ABSTRACT
ABSTRACT Objective To describe the personal protective equipment training strategies during the beginning of the pandemic and to investigate the association between training and COVID-19 infection among healthcare workers. Methods This cross-sectional study conducted between March and May 2020 included 7,142 healthcare professionals who were eligible for both online and face-to-face simulation-based training on personal protective equipment use. Simulation training attendance was assessed by reviewing the attendance list, and the COVID-19 sick leave records recovered from the institutional RT-PCR database used to grant sick leave. The association between personal protective equipment training and COVID-19 was investigated using logistic regression, adjusted for sociodemographic and occupational characteristics. Results The mean age was 36.9 years (± 8.3), and 72.6% of participants were female. A total of 5,502 (77.0%) professionals were trained: 3,012 (54.7%) through online training, 691 (12.6%) through face-to-face training, and 1,799 (32.7%) through both strategies. During the study period, 584 (8.2%) COVID-19 cases were diagnosed among these professionals. The number of positive RT-PCR tests was 180 (11.0%) for untrained professionals, 245 (8.1%) for those trained only online, 35 (5.1%) for those trained face-to-face, and 124 (6.9%) for those trained with both strategies (p<0.001). Participants who received face-to-face training had a 0.43 lower risk of contracting COVID-19. Conclusion Personal protective equipment training decreased the odds of COVID-19 among healthcare professionals, with face-to-face simulation-based training being most effective.
ABSTRACT
Introdução A simulação é uma metodologia usada para substituir ou amplificar experiências reais por experiências guiadas que evocam ou replicam aspectos do mundo real de maneira interativa. A simulação in situ leva essa técnica diretamente aos locais onde ocorrem atendimentos, com a própria equipe de saúde atuando em seu ambiente de trabalho em cenário simulado. Objetivo Descrever experiência piloto de simulação in situ realizada em unidade de pronto atendimento, destacando oportunidades de avaliação de sistema de atendimento, trabalho em equipe e detecção de ameaças latentes à segurança (ALS). Métodos Estudo aplicado na Unidade Ibirapuera do Hospital Israelita Albert Einstein e realizado pelo Centro de Simulação Realística Albert Einstein. Foi apresentado cenário de paciente de 45 anos com síndrome coronariana aguda que evolui para parada cardiorrespiratória. Simulação híbrida de 30 minutos com uso de ator e simulador de alta fidelidade (SimMan 3G®).Utilizado checklist e filmagem para avaliar habilidades e atitudes, usados em debriefing estruturado com uma hora de duração. Resultados A experiência proporcionou avaliação técnica, comportamental e sistemas. Detectou quatro ALS e permitiu reflexão guiada sobre trabalho em equipe. Conclusão Este piloto contribuiu para o alcance dos objetivos propostos com o cenário e demonstrou oportunidades de treinamento e melhoria. A simulação in situ pode ser usada no futuro sistematicamente para treinamento contínuo de equipes, visando à melhoria da qualidade de atendimento e à segurança do paciente. .
Introduction Simulation is a method used to substitute or enhance real experiences with guided, interactive experiences that are reminiscent of or replicate aspects of the real world.In situ simulation takes this technique directly to the places where health care is rendered, with the health team acting in a simulated scenario within their work environment. Objective To describe the pilot in situ simulation experience conducted at an accident and emergency unit, highlighting the opportunities to assess the care system, teamwork and detection of latent safety threats (LSTs). Methods The study was applied at the Ibirapuera Unit of the Hospital Israelita Albert Einstein and performed by the Albert Einstein Realistic Simulation Centre.A scenario was presented wherein a 45-year old patient whose acute coronary syndrome evolves into cardiac arrest.A 30-minute hybrid simulation involving the use of an actor and high fidelity simulator (SimMan 3G®).A checklist was used and the simulation was filmed in order to evaluate skills and attitudes in a structured 1-hour long debriefing. Results The experience provided a technical, behavioural and system assessment. Four LSTs were detected and it enabled a guided reflection on teamwork. Conclusion This pilot contributed to achieving the objectives proposed with the scenario and demonstrated opportunities for training and improvement.In situ simulation may be used systemically in the future for continuous team training, aimed at improving service quality and patient safety. .