Using Video-Reflexive Methods to Develop a Provider Down Protocol for the New South Wales Biocontainment Center.

IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Health Security Pub Date : 2024-09-01 Epub Date: 2024-08-12 DOI:10.1089/hs.2023.0165
Mary Wyer, Su-Yin Hor, Patricia E Ferguson, Arwen Morath, Ruth Barratt, Catherine M Priestley, Alice Polak, Gwendolyn L Gilbert
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Abstract

The New South Wales Biocontainment Centre is a statewide referral facility for patients with high-consequence infectious disease (HCID). The facility collaborates with researchers to adapt existing HCID procedures such as donning and doffing of personal protective equipment (PPE). However, information on how to respond safely to collapse of a healthcare provider in full PPE within a contaminated zone is scarce. To address this gap, we adapted Nebraska Medicine's "provider down" protocol on paper and then simulated and video recorded the process, iteratively, in the facility. Clinicians analyzed the recordings collaboratively in researcher-facilitated reflexive discussions. Our primary aim was to ascertain how to maintain optimal infection prevention and control while providing urgent care for the healthcare provider. We tested participants' suggested modifications, in repeated video recorded simulations, until consensus on optimal practice was achieved. Our secondary aim was to assess the utility of video-reflexive methods to enhance clinicians' awareness and understanding of infection prevention and control in a rare and complex scenario. Six adaptations and simulations were discussed in video-reflexive sessions before consensus was reached; the final version of the protocol differed considerably from the first. Viewing footage of simulations in situ enabled participants to (1) identify infection and occupational risks not identified on paper or during verbal postsimulation debriefs and (2) test alternative perspectives on safe procedure. Video-reflexivity enables context-sensitive and consensus-building codesign of policies and procedures, critical to protocol development in a new unit. It contributes to a culture of teamwork, preparedness, and confidence before, rather than in the heat of, a crisis.

使用视频反思方法为新南威尔士生物安全中心制定 "提供商停机协议"。
新南威尔士生物封闭中心是全州范围内的高危传染病 (HCID) 患者转诊机构。该机构与研究人员合作,调整现有的 HCID 程序,例如穿脱个人防护设备 (PPE)。然而,关于如何安全应对在污染区中穿着全套个人防护设备的医护人员倒地的信息却很少。为了填补这一空白,我们在纸上改编了内布拉斯加州医学会的 "医护人员倒地 "协议,然后在医疗机构中反复模拟并录制了这一过程。临床医生在研究人员主持的反思性讨论中共同分析了录像。我们的主要目的是确定如何在为医疗服务提供者提供紧急护理的同时保持最佳的感染预防和控制效果。我们在反复录制的模拟视频中测试参与者提出的修改建议,直到就最佳做法达成共识。我们的第二个目的是评估视频反思法在罕见的复杂场景中提高临床医生对感染预防和控制的认识和理解的效用。在达成共识之前,我们在视频反思会议上讨论了六种改编和模拟方案;方案的最终版本与第一版有很大不同。通过观看现场模拟的录像,参与者能够:(1)识别纸面上或模拟后口头汇报中未识别的感染和职业风险;(2)检验对安全程序的其他看法。通过视频反思,可以对政策和程序的设计进行背景敏感性分析并达成共识,这对新单位的规程制定至关重要。它有助于在危机发生之前,而不是在危急关头,形成一种团队合作、有备无患和充满信心的文化。
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来源期刊
Health Security
Health Security PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
4.80
自引率
6.10%
发文量
70
期刊介绍: Health Security is a peer-reviewed journal providing research and essential guidance for the protection of people’s health before and after epidemics or disasters and for ensuring that communities are resilient to major challenges. The Journal explores the issues posed by disease outbreaks and epidemics; natural disasters; biological, chemical, and nuclear accidents or deliberate threats; foodborne outbreaks; and other health emergencies. It offers important insight into how to develop the systems needed to meet these challenges. Taking an interdisciplinary approach, Health Security covers research, innovations, methods, challenges, and ethical and legal dilemmas facing scientific, military, and health organizations. The Journal is a key resource for practitioners in these fields, policymakers, scientific experts, and government officials.
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