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Trained Observers for
Donning/Doffing PPE
1
Reducing Serious Communicable Disease Threats
Join the Move to Sustainable Saf...
At the end of this session you will understand:
• The Culture of Safety
• What Trained Observers watch for in Donning/Doff...
THE CULTURE OF SAFETY
3
The Culture of Safety
• Safety is everyone’s
responsibility
• Openly sharing
information without
reprisal is essential
• L...
Language is Important
• United Airlines discovered
that crew “hierarchy” can
lead to important
information being missed,
w...
Language is Important
• When black box tapes
from air crashes were
reviewed, it was noted
there were times the
Co-pilot ex...
CUUS
United Airlines created CUUS - 4 critical words – which - if used
- translate to
“STOP AND LISTEN. We have a potentia...
You will know you have a
Culture of Safety when you:
• Openly share ideas
• Listen to each other
• Think innovatively
abou...
TRAINED OBSERVERS FOR
DONNING/DOFFING PPE
9
What is a Trained Observer?
That’s a great question!
In general terms, Trained Observers are people
trained to “observe a ...
Trained Observers
for Donning/Donning of PPE
This Trained Observer will watch others:
1. Prepare to Don PPE
2. Don their P...
Trained Observers for
Donning and Doffing of PPE
• Observe others donning-
doffing, using a check list to
insure it is don...
Trained Observers for
Donning and Doffing of PPE
• The Trained Observer must
verbally confirm each step
with the person be...
Trained Observers for
Donning and Doffing of PPE
• If staff need hands-on
assistance, a “buddy”
should help and the Traine...
Trained Observers for
Donning and Doffing of PPE
• Over time, as staff gain
experience, they will be
able to don and doff ...
Trained Observers for
Donning and Doffing of PPE
• The Safest Model for a
Trained Observer in the
Donning and Doffing of P...
To Support the Trained Observer
Institutions/Agencies must
have:
• Checklists for donning and
doffing their specific PPE
•...
ORGANIZATIONAL SAFETY LEADERS
Working with
18
Organizational Safety Leaders
• The Role of a Safety Leader
is to monitor workplace
activities to ensure workers
comply wi...
In the Setting of A Serious Communicable Disease
Organizational Safety Leaders oversee:
• Risk based Selection of PPE
• Sc...
In the Setting of A Serious Communicable Disease
Organizational Safety Leaders
Must work with others to
establish protocol...
In the Setting of A Serious Communicable Disease
Organizational Safety Leaders
22
• Must be strong
promoters of the
Cultur...
FAILURE MODE AND EFFECTS
ANALYSIS
23
Failure Mode and Effects Analysis
(FMEA)
FMEA is a systematic,
proactive method for
evaluating a process to:
• Identify wh...
Failure Mode and Effects Analysis
(FMEA)
• The Ultimate Goal of
FMEA is identifying
risk/failures and
PROACTIVELY
correcti...
EXERCISING YOUR OBSERVER
(FMEA) SKILLS DAILY
26
Exercising your
Observer (FMEA) Skills Daily
• Hand-washing
• Seal checks of your N95
• Proper Glove removal
• Waste dispo...
Exercising your Trained
Observer (FMEA) Skills Daily
Review online protocols or the
training materials of others to:
• Ide...
EXERCISE YOUR OBSERVER SKILLS
29
Failure RISK?
Anticipate Correction
30
Failure Risk?
Pre: PPE Vitals: Anticipate Correction
• P120
• BP 160/100
• R 24
• O2Sat 95%
• T 37.6
31
Failure Risk?: Pre-PPE
Caution: If Drink 700 cc Correction
32
Failure Risk?
Anticipate Correction
33
Failure Risk?
Anticipate Correction
34
Failure Risk?
Anticipate Correction
35
Failure Risk?
Anticipate Correction
36
Failure Risk?
Anticipate Correction
37
Failure Risk?
Anticipate Correction
38
Failure Risk?
