2. At the end of this session you will understand:
• The Culture of Safety
• What Trained Observers watch for in Donning/Doffing
• Why Organizational Safety Leaders need your input
• Failure Mode and Effect Analysis (FMEA)
• How you can use your Observer (FMEA) Skills Daily
2
4. The Culture of Safety
• Safety is everyone’s
responsibility
• Openly sharing
information without
reprisal is essential
• LISTENING is the first
step in mitigating risks
CHECK OUT: http://www.ihi.org/resources/Pages/Changes/DevelopaCultureofSafety.aspx
http://aubreydaniels.com/blog/2013/01/23/7-keys-for-creating-a-safety-culture/ 4
5. Language is Important
• United Airlines discovered
that crew “hierarchy” can
lead to important
information being missed,
with sometimes fatal results
CHECK OUT: http://en.wikipedia.org/wiki/Crew_resource_management 5
6. Language is Important
• When black box tapes
from air crashes were
reviewed, it was noted
there were times the
Co-pilot expressed
concerns to the Pilot,
that could have
prevented the crash
6CHECK OUT: http://gtresearchnews.gatech.edu/newsrelease/CREW.html
7. CUUS
United Airlines created CUUS - 4 critical words – which - if used
- translate to
“STOP AND LISTEN. We have a potential problem.”
• I am Concerned
• I am Uncomfortable
• This is Unsafe
• I am Scared
If anyone uses this language, it is important to immediately STOP
AND LISTEN.
7
8. You will know you have a
Culture of Safety when you:
• Openly share ideas
• Listen to each other
• Think innovatively
about safety
• Develop ways together
to reduce risk and
prevent failure
8
10. What is a Trained Observer?
That’s a great question!
In general terms, Trained Observers are people
trained to “observe a situation” and “rate it”
using:
• written description
• photographs, or
• other visual scales such as drawings or videos
10http://www.urban.org/toolkit/data-methods/ratings.cfm
11. Trained Observers
for Donning/Donning of PPE
This Trained Observer will watch others:
1. Prepare to Don PPE
2. Don their PPE
3. Doff Their PPE
AND correct any risks or failures they observe in the process
To do this Trained Observers will use:
• Written aids such as check lists
• Photo or visual aids
• Rating scales
11
12. Trained Observers for
Donning and Doffing of PPE
• Observe others donning-
doffing, using a check list to
insure it is done correctly
• Do not perform hands-on
tasks to assist (unless an
emergency)
• Is there a Trained Observer
in this picture?
12
13. Trained Observers for
Donning and Doffing of PPE
• The Trained Observer must
verbally confirm each step
with the person being
observed
• Is there a Trained Observer
in this picture?
13
14. Trained Observers for
Donning and Doffing of PPE
• If staff need hands-on
assistance, a “buddy”
should help and the Trained
Observer remains a 3rd
person
• Is there a Trained Observer
in this picture?
14
15. Trained Observers for
Donning and Doffing of PPE
• Over time, as staff gain
experience, they will be
able to don and doff by
themselves.
• To reach this level requires
almost daily practice ( rare).
• The buddy could potentially
become a Trained Observer
under those conditions
• Is there a potential Trained
Observer in this picture?
15
16. Trained Observers for
Donning and Doffing of PPE
• The Safest Model for a
Trained Observer in the
Donning and Doffing of PPE
is using 3 people
– Two Buddies in PPE to assist
each other as needed.
– One Trained Observer
• Is there a Trained Observer
in this picture?
16
17. To Support the Trained Observer
Institutions/Agencies must
have:
• Checklists for donning and
doffing their specific PPE
• Simple protocols for
documentation
• Training sessions to
develop/maintain the
Trained Observer Skills
• A Safety Leader if
assistance is needed
17
19. Organizational Safety Leaders
• The Role of a Safety Leader
is to monitor workplace
activities to ensure workers
comply with company
policies and government
safety regulations
• This includes organizational
policy development, safety
inspections and training.
19
20. In the Setting of A Serious Communicable Disease
Organizational Safety Leaders oversee:
• Risk based Selection of PPE
• Screening Staff for suitability to use PPE
• Development of Donning and Doffing Protocols
• Setting up Serious Communicable Disease Units and
Teams
• Training Teams including Trained Observers for PPE
20
21. In the Setting of A Serious Communicable Disease
Organizational Safety Leaders
Must work with others to
establish protocols for the safe
management of:
• Lab specimens
• Waste
• Patient movement within
the hospital
• Diagnostic Imaging
• Visitors
• Etc.
21
22. In the Setting of A Serious Communicable Disease
Organizational Safety Leaders
22
• Must be strong
promoters of the
Culture of Safety
• Remain current and
continually monitor
health and safety
guidance as it evolves
• Work with staff to find
even better ways to
improve safety
24. Failure Mode and Effects Analysis
(FMEA)
FMEA is a systematic,
proactive method for
evaluating a process to:
• Identify where and how
it might fail
• Assess the relative
impact of different
failures
24
25. Failure Mode and Effects Analysis
(FMEA)
• The Ultimate Goal of
FMEA is identifying
risk/failures and
PROACTIVELY
correcting them
• This is the main role of
a Trained Observer
25
CHECK OUT:
http://www.ihi.org/resources/Pages/Tools/FailureModesandEffectsAnalys
isTool.aspx
27. Exercising your
Observer (FMEA) Skills Daily
• Hand-washing
• Seal checks of your N95
• Proper Glove removal
• Waste disposal
• All of the above are
Donning-Doffing Steps you
do daily
• Practice them as if you were
dealing with a patient with
a Serious Communicable
Disease
27
28. Exercising your Trained
Observer (FMEA) Skills Daily
Review online protocols or the
training materials of others to:
• Identify the risk
• Consider the impact of the
failure
• Think proactively of
correction
28
53. General Failure Risks
• Contamination
• Equipment: Improper use or Failure
• Physiologic: Fatigue, Heat
• Psychological: Claustrophobia
53
54. Safety belongs to all of US
• The CBRNE Collaborative
is a Public Health Agency
of Canada Project,
sponsored by the
Canadian Safety and
Security Program.
• It is managed by
Sunnybrook Research
Academy (Toronto).
• Check us out at:
www.cbrnecc.ca
54
55. The Trained Observer
Slide Presentation
• Was Created by Dr. Laurie
Mazurik, Staff Emergency
Physician at Sunnybrook
Health Science Centre
Toronto, CANADA
• Her experience with SARS in
2003, ignited a passion to
support better training for
HCW in personal protection
and emergency
preparedness.
• Laurie.mazurik@cbrnecc.ca
55www.cbrnecc.ca
