Figure 1 - uploaded by Lukas Jyuhn-Hsiarn Lee
Content may be subject to copyright.
Kaoshsiung SARS fever screening and observation facility, design layout and staff flow diagram. PPE, personal protective equipment. From: Recommendations for Design of a SARS Patient Screening, Isolation and Care Facility. Bloland PB, Esswein EJ, and Wong W; 5/23/2003.

Kaoshsiung SARS fever screening and observation facility, design layout and staff flow diagram. PPE, personal protective equipment. From: Recommendations for Design of a SARS Patient Screening, Isolation and Care Facility. Bloland PB, Esswein EJ, and Wong W; 5/23/2003.

Source publication
Article
Full-text available
Industrial hygiene specialists from the National Institute for Occupational Safety and Health (NIOSH) visited hospitals and medical centers throughout Taiwan. They assisted with designing and evaluating ventilation modifications for infection control, developed guidelines for converting hospital rooms into SARS patient isolation rooms, prepared des...

Context in source publication

Context 1
... facility could also function as a quarantine station if needed. The floor plan of this converted barracks building is shown in Figure 1. ...

Similar publications

Article
Full-text available
To identify characteristics and activities that should be studied in evaluating the efficacy of infection surveillance and control programs (ISCPs), we developed a conceptual model for use in designing the data collection forms and analytic strategies for the Study on the Efficacy of Nosocomial Infection Control. The model emphasizes the prevention...

