Utilizing Outpatient Staff as Personal Protective Equipment Coaches During the COVID-19 Pandemic

Abstract

Background:

The novel coronavirus (COVID-19) is a highly contagious, public health emergency. COVID-19 creates risk for healthcare workers, especially those unfamiliar with utilizing personal protective equipment (PPE). In a large pediatric health care system, we aimed to reduce transmission from COVID-19 patients as well as transmission from clinical staff and patient/caregivers by creating the role of PPE coach (PPEC).

Methods:

Our health system redeployed outpatient clinical staff (OCS) into the role of the PPECs, including registered respiratory therapists, registered nurses, nurse anesthetists, and surgical technicians. PPECs received training on PPE best practices, organizational standards, and coaching within the clinical environment. PPECs were introduced to our organization by utilizing mass email distribution and visible by assigning them as PPECs in the hospital communication tool (Voalte, Inc., FL). PPECs began supporting the health system on April 1st, 2020. PPECs were primarily responsible for observing and providing feedback on PPE donning and doffing. They were also able to answer PPE-related questions and escalate concerns or issues to our organizational COVID-19 incident command team. PPECs remained deployed throughout the COVID-19 pandemic. An IRB approved survey (Table 1) was sent out to associates via mass email distribution to review the PPEC role after 30 days on 5/1/20 and was open for 15 days.

Results:

PPECs observed, on average, 47.6 donning or doffing events each day. 64.80% of surveyed staff found that PPECs were able to improve their donning and doffing technique to remain in compliance with procedural standards (n=116). 78.63% of staff surveyed found the role of the PPEC to be effective (n=116). From 4/1/20-4/30/20 PPECs escalated 152 issues to incident command, which resulted in 43 changes to the standard practice during this global emergency. The role also appeared to aid in reducing anxiety related to PPE in our institution.

Conclusions:

By redeploying staff within our health system as PPECs, we were able to increase safety practices and reduce potential contamination during PPE donning and doffing. Redeployment of OCS in the role of PPECs during the COVID-19 pandemic was paramount in our organizational success in this climate. Further studies must be done to assess temporary roles and re-deployment practices within the field of respiratory care and other disciplines as well as the overall impact.

PPEC 30-day Feedback Survey Questions

Question #	Question	Response Options
1	Donning and Doffing of PPE was modified based on PPEC instruction what percentage of the time?	a. N/A or not observedb. 0% of the timec. 20% of the timed. 40% of the timee. 60% of the timef. 80% of the timeg. 100% of the time
2	Do you feel that the role of the PPEC is useful and effective?	a. Yesb. No
3	Was the PPEC was easily accessible on Voalte?	a. Yesb. No
4	I received closed loop communication and closure to unanswered questions/concerns within 72 hours?	a. Yesb. No
5	The role of PPEC would be useful outside of a global pandemic?	a. Trueb. False
6	Any additional feedback/comments	Blank type box responses permitted

Table 1 shows the survey items sent to associates after PPEC were deployed for 30 days.

Graph 1 shows the number of reported PPE Observations per day in the month of April.

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