Anticipate Correction
39http://www.ecdc.europa.eu/
Failure RISK?
Anticipate Correction
40
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
45
Failure Risk?
Anticipate Correction
46http://www.ecdc.europa.eu/
Failure Risk?
Anticipate Correction
47http://www.ecdc.europa.eu/
Failure Risk?
Anticipate Correction
48
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
52
General Failure Risks
• Contamination
• Equipment: Improper use or Failure
• Physiologic: Fatigue, Heat
• Psychological: C...
Safety belongs to all of US
• The CBRNE Collaborative
is a Public Health Agency
of Canada Project,
sponsored by the
Canadi...
The Trained Observer
Slide Presentation
• Was Created by Dr. Laurie
Mazurik, Staff Emergency
Physician at Sunnybrook
Healt...
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Trained observers for donning doffing ppe cbrne collaborative[1]

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Trained observers for donning doffing ppe cbrne collaborative[1]

  1. 1. Trained Observers for Donning/Doffing PPE 1 Reducing Serious Communicable Disease Threats Join the Move to Sustainable Safety: www.cbrnecc.ca
  2. 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. 3. THE CULTURE OF SAFETY 3
  4. 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. 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. 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. 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. 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
  9. 9. TRAINED OBSERVERS FOR DONNING/DOFFING PPE 9
  10. 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. 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. 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. 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. 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. 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. 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. 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. 18. ORGANIZATIONAL SAFETY LEADERS Working with 18
  19. 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. 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. 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. 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. 23. FAILURE MODE AND EFFECTS ANALYSIS 23
  24. 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. 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. 26. EXERCISING YOUR OBSERVER (FMEA) SKILLS DAILY 26
  27. 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. 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. 29. EXERCISE YOUR OBSERVER SKILLS 29
  30. 30. Failure RISK? Anticipate Correction 30
  31. 31. Failure Risk? Pre: PPE Vitals: Anticipate Correction • P120 • BP 160/100 • R 24 • O2Sat 95% • T 37.6 31
  32. 32. Failure Risk?: Pre-PPE Caution: If Drink 700 cc Correction 32
  33. 33. Failure Risk? Anticipate Correction 33
  34. 34. Failure Risk? Anticipate Correction 34
  35. 35. Failure Risk? Anticipate Correction 35
  36. 36. Failure Risk? Anticipate Correction 36
  37. 37. Failure Risk? Anticipate Correction 37
  38. 38. Failure Risk? Anticipate Correction 38
  39. 39. Failure Risk? Anticipate Correction 39http://www.ecdc.europa.eu/
  40. 40. Failure RISK? Anticipate Correction 40
  41. 41. Failure Risk? Anticipate Correction 41http://www.ecdc.europa.eu/
  42. 42. Failure Risk? Anticipate Correction 42http://www.ecdc.europa.eu/
  43. 43. Failure Risk? Anticipate Correction 43http://www.ecdc.europa.eu/
  44. 44. Failure Risk? Anticipate Correction 44http://www.ecdc.europa.eu/
  45. 45. Failure Risk? Anticipate Correction 45
  46. 46. Failure Risk? Anticipate Correction 46http://www.ecdc.europa.eu/
  47. 47. Failure Risk? Anticipate Correction 47http://www.ecdc.europa.eu/
  48. 48. Failure Risk? Anticipate Correction 48
  49. 49. Failure Risk? Anticipate Correction 49http://www.ecdc.europa.eu/
  50. 50. Failure Risk? Anticipate Correction 50http://www.ecdc.europa.eu/
  51. 51. Failure Risk? Anticipate Correction 51http://www.ecdc.europa.eu/
  52. 52. Failure Risk? Anticipate Correction 52
  53. 53. General Failure Risks • Contamination • Equipment: Improper use or Failure • Physiologic: Fatigue, Heat • Psychological: Claustrophobia 53
  54. 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. 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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