PE RSONAL PROT ECT IVE EQUIPMENT
Quality care begins with self-care The training solutions developed are broader than just technology. We explored mindfulness and self-care techniques and how they can be integrated into training. Mindfulness programmes have been seen to significantly reduce burnout and perceived stress for healthcare professionals while increasing resilience and work engagement in a large healthcare system.4
As a result
of the current COVID-19 pandemic, it is important that we recognise these stresses, fears, and risks of burnout among healthcare workers. Therefore, when designing a technology to support PPE training, we have sought to include mindfulness within the hand hygiene process. By participating in an act of self-care, you are looking after yourself which means you are better equipped to look after your patients.
Human Factors First Approach Led by Dr. Joan Cahill, research fellow, psychology, in Trinity College Dublin, the project took a “Human Factors First” approach and investigated the lived experience of HCWs during the pandemic. They followed a series of co-design sessions that incorporated HCWs into the technology development process.
As already stated, donning and doffing of PPE is a very stressful moment for staff and there is a well-established relationship
between wellbeing, performance, and safety. The challenge is to reduce the risk of burnout and the stress of donning and doffing by providing a system that provides a checklist for practice and incorporates mindfulness into the donning and doffing process. We already know from research that mindfulness reduces stress and by incorporating it in training, it offers a moment for pause and time out for HCWs. We need to change how PPE training is currently delivered and technology can give HCWs the tools they need to deliver safe, quality care. Checklists are an established
mechanism for reducing errors of omission in healthcare.5
But when people are tired
or distracted it can be difficult to follow a checklist. Following discussions with colleagues in Neuroscience, we became aware of the work on workplace safety called Kiken Yochi Training (KYT).6
This technique,
developed originally in Japan, is widespread in industry and healthcare. The concept is that, when checking a hazard, it is identified by a pointing gesture and spoken word – hence the nickname “point and call”. The reason that KYT is so successful, with a significant reduction in workplace incidents is that the physical movement and vocalisation turn on our attention mechanism. This reduces the risk that we will miss a step due to tiredness or distraction. It also sharpens awareness and helps learners to stop and think. The use of checklists for risk reduction has a long history in aviation and surgery7
and
in the design of the PPE training we have incorporated the gestures from KYT into working through the PPE checklist.
Leveraging hand hygiene training technology
Our PPE training solution is currently being finalised with the help of feedback from IPC experts around the world. The design has leveraged the existing SureWash Augmented Reality (AR) technology platform that delivers hand hygiene training via mobile apps and interactive kiosks which can be linked to learning management systems in healthcare settings around the world. Performing correct hand hygiene is of course a key part of the PPE donning and doffing.
AR has been shown to be especially effective as a learning tool for complex movement skills as it allows users to verify their learning outcomes while practising. This resulted in significantly accelerated learning compared to video instruction.8
see their progress and get instructions from the computer. The image is overlaid with real time feedback on their progress using augmented reality. The PPE trainer builds on the already validated hand hygiene training system to now include glove use, mask fit check and the donning and doffing of other elements of PPE.
AR
also produced better learning outcomes in physical education than video instruction, with more substantial effects for more complex movements.9 AR is particularly effective for PPE training as the large screen live video image acts a “magic mirror” allowing the user to
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Using an AR kiosk to deliver the PPE training makes it accessible 24/7, 365 days a year. It will also use a facility’s existing Learning Management System (LMS) to deliver comprehensive Infection Prevention and Control training. This therefore facilitates both at home knowledge training with workplace practice training. Ultimately, the PPE training kiosk will help reduce the time needed from IPC professionals, reduce the consumption of PPE during training and improve the overall usage of PPE. Quality training and retraining will help reduce the spread of HCAIs, improving patient outcomes and reducing hospital stays for patients. There is no doubt that COVID-19 has changed how training needs to be delivered going forward. Facilities need the ability to roll out training to a vast number of staff, rapidly, to be prepared for future outbreaks. This training needs to be convenient and self-operating to free up time needed by IPC professionals for other important tasks on the wards. Training and simulation technologies give staff the tools they need to succeed. However, as we have already mentioned, it goes beyond just technology. Self-care is the cornerstone to ensure safe, quality care
AUGUST 2021
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