Cognitive load and performance of health care professionals in donning and doffing PPE before and after a simulation-based educational intervention and its implications during the covid-19 pandemic for biosafety

Introduction: The Personal Protective Equipment (PPE) is essential to avoid the COVID-19 spread to health care Workers. Its use can be difficult, posing a high risk of contamination, mainly during doffing, then With the risk of becoming infected. Methods: We conducted a prospective before-and-after design that used clinical simulation as a research methodology in a clinical simulation center of Colombia. A simulation-based educational intervention With two cases related to COVID-19 Was proposed in the emergency room and the intensive care unit. We conducted A Workshop for donning and doffing of personal protective equipment (PPE) and a debriefing after the first case. Results: In the pre-test, 100% of participants failed donning and doffing PPE, 98.4% Were contaminated, only one-person did not contaminate out of. The mean cog nitive load Was high (7.43±0.9 points). In the post-test, 100% Were successful in donning the PPE and 94.8% in doffing; only 9.8% Were contaminated. The mean of the cognitive load Was loW (4.1±1.4 points), and the performance Was high (7.9±1.1). Of the total, 73.8% of participants reported overload in the doffing. The most difficulties Were in gown/overall, and N95 mask removal. Discussion: The PPE donning and doffing is critical and may be changed significantly by active training. In responding to the current COVID-19 pandemic in 2020, activities of training in donning and doffing PPE Would provide a means of training personnel, reducing the cognitive load and maybe the risk of contamination and infection of health care Workers.