key: cord-0989879-22gjsv15 authors: Lincoln Liow, Ming Han; Lee, Lai Chee; Nigel Tan, Choon Kiat; Tan, Hiang Khoon; Chow, Weien; Elaine Wee, Geok Ling; Wong, Sin Hui; Paramasivam, Jayarani; Tan, Kevin; Ling, Moi Lin title: Personal Protective Equipment Training For Non-Healthcare Workers In The Covid-19 Pandemic: Effectiveness Of An Evidence-Based Skills Training Framework date: 2021-10-07 journal: Infect Dis Health DOI: 10.1016/j.idh.2021.09.040 sha: 4c484f67de895cb5c1c2a33e50a11e62f6f86526 doc_id: 989879 cord_uid: 22gjsv15 BACKGROUND: Large-scale quarantine facilities staffed with non-healthcare workers (NHCW) were instrumental in preventing community spread of COVID-19 (coronavirus disease of 2019). The objective of this study was to determine the effectiveness of a newly developed procedural skills training framework in ensuring personal protective equipment (PPE) compliance of PPE-naïve NHCWs. MATERIALS AND METHODS: We developed a PPE procedural skills training framework for NHCWs using the Learn, See, Practice, Prove, Do, and Maintain (LSPPDM) framework and international guidelines on PPE for healthcare workers. The NHCWs underwent PPE training using this framework, conducted by a team of Infection Prevention nurses, prior to being stationed within the CCF. Effectiveness of the LSPPDM PPE training framework was assessed using: 1) competency assessment scores for NHCWs, 2) PPE compliance rates from daily audit findings, and, 3) healthcare-associated COVID-19 infection rates of NHCWs. RESULTS: A total of 883 NHCWs had completed the PPE training and demonstrated competency in PPE compliance, fulfilling 100% of the checklist requirements. Mean PPE compliance of all NHCWs during the 11-week study period was noted to be >96%. The post-implementation improvement was statistically significant when the compliance was expressed in 3-days blocks) and in bed management staff (P = < 0.05). None of the 883 NHCWs who underwent PPE training via the LSPPDM framework were diagnosed with healthcare-associated COVID-19 infection. CONCLUSIONS: An evidence-based skills training framework is effective in PPE training of large numbers of NHCWs, resulting in high compliance of appropriate PPE use and prevention of healthcare-associated COVID-19 infection. Conceptualization and design of the study; analysis and interpretation of the findings; gave final approval of the article to be published Moi Lin Ling Conceptualization and design of the study; analysis and interpretation of the findings; gave final approval of the article to be published 1 Background: 24 Large-scale quarantine facilities staffed with non-healthcare workers (NHCW) were 25 instrumental in preventing community spread of COVID-19 (coronavirus disease of 2019). 26 The objective of this study was to determine the effectiveness of a newly developed procedural 27 skills training framework in ensuring personal protective equipment (PPE) compliance of 28 PPE-naïve NHCWs. Materials and methods: 30 We developed a PPE procedural skills training framework for NHCWs using the Learn, See, 31 Practice, Prove, Do, and Maintain (LSPPDM) framework and international guidelines on PPE 32 for healthcare workers. The NHCWs underwent PPE training using this framework, conducted 33 by a team of Infection Prevention nurses, prior to being stationed within the CCF. Effectiveness of the LSPPDM PPE training framework was assessed using: 1) competency 35 assessment scores for NHCWs, 2) PPE compliance rates from daily audit findings, and, 3) 36 healthcare-associated COVID-19 infection rates of NHCWs. demonstrate competencies in all assessed aspects before they were considered 'competent' and 136 allowed to work in "hot zones" within CCF@EXPO. No funding had been received during or after this study. Provenance and peer review 324 Not commissioned; externally peer reviewed. The authors have no conflict of interest to declare. The glove is then peeled off, turned inside out and removed 2.4 The removed gloved is held in the palm of the other gloved hand 2.5 Un-gloved fingers are slid under the remaining glove and the remaining glove is turned inside out and removed 3 Gown is removed in correct sequence and safe manner 3. 1 The bottom ties are unfastened followed by the top ties 3.2 Ribbon knots are NOT snapped 3.3 Hands and the sleeves do not make contact with other surfaces of the body 3.4 Gown is pulled away from the neck and shoulders, touching the inside only 3.5 Gown is turned inside out 3.6 Both elbows are straightened, gown is then rolled downwards and away from the body 3.7 Gown is not torn forcefully 4 Eye protection is removed in correct sequence and safe manner 4.1 Head is leaned forward slightly and chin is lifted up 4.2 Goggles strap or face shield headband is removed gently 5 N95 mask is removed in correct sequence and safe manner 5.1 Bottom strap of the mask is grasped firmly and then the top strap is grasped using another hand 5.2 Mask is removed by pulling it away from face without touching any part of the face Managing COVID-19 in a 334 novel, rapidly deployable community isolation quarantine facility SARS-CoV-2) from a symptomatic patient 328 We wish to thank and acknowledge the contribution of all staff who had contributed in the 3- Eyes protection is donned on as indicated Eye protection is donned on in correct sequence and safe manner Eye protection is removed in correct sequence and safe manner Eye protection is disinfected properly after use Eye protection is kept in a clean re-sealable plastic bag in safe manner when not in use Disposable eye protection is disposed in safe manner 6. Head cover ** Head cover is donned on as indicated Head cover is donned on in correct sequence and safe manner Head cover is removed in correct sequence and safe manner Head cover is disposed in safe manner Note * This checklist focuses on staff' compliance in appropriate use of PPE. The audit on the compliance of other IP measures including accessibilities of hand hygiene agents and PPE is outlined in another checklist.Note ** Head cover is NOT part of PPE standards. The only indication is for staff with long hair to contain their hair while carrying out duties in the hot zone. Care must be taken to prevent self-contamination during removal and thus the item has been included in the audit. Infection Prevention Team used the checklist to audit staff compliance with hand hygiene and 426 PPE (personal protective equipment) protocols. "Yes" = compliance; "No" = non-compliance; "NA" = non-applicable.