71 To train and to save: MDSSC’s experience on ppe substitutes or simulation training during COVID-19 outbreak

IntroductionIn view of global shortage of Personal Protective Equipment (PPE), Hospital Authority faced the dilemma of conserving PPE for clinical use versus consuming over 1,400 sets of PPE for simulation training in February 2020. To stockpile for an emergency preparedness, prudent use of PPE in non-emergent and non-essential services seemed necessary but not sufficient. The gist of management in healthcare simulation was the balance of achieving training objectives (trained over 1,400 staff to prevent nosocomial infection and transmission during high-risk procedures) with adequate fidelity and reducing PPE consumption for clinical use.MethodsMulti-disciplinary Simulation and Skills Centre (MDSSC) took reasonable steps to substitute ‘genuine PPE’ in training: i) produced 720 handcrafted face shields with kitchen sponge and laminating pouch film, ii) prototyped and printed the eye-visor frame with 3D-printing technology, iii) sourced industrial-used N95 respirators from online shop, and iv) applied expired stock/low-price gown from e-procurement for doffing of PPE practice. The extent to which reduced fidelity, followed by replacement of genuine PPE with alternative items, sacrifices overall training satisfaction was evaluated using 5-point Likert scales.ResultsTraining coverage for 80% healthcare professionals working closely with suspected and confirmed cases was achieved. An acceptable trade-off was identified: In sacrificing 3% of realism, no significant drop (p>.05) was found in psychological safety, mental preparedness, as well as overall satisfaction.DiscussionWith the support of hospital management and administrative departments, decisive, cohesive, and sustainable responses under good leadership are keys. When it comes to extremely immense demand of PPE, innovation of intellectual minds enabled entire healthcare system to optimize effectiveness in resources allocation for quality service and safety of service users and healthcare providers.