used RPE was N95 (58.4%), the majority of N95 was 3MVLFEX 9105. Compared with the pretraining test, the proportion of correct responses in the immediate post-training test increased by 11% (p < 0.001; 95% CI 1.07-2.23). Similarly, in 3-month post-training, the percentage of correct response also increased from pre-training by 10.4% (p < 0.001; 95% CI 0.08-2.28). HCP had an excellent level of perception on using RPE during COVID-19. No significant change in perception was found between pretraining and both immediate and 3-months after training (p = 0.536 and p = 0.384 respectively) The pass rate significantly raised to 96.6% for an immediate post-training test (p < 0.001) and to 98.8% after 3-month (p < 0.001). CONCLUSION: Training has played an important role to help HCP improve their knowledge and practice regarding the usage of RPE, but has no significant effect on perception. The assessment of knowledge, perception and practice retention of RPE usage after 3-month showed the positive impacts of video-based training groups on participants' knowledge and practice. Further evaluations are needed on the interventions that enhance HPC perceptions and attitudes on safety behavior. Pre-and in-service training programs for frontline HPC during a Coronavirus 19 disease pandemic need to be considered by Thai Ministry of Public Health.
Infection Control and Hospital Epidemiology, 2023
Background: Healthcare personnel (HCP) may encounter unfamiliar personal protective equipment (PPE) during clinical duties, yet we know little about their doffing strategies in such situations. Objective: To better understand how HCP navigate encounters with unfamiliar PPE and the factors that influence their doffing strategies. Setting: The study was conducted at 2 Midwestern academic hospitals. Participants: The study included 70 HCP: 24 physicians and resident physicians, 31 nurses, 5 medical or nursing students, and 10 other staff. Among them, 20 had special isolation unit training. Methods: Participants completed 1 of 4 doffing simulation scenarios involving 3 mask designs, 2 gown designs, 2 glove designs, and a full PPE ensemble. Doffing simulations were video-recorded and reviewed with participants during think-aloud interviews. Interviews were audiorecorded and analyzed using thematic analysis. Results: Participants identified familiarity with PPE items and designs as an important factor in doffing. When encountering unfamiliar PPE, participants cited aspects of their routine practices such as designs typically used, donning and doffing frequency, and design cues, and their training as impacting their doffing strategies. Furthermore, they identified nonintuitive design and lack of training as barriers to doffing unfamiliar PPE appropriately. Conclusion: PPE designs may not be interchangeable, and their use may not be intuitive. HCP drew on routine practices, experiences with familiar PPE, and training to adapt doffing strategies for unfamiliar PPE. In doing so, HCP sometimes deviated from best practices meant to prevent self-contamination. Hospital policies and procedures should include ongoing and/or just-in-time training to ensure HCP are equipped to doff different PPE designs encountered during clinical care.
Journal of Occupational & Environmental Medicine, 2020
Objective: To develop an emergency training program of personal protective equipment (PPE) for general healthcare workers (HCWs) who may be under the threat of Corona Virus Disease 2019 (COVID-19) and evaluate the effect of the program. Methods: A three-stage training program was designed. The complete clinical workflow together with infectious disease ward was simulated. To verify the effect of the program, an experimental training with pre- and post-test was conducted before large-scale training. Results: Post-test scores were significantly improved when compared with the pre-test scores. Among all PPE, N95 respirator and protective coverall needed training most. Meanwhile, “proficiency level” and “mutual check & help” also needed to be strengthened as independent scoring points. Conclusion: This training program significantly improved the performances of participants. It may therefore be applied for general HCWs on a larger scale.
Cureus, 2022
Introduction The COVID-19 pandemic exposed gaps in the knowledge of correct donning and doffing of personal protective equipment (PPE) among healthcare workers, causing hospitals to ramp up training. However, social distancing measures forced most institutions and workplaces to shift to remote operations, allowing only essential personnel onsite. Virtual simulation is a growing trend in healthcare simulation education, even more so in this pandemic era. Yet, we have found no evidence of the perceived effectiveness of virtual simulation for training healthcare providers in the proper donning and doffing of PPE. This study aims to determine learner perceptions of the effectiveness of a virtual simulation PPE training module. Methods To address this gap, we used a virtual simulation training module in an online format to determine the perceived efficacy of this method of instruction with the contribution of a variety of healthcare providers and trainees, including physicians, surgeons, pharmacists, dentists, and nurses. Results We found a statistically significant difference in the confidence level of observing best practices of donning and doffing PPE before and after the training sessions. We also found that participants believe virtual simulation can be an effective educational tool for clinical skills. Conclusions This paper presents an international, guideline-based virtual simulation training module that can serve to educate, train, and assess healthcare workers in the proper sequence and technique of donning (putting on), doffing (removing), and disposing of PPE without contaminating themselves or others.
