Personal protective equipment training & lived experience for healthcare staff during COVID-19.

Objectives: To describe the lived experience of healthcare staff during the Coronavirus Disease 2019 (COVID-19) pandemic relating to the use of personal protective equipment (PPE) and investigate risks associated with PPE use, error mitigation and acceptability of mindfulness incorporation into PPE practice. Methods: A qualitative human factors' study at two Irish hospitals occurred in late 2020. Data was collected by semi-structured interview and included role description, pre-COVID-19 PPE experience, the impact of COVID-19 on lived experience, risks associated with PPE use, contributory factors to errors, error mitigation strategies and acceptability of incorporating mindfulness into PPE practice. Results: Of 45 participants, 23 of whom were nursing staff (51%), 34 (76%) had previously worn PPE and 25 (56%) used a buddy system. COVID-19 lived experience impacted most on social life/home-work interface (n=36, 80%). Nineteen staff (42%) described mental health impacts. The most cited risk concerned 'knowledge of procedures' (n=18, 40%). Contributory factors to PPE errors included time (n=15, 43%) and staffing pressures (n=10, 29%). Mitigation interventions included training/education (n=12, 40%). The majority (n=35, 78%) supported mindfulness integration into PPE practice. Conclusions: PPE training should address healthcare staff lived experiences and consider incorporation of mindfulness and key organisational factors contributing to safety.

Safe PPE: user needs for an interactive ppe training tool

Introduction: Staff competency and access to PPE training became critical early in the COVID 19 pandemic. This placed demands on infection prevention & control staff when already busy with COVID-19-related tasks. Objectives: To be prepared for the next pandemic, we investigated the role of mindfullness and technology in PPE training. Methods: Human factors research involving three clinical sites (N = 174) consiting of interviews, workshops and participatory codesign sessions. This was extended by interviews with 14 IPC experts from 7 sites in UK and USA. Results: Existing PPE & HH Training: - Addressed the lived experience of using PPE - Variety of training formats e.g. classroom (15%) and in-unit training (85%) - One (1/10) site assessed PPE competency - Four (4/10) sites used a Virtual Learning Environment to track the learner journey - One (1/10) site used a mobile phone based training Performance Shaping Factors: - Training, Fatigue, Distraction, Rushing, Stress, etc. - Changing types of PPE with different quality and fit - Changing PPE guidelines as IPC knowledge evolved Emerging Mobile Learning App Concept & Requirements: - All trainers expressed concerns of low engagement with phonebased training - Online and in-person training must be consistent - Assessment should be carried out on-site, with special-purpose equipment - PPE and Hand Hygiene training should incorporate self-care & mindfulness - Scenario-based training needed to support different clinical roles and needs - Customise training to local guidelines Conclusion: Mindfulness is a protective factor for effective and safe performance. Organisations should consider integrating wellness into IPC training. Technology can support in-person training but it is not a replacement and must be available 24-7. A variety of training access pathways are good but the Learner Journey should be tracked to ensure everyone is trained and skills are maintained over time.