Training and Simulation
During disease outbreaks, PPE in healthcare institutions is the vital link to curb potential spread of disease. It is mandatory for every healthcare worker to undergo training in appropriate and proper use of PPE. This includes correct sequencing of donning and doffing of PPE. Teaching through electronic refresher modules is mandated for every staff in the hospital. In addition, reminders on strict observance of hand hygiene as well as updates on hand hygiene compliance are frequently emphasised and reinforced in the hospital.
Training in the handling of PAPR is conducted by the Occupational and Environmental Unit for doctors and nurses. This includes the maintenance and checking on the functionality of the PAPR equipment, as well as its cleaning and disinfection.
Emphasis was placed on training including scenario modelling coupled with simulation dry-runs. Our objective was to foster understanding between different departments in the adoption and implementation of the newly-developed algorithms and protocols, so that each party is fully aware of its roles and level of participation in the event of encountering a true COVID-19 suspect or confirmed pregnant mother. This included physical dry-runs between the various stations and venues (such as labour ward, isolation ward, designated operating theatre and the emergency department), while assessing the logistics and feasibility of our developed pathways and algorithms. In addition, we conducted a separate in-situ simulation on a healthy patient who was planned for an elective caesarean section. This was conducted with her full consent. The caesarean section was performed with full PPE and full infection control protocols with the objective of identifying potential gaps or deficiencies for improvement. A post-mortem meeting with all multidisciplinary participants was conducted to identify areas of deficiencies and to propose measure to address them. All clinicians from our maternity centre are kept abreast of these finalised processes.