Introducing a protective equipment marshal service

Case study: Led by Jessica Speight, South Tees Hospital NHS Foundation Trust

Background to learning

During the pandemic nurses have been at the forefront of local implementation of national IPC guidance to minimise transmission of infection and keep both patients and colleagues safe. This case study looks at how a marshal service has supported practice in PPE ‘donning/doffing’ at South Tees Hospital NHS Foundation Trust.

Learning and advice to be shared

In March 2020 South Tees Trust launched a series of Donning and Doffing and fit testing training programmes to support colleagues to correctly and safely use the relevant protective equipment. These training programmes utilised the skills of staff redeployed from clinical areas where activity had decreased, or paused, as part of the pandemic response. However, it was recognised early, through direct observation and conversations, that many staff still had some anxieties and uncertainty about donning and doffing practice.

To address this, a new Marshal Service was established which sat alongside the trust’s FIT testing and donning and doffing training programmes. Donning and doffing protective equipment is not straightforward and consists of multiple phases with each phase carrying its own potential risk of accidental exposure if not performed properly.

This marshal service supported staff and provided a range of benefits:

  • Supporting social distancing and hand hygiene
  • Intervening, if needed, where staff became fatigued and could unknowingly become complacent in donning and doffing practice.
  • Providing valuable assurance in the appropriate use of protective equipment.
  • Providing invaluable intelligence to the trust IPC team.
  • Identifying areas of good practice and any areas of concern and taking prompt action to rectify issues, supported by record keeping and monitoring audits.

Staff in the trust have reported feeling “better protected” and rates of best practice on donning and doffing practice have been raised and maintained.

Would it be beneficial to retain these changes?

The trust has identified how it can embed this service that has demonstrated real value. Initially, the service has relied on redeployed staff, but, moving forward, it will consist of five full-time seconded roles aligned closely to the trust IPC team.

The trust has resourced this service to ensure staff are supported and trained appropriately in PPE moving into the next phase of the pandemic. Embedding best practice and processes via the marshal team aims to better prepare for future surges in activity related to COVID-19, particularly over the winter period.

The trust believes supporting staff through this training increases staff confidence in that they can perform their role safely.  As such, it is a key part of supporting well-being alongside the trust’s wider mental health and well-being offer. As the pandemic eased the trust has been surveying staff on the role of the marshal to ensure the marshal team continues to meet the needs of staff and services.