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How to rapidly design and operationalise PPE donning and doffing areas for a COVID-19 care facility: quality improvement initiative.
BMJ Open Qual. 2020 09; 9(3)BO

Abstract

INTRODUCTION

Effective implementation of standard precautions specific to COVID-19 is a challenge for hospitals within the existing constraints of time and resources.

AIM

To rapidly design and operationalise personal protective equipment (PPE) donning and doffing areas required for a COVID-19 care facility.

METHODS

Literature review was done to identify all issues pertaining to donning and doffing in terms of Donabedian's structure, process and outcome. Training on donning and doffing was given to hospital staff. Donning and doffing mock drills were held. 5S was used as a tool to set up donning and doffing areas. Instances of donning and doffing were observed for protocol deviations and errors. Plan-do-study-act cycles were conducted every alternate day for 4 weeks. The initiative was reported using Standards for QUality Improvement Reporting Excellence (SQUIRE) guidelines.

RESULTS

Best practices in donning and doffing were described. Our study recommends a minimum area of 16 m2 each for donning and doffing rooms. Verbally assisted doffing was found most useful than visual prompts.

DISCUSSION

Challenges included sustaining the structure and process of donning and doffing, varied supplies of PPE which altered sequencing of donning and/or doffing, and training non-healthcare workers such as plumbers, electricians and drivers who were required during emergencies in the facility.

CONCLUSION

Our study used evidence-based literature and quality improvement (QI) tools to design and operationalise donning and doffing areas with focus on people, task and environment. Our QI will enable healthcare facilities to rapidly prototype donning and doffing areas in a systematic way.

Authors+Show Affiliations

Hospital Administration, All India Institute of Medical Sciences, New Delhi, India TEJ.WUNDAVALLI@GMAIL.COM.Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32978176

Citation

Wundavalli, LaxmiTej, et al. "How to Rapidly Design and Operationalise PPE Donning and Doffing Areas for a COVID-19 Care Facility: Quality Improvement Initiative." BMJ Open Quality, vol. 9, no. 3, 2020.
Wundavalli L, Singh S, Singh AR, et al. How to rapidly design and operationalise PPE donning and doffing areas for a COVID-19 care facility: quality improvement initiative. BMJ Open Qual. 2020;9(3).
Wundavalli, L., Singh, S., Singh, A. R., & Satpathy, S. (2020). How to rapidly design and operationalise PPE donning and doffing areas for a COVID-19 care facility: quality improvement initiative. BMJ Open Quality, 9(3). https://doi.org/10.1136/bmjoq-2020-001022
Wundavalli L, et al. How to Rapidly Design and Operationalise PPE Donning and Doffing Areas for a COVID-19 Care Facility: Quality Improvement Initiative. BMJ Open Qual. 2020;9(3) PubMed PMID: 32978176.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How to rapidly design and operationalise PPE donning and doffing areas for a COVID-19 care facility: quality improvement initiative. AU - Wundavalli,LaxmiTej, AU - Singh,Sheetal, AU - Singh,Angel Rajan, AU - Satpathy,Sidhartha, PY - 2020/05/17/received PY - 2020/07/27/revised PY - 2020/09/03/accepted PY - 2020/9/26/entrez PY - 2020/9/27/pubmed PY - 2020/10/21/medline KW - PDSA KW - checklists KW - continuous quality improvement KW - healthcare quality improvement KW - infection control JF - BMJ open quality JO - BMJ Open Qual VL - 9 IS - 3 N2 - INTRODUCTION: Effective implementation of standard precautions specific to COVID-19 is a challenge for hospitals within the existing constraints of time and resources. AIM: To rapidly design and operationalise personal protective equipment (PPE) donning and doffing areas required for a COVID-19 care facility. METHODS: Literature review was done to identify all issues pertaining to donning and doffing in terms of Donabedian's structure, process and outcome. Training on donning and doffing was given to hospital staff. Donning and doffing mock drills were held. 5S was used as a tool to set up donning and doffing areas. Instances of donning and doffing were observed for protocol deviations and errors. Plan-do-study-act cycles were conducted every alternate day for 4 weeks. The initiative was reported using Standards for QUality Improvement Reporting Excellence (SQUIRE) guidelines. RESULTS: Best practices in donning and doffing were described. Our study recommends a minimum area of 16 m2 each for donning and doffing rooms. Verbally assisted doffing was found most useful than visual prompts. DISCUSSION: Challenges included sustaining the structure and process of donning and doffing, varied supplies of PPE which altered sequencing of donning and/or doffing, and training non-healthcare workers such as plumbers, electricians and drivers who were required during emergencies in the facility. CONCLUSION: Our study used evidence-based literature and quality improvement (QI) tools to design and operationalise donning and doffing areas with focus on people, task and environment. Our QI will enable healthcare facilities to rapidly prototype donning and doffing areas in a systematic way. SN - 2399-6641 UR - https://www.unboundmedicine.com/medline/citation/32978176/How_to_rapidly_design_and_operationalise_PPE_donning_and_doffing_areas_for_a_COVID_19_care_facility:_quality_improvement_initiative_ L2 - https://bmjopenquality.bmj.com/lookup/pmidlookup?view=long&pmid=32978176 DB - PRIME DP - Unbound Medicine ER -