Personal Protective Equipment for CUH staff during the COVID-19 outbreak – Trust agreed guideline
The objective of this guideline for staff is to:
- Maximise the protection for our staff working with suspected or confirmed COVID-19 patients
- Enable our staff to feel confident in performing their duties
- Maximise the efficiency and effectiveness of our PPE usage
Tuesday 01 September 2020 – updated PHE infection prevention & control guidance
Public Health England (PHE) has recently published updated COVID-19 infection prevention & control guidance. Notably this includes a de-escalation in some aspects of the PPE required for healthcare workers managing patients who have tested COVID-negative whilst maintaining the current PPE strategy for those patients who are confirmed as COVID-positive or whose COVID status is unknown.
Divisional leaders have been informed of the new guidance and have been asked to cascade to their teams for implementation. The full guidance can be found here.
In response to the COVID-19 outbreak, the following protocol is now in place for the use of PPE when working with COVID-19 positive or suspected patients. The protocol also provides recommendations for best working practice during this response.
The proposal is outlined in the following scenarios:
- Scenario 0: All clinical areas without any known or suspected COVID-19 cases
- Scenario 1: Designated ward, triage and assessment based care with suspected or confirmed COVID-19 patients;
- Scenario 2: Cohorted areas where aerosol-generating procedures (AGP) are carried out frequently with suspected or confirmed COVID-19 patients; and
- Scenario 3: Operating theatres and other areas where procedures are performed with suspected or confirmed COVID-19 patients.
PPE educational programme
To ensure staff feel confident in the use of PPE during the COVID-19 pandemic, a DOT training package is now available for all staff, which consists of e-learning and face-to-face sessions (with appropriate social distancing).
On the DOT e-learning package, staff will watch two videos detailing the PPE required for scenario 0 and 1.These scenarios cover all clinical areas, with the exception of critical care, and include the approach to PPE for all patients. This includes those without COVID-19 and those who are known or suspected to have the virus. There is also information on understanding the risks of aerosol generating procedures (AGPs), as well as a link to the updated guidance on basic life support and resuscitation, relevant to all staff in the Trust. You will then be tested with 10 multiple choice questions to consolidate your learning.
The second DOT package relates to practical training and is complimentary to the e-learning package. The practical sessions are being held in the William Harvey Lecture Theatre and the Alice Fisher Lecture Theatre (with appropriate social distancing) for the next three weeks and can be booked via the DOT portal. While the content is much the same as the e-learning package, this practical session includes a personal demonstration of PPE donning and doffing procedures, as well as a question and answer session.
Many staff members, and in particular non-clinical staff who have had limited experience of using PPE, may find it helpful to attend one of these sessions.
Additional recommendations for working practice :
- Staff working in critical care areas to take breaks every four hours in order to:
- Maximise the efficiency of our PPE usage as over the course of a 12-hour shift this will only incur the need for three changes of PPE
- Move from fit-testing to fit-checking after our experts agreed that:
- There is presently an inconsistency of FFP3 mask brands supplied to the Trust, each mask brand requiring a unique fitting;
- By moving to a fit checking process we will ensure that every time an FFP3 mask is used, a good facial seal is confirmed;
- This change in protocol has been employed by fellow Shelford Group trusts and has been risk assessed by the Trust;
- This will optimise the most efficient use of the FFP3 stock available to ensure we have a consistent supply for staff who need to wear full PPE;
- In the rare case where it is not possible to achieve a good seal, the Trust has ordered an increased supply of respiratory hoods.
- Please see films below showing how to fit check FFP3 masks with and without a valve.
- Cohorting of suspected or confirmed COVID-19 patients in order to:
- Avoid positive and suspected patients being placed on wards with asymptomatic patients;
- Improve the efficiency of our PPE usage.
- ( a risk assessment will be undertaken to assess the risk of cohorting suspected patients with confirmed positives)
- Decontamination and re-use of goggles and visors in order to:
- Improve the efficiency of our PPE usage
- (a risk assessment will be undertaken to assess the risk of decontaminating and re-using googles and visors)
- Use of visors with FFP3 masks
- In line with national guidance, when using FFP3 masks with valves staff should use visors, which are full face, rather than goggles.
Fit checking films
FFP3 mask with a value
This video is suitable for any valved FFP3 mask.
FFP3 mask without a valve
This video is suitable for any FFP3 mask without a valve.