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.