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

Area of Science:

• Infection Control and Prevention
• Occupational Health and Safety
• Healthcare Simulation

Background:

• High-consequence infectious disease (HCID) facilities require robust safety protocols.
• Existing procedures for HCID, including personal protective equipment (PPE) use, are established.
• A significant gap exists in protocols for managing a collapsed healthcare provider within a contaminated zone.

Purpose of the Study:

• To develop and optimize a safe protocol for responding to a healthcare provider collapse in full PPE within a contaminated zone.
• To assess the effectiveness of video-reflexive methods in enhancing clinician understanding of infection prevention and control in rare, complex scenarios.

Main Methods:

• Adaptation of an existing "provider down" protocol.
• Iterative simulation and video recording of the adapted protocol within a biocontainment facility.
• Collaborative analysis of video recordings through researcher-facilitated reflexive discussions.
• Testing and refinement of protocol modifications until consensus was achieved.

Main Results:

• Six adaptations and simulations were necessary to reach consensus on the final protocol.
• The final protocol significantly differed from the initial version.
• Video-reflexive sessions identified risks missed in initial protocol development and debriefs.
• Participants identified and tested alternative perspectives on safe procedures.

Conclusions:

• Video-reflexivity is a valuable method for context-sensitive, consensus-based policy and procedure co-design in specialized healthcare units.
• This approach enhances clinician awareness and understanding of infection prevention and control for complex, rare events.
• The process fosters teamwork, preparedness, and confidence in managing crises.