Exploring the Impact of Prerequisite eLearning on Respiratory Protection Equipment Safety Behaviors in Simulation Training

Military healthcare workers (HCWs) face similar clinical challenges in providing care during the pandemic as the civilian workforce. The most common respirator used in healthcare is the N95 filtering facepiece respirator (FFR). Video scoring has been successful in describing the challenges HCWs face with transmission-based precautions in healthcare. This case study explores the critical safety behavioral outcomes of 2 training interventions for respiratory protective equipment use by military HCWs during a Center for Sustainment of Trauma and Readiness Skills course on biocontainment care in Omaha, Nebraska, at the University of Nebraska Medical Center. The study included a knowledge quiz and computer-based educational materials. Behavioral assessment was done by video recording and scoring skills performance during 3 donning and doffing N95 respirator opportunities in the training course. The main finding of the knowledge quiz was the gap in recognition that hand hygiene is warranted after the personal touching required when donning a respirator. The expert scoring of respirator use showed poor performance of critical safety behaviors such as performing the user seal check for the respirator. Training opportunities can be used for data collection related to respirator safety behavior change, but our investigators would recommend isolating the behavioral interest more than this case study was able to do. There were limitations in this project by the nature of combining this assessment with the training course and its dense curriculum. This investigation into respiratory protection equipment behavior interventions during a pandemic may provide for improvement in future educational and behavioral assessment activities.