Table 7.
Personal protective equipment adherence and provider safety checklist during the Coronavirus disease 2019 pandemic
| Name: Age: Gender: ID no: Date: Diagnosis:- Choose patient type: Laboratory-confirmed COVID-19 case/suspect COVID-19 case/symptomatic high-risk contact/asymptomatic high-risk contact/symptomatic low-risk contact/asymptomatic low-risk contact COVID-19 category (for laboratory-confirmed or suspect case): A/B/C Location of primary isolation area in hospital: Procedure: Describe requirement of emergency surgery: Write all team member’s names: (surgeons, anesthesiologists, scrub nurse, infection control nurse, support staff) | |||
| Safety checklist entries | Concordant | Discordant | Corrective initiative done |
|---|---|---|---|
| Infection control precautions | |||
| All team members have participated in mock drills and COVID-19 training programs | |||
| All team members have adhered to strict hand hygiene | |||
| All team members have introduced each other | |||
| Surgery is undertaken in designated COVID-19 OR only | |||
| Infection control precautions displayed at various areas of the OR | |||
| Negative-pressure isolation system is available in OR else use of split air conditioner discussed among team members | |||
| Essential steps of surgery and plan of anesthesia discussed before donning PPE | |||
| No mobile phones/pagers/tablets/laptop computers inside OR | |||
| All team members have worn Level III PPE | |||
| PPE fit has been tested and found adequate by each team member | |||
| Wearing PPE has been monitored by an infection control nurse | |||
| Security system officers of the hospital informed prior to patient shift-in (at least 30 min prior) | |||
| Ready to shift patient message sent to primary care area of the patient | |||
| Patient received with N95/surgical face mask worn | |||
| Anaesthesia and intubation precautions | |||
| Dedicated anesthesia machine with bacterial and viral filters available | |||
| Disposable equipment used wherever possible | |||
| Rapid sequence induction used for general anesthesia induction | |||
| Video-laryngoscope used for intubation | |||
| In-line closed suction unit used if required | |||
| Patient wears surgical mask or N95 mask throughout if regional anesthesia is chosen | |||
| Backup anesthesiologist available in separate adjacent sterile area with advanced airway carts and resuscitation trolley | |||
| Only minimum number of most essential personnel enter the OR | |||
| Use disposable pens for data entry | |||
| Prophylactic anti-emetics administered and extubation done with minimal aerosol generation | |||
| OR conduct and disinfection precautions | |||
| Surgical specimens/blood samples collected are labeled in double covered containers carrying label “COVID-19” | |||
| Security system officers of the hospital informed prior to patient shift-out (at least 30 min prior) | |||
| Patient is NOT holded in the recovery area after surgery and directly shifted to isolation ICU/HDU | |||
| Each team member has doffed PPE only after patient shift-out | |||
| Doffing of each team member is monitored by an infection control nurse but NOT assisted | |||
| Disposable equipment used are discarded after the procedure | |||
| Adequate disinfection practices adhered to for disinfecting reusable machinery | |||
| CO2 absorbent of anesthesia machine discarded after the case | |||
| Anaesthesia machine has been dedicated for COVID-19 cases during the pandemic and not to be used for any other cases | |||
| Followed bio-containment regulations for waste disposal | |||
| All team members are debriefed after the surgery | |||
| No accidental breach in PPE use by any of the team member | |||
COVID-19: Coronavirus disease 2019, PPE: Personal protective equipment, ICU/HDU: Intensive care units/high-dependency units, OR: Operating room