Full-Dress Rehearsals with Actual Non-Infected Patients Builds Confidence and Familiarity - An Experience from Singapore during the COVID-19 Pandemic.

PURPOSE: COVID-19 has spread throughout the world with merciless pace. Personal protective equipment (PPE) is required to protect healthcare workers from contracting the virus. The authors evaluated the use of full-dress rehearsals (FDR) to familiarize staff with protocols and equipment that are not often use otherwise. METHODS: A single institution in Singapore performed FDR with noninfected patients for endoscopy after refresher courses with PPE were conducted. FDRs were conducted between February and March 2020, during the initial phase of the COVID-19 outbreak. The FDRs involved all phases of endoscopy. Statistics from the FDRs were compared against baseline procedure statistics. A self-administered survey was conducted for the procedurists after the FDRs. RESULTS: A total of 26 FDRs were conducted and 20 (77%) completed the survey. Among all the FDRs conducted, there was a slight increase in duration for colonoscopy FDRs (21.5 min vs 20.0 min, p = 0.22). There were no complications. All respondents had a good experience (score rating of 4-5/5).On qualitative analysis, the themes identified were:FDRs provided a good opportunity to have hands-on familiarization of the equipment on top of routine refresher training.Participants were cognizant of the ongoing outbreak and the evolving threat.Safety measures were reinforced.Procedurists who acknowledged weaknesses, requested for more training. CONCLUSIONS: Simulation training with patients provides participants with a level of realism that is critical for rapid learning. In crisis management, the most effective protocol familiarization is important to instill confidence in the PPE, workflows and healthcare partners.

Perceptions of healthcare workers in high-risk areas of a Singapore hospital during COVID-19: a cross-sectional study.

Introduction: There is worldwide concern over the psycho-emotional impact of COVID-19 on healthcare workers (HCWs). This study aimed to elicit HCWs' perceptions of the adequacy of protective measures in high-risk clinical areas and the factors associated with these perceptions. Methods: This was a cross-sectional study conducted in April 2020. An anonymous electronic survey was sent via email to operating theatre (OT) and intensive care unit (ICU) staff of Sengkang General Hospital, Singapore. Results: Of the 358 eligible participants, 292 (81.6%) responded to the survey. 93.2% of the participants felt that precautionary measures at work were sufficient and 94.9% acknowledged that adequate training was provided. More than 60% of the participants opined that their chances of contracting COVID-19 were moderate to high. Female gender, nursing occupation and duration of service <10 years were significantly associated with increased fear of contracting COVID-19, less control over occupational exposure and lower perceived need to care for COVID-19 patients. Having young children at home did not significantly affect these perceptions. The most important ICU precautions were availability of personal protective equipment outside the rooms of COVID-19 positive patients (95.3%) and having visitor restrictions (95.3%). The most important OT measures were having a dedicated OT for COVID-19 positive patients (91.2%) and having simulation as part of protocol familiarisation (91.7%). Conclusion: Overall, there was high confidence in the adequacy of COVID-19 protective measures to prevent healthcare transmission in Singapore. The pandemic had a lower degree of psycho-emotional impact on HCWs here as compared to other countries.