Deliverable 9-Evaluation report of training and the use of training tools
Page 1. 1 Improving the continuity of patient care through identification and implementation of novel patient handover processes in Europe HANDOVER – 2008 - 223409 Project Deliverable Report Deliverable 9 - Evaluation report of training and the use of training tools Work Package 4 Task Evaluation report regarding training and use of tools Date of delivery Contractual: 30-09-2011 Actual: 27-09-2011 Code name Version: 1.0 Final x Type of deliverable Report Security (distribution level) PU ...
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2023
Introduction: Acquiring and retaining minimally invasive surgery (MIS) skills may be aided by using MIS take-home box simulators. This study aims to evaluate the use of a take-home MIS box trainer for training sessions at-home. Methods: Trainees who previously bought the LaparoscopyBoxx (between 2016 and 2020) were asked to complete an online questionnaire. The first part was on their demographic data, and the second part was on their use and opinion on the box trainer (on a 5-point Likert scale). Results: A total of 39 participants (9 surgeons and 30 trainees) completed the questionnaire (response rate 40%). Overall, participants had a positive opinion on the use of the box trainer and would recommend it to others for training (mean 4.2). Basic tasks, such as needle trail and ring transfer, were practiced most often and were regarded most relevant (mean 4.1-4.3). They regarded practicing on the stimulator of added value to practicing in the clinic (mean 4.2), were more confident during clinical procedures (mean 3.9), and felt that their skills had improved (mean 4.1). Of quarter of the participants who bought the MIS box trainer during the COVID-19 pandemic reported an increased use during times of less clinical exposure. Conclusion: Surgeons and trainees have a positive opinion on using a take-home MIS box trainer for at-home training for general as well as for pediatric MIS skills. Especially during periods of less exposure in the clinical setting and less hands-on courses, such as during the COVID-19 pandemic, at-home training may be a valuable addition.
Building an effective training continuum in surgery:Developing a safe practitioner.pdf
Medical education has initiated major paradigm shifts in the last few decades aimed primarily at meeting the challenges of medical practice in the 21st century and also because of patient safety concerns. It is imperative that the design of a curriculum appropriate for surgical trainees in this new millennium must ensure a continuum of learning from undergraduate to postgraduate education and training. Educational leaders and team members responsible for planning and implementation of any curriculum reform should apply the principles of Best Evidence Medical Education (BEME) in the decisionmaking process in order to optimise the educational process and results. It is best to adopt a result oriented course design in developing and planning a surgical training programme which would equip the surgeon with the requisite professional competencies for practice in the 21st century.
Training and simulation for patient safety
Quality and Safety in Health Care, 2010
Background Simulation-based medical education enables knowledge, skills and attitudes to be acquired for all healthcare professionals in a safe, educationally orientated and efficient manner. Procedure-based skills, communication, leadership and team working can be learnt, be measured and have the potential to be used as a mode of certification to become an independent practitioner. Results Simulation-based training initially began with life-like manikins and now encompasses an entire range of systems, from synthetic models through to high fidelity simulation suites. These models can also be used for training in new technologies, for the application of existing technologies to new environments and in prototype testing. The level of simulation must be appropriate to the learners' needs and can range from focused tuition to mass trauma scenarios. The development of simulation centres is a global phenomenon which should be encouraged, although the facilities should be used within appropriate curricula that are methodologically sound and cost-effective. Discussion A review of current techniques reveals that simulation can successfully promote the competencies of medical expert, communicator and collaborator. Further work is required to develop the exact role of simulation as a training mechanism for scholarly skills, professionalism, management and health advocacy.
Do medical students receive training in correct use of personal protective equipment?
Medical education online, 2017
Healthcare personnel often use incorrect technique for donning and doffing of personal protective equipment (PPE). We tested the hypothesis that medical students receive insufficient training on correct methods for donning and doffing PPE. We conducted a cross-sectional survey of medical students on clinical rotations at two teaching hospitals to determine the type of training they received in PPE technique. The students performed simulations of contaminated PPE removal with fluorescent lotion on gloves and were assessed for correct PPE technique and skin and/or clothing contamination. To obtain additional information on PPE training during medical education, residents, fellows, and attending physicians completed written questionnaires on PPE training received during medical school and on knowledge of PPE protocols recommended by the Centers for Disease Control and Prevention. Of 27 medical students surveyed, only 11 (41%) reported receiving PPE training, and none had received train...