Citations

... During the 2003 SARS outbreak in Taiwan, the government implemented dedicated SARS hospitals across the country as part of the strategy to deal with the surge of patients. 31 A similar approach was considered in Toronto, Canada, however, implementing dedicated SARS hospitals proved challenging and instead many hospitals were prepared to care for SARS patients. 32 When the second wave occurred in Toronto, four hospitals became designated SARS hospitals. ...
... In those cases, visitors were screened for symptoms and required to wear PPE during visits. 31,33,72,[74][75][76] Required PPE ranged from complete contact and droplet precautions (gown, gloves, and N95 respirators) to simply a surgical mask. 33,52,72 The CDC, Africa CDC, and WHO have issued recommendations regarding visitation in the context of the COVID-19 pandemic. ...
Article
Full-text available
Infection prevention and control (IPC) strategies are key in preventing nosocomial transmission of COVID-19. Several commonly used IPC practices are resource-intensive and may be challenging to implement in resource-constrained settings. An international group of healthcare professionals from or with experience in low- and middle-income countries (LMICs) searched the literature for relevant evidence. We report on a set of pragmatic recommendations for hospital-based IPC practices in resource-constrained settings of LMICs. For cases of confirmed or suspected COVID-19, we suggest that patients be placed in a single isolation room, whenever possible. When single isolation rooms are unavailable or limited, we recommend cohorting patients with COVID-19 on dedicated wards or in dedicated hospitals. We also recommend that cases of suspected COVID-19 be cohorted separately from those with confirmed disease, whenever possible, to minimize the risk of patient-to-patient transmission in settings where confirmatory testing may be limited. We suggest that healthcare workers be designated to care exclusively for patients with COVID-19, whenever possible, as another approach to minimize nosocomial spread. This approach may also be beneficial in conserving limited supplies of reusable personal protective equipment (PPE). We recommend that visitors be restricted for patients with COVID-19. In settings where family members or visitors are necessary for caregiving, we recommend that the appropriate PPE be used by visitors. We also recommend that education regarding hand hygiene and donning/doffing procedures for PPE be provided. Last, we suggest that all visitors be screened for symptoms before visitation and that visitor logs be maintained.
... result of which they became the source for many instances in the transmission of the disease. 5,6 Initial triage is based on the symptomatology without a definitive diagnosis and they highlight the importance of isolation and decontamination to prevent further spread or exposure to patients and responders. Using the triage protocols during the pandemics will also help us in utilizing the available resources to optimize the health care deivery. ...
Article
Full-text available
Amid this pandemic, which has been spreading like a wildfire globally, Nepal is not an exception to it. With this, we have been hearing the news of global shortage of personal protective equipment (PPE), with growing concern over the safety of medical community and possibility of cross-contamination. Triaging is less researched and reported in COVID-19. It is as important as PPE, a gateway of safety for health care worker. If we have to manage COVID-19, ensuring triage should be among the priority strategies. Patan hospital is among the few hospitals in Nepal where triaging is practiced.
... During SARS outbreak in 2003, due to lack of triaging in many hospitals, it became the instances for transmission. 12,13 Separating non and COVID emergency is important one of safety measures; ensuring effective triaging seems more important as a barrier against crosscontamination. Our finding shows the need of having primary and secondary triage as a priority safety measure. ...
Research
Full-text available
Introduction: Patan Hospital (PH), Patan Academy of Health Sciences (PAHS) has separated non COVID and COVID emergencies for the safety of health care workers (HCWs). This study was conducted to assess the safety perception of healthcare workers working in emergency departments during the outbreak of COVID-19.
... During SARS outbreak in 2003, due to lack of triaging in many hospitals, it became the instances for transmission. 12,13 Separating non and COVID emergency is important one of safety measures; ensuring effective triaging seems more important as a barrier against crosscontamination. Our finding shows the need of having primary and secondary triage as a priority safety measure. ...
Article
Full-text available
Introduction: Patan Hospital (PH), Patan Academy of Health Sciences (PAHS) has separated non COVID and COVID emergencies for the safety of health care workers (HCWs). This study was conducted to assess the safety perception of healthcare workers working in emergency departments during the outbreak of COVID-19. Method: A cross sectional descriptive study was conducted among HCWs in non COVID and COVID emergency departments at PH, PAHS, Nepal, in April 2020 during COVID-19 outbreak. Questionnaires containing open and closed questions were used. Ethical approval was obtained. Result: Out of 72 HCWs, 58 (80.5%) responded, 47 (81%) felt need to have separate non COVID and COVID emergencies, 27 (46.6%) answered they were not comfortable working with the partial PPE (masks, gloves), 29 (50%) felt the need of having primary and secondary triaging. Conclusion: Emergency staff expressed need of having separate non COVID and COVID emergencies, and importance of primary and secondary triage.
... Alternative ventilation control systems have also been considered, e.g. when there is an immediate need for reconfiguring existing patient rooms to serve as airborne isolation rooms. Exhaust fans were installed in the windows of an air-conditioned ward to create negative pressure during the SARS epidemics [11][12][13][14]. Temporary isolation rooms were also created during the SARS epidemic from the existing hospital wards. ...
Article
High ventilation rate is shown to be effective for reducing cross-infection risk of airborne diseases in hospitals and isolation rooms. Natural ventilation can deliver much higher ventilation rate than mechanical ventilation in an energy-efficient manner. This paper reports a field measurement of naturally ventilated hospital wards in Hong Kong and presents a possibility of using natural ventilation for infection control in hospital wards. Our measurements showed that natural ventilation could achieve high ventilation rates especially when both the windows and the doors were open in a ward. The highest ventilation rate recorded in our study was 69.0 ACH. The airflow pattern and the airflow direction were found to be unstable in some measurements with large openings. Mechanical fans were installed in a ward window to create a negative pressure difference. Measurements showed that the negative pressure difference was negligible with large openings but the overall airflow was controlled in the expected direction. When all the openings were closed and the exhaust fans were turned on, a reasonable negative pressure was created although the air temperature was uncontrolled.The high ventilation rate provided by natural ventilation can reduce cross-infection of airborne diseases, and thus it is recommended for consideration of use in appropriate hospital wards for infection control. Our results also demonstrated a possibility of converting an existing ward using natural ventilation to a temporary isolation room through installing mechanical exhaust fans.
... Others constructed new isolation wards and rooms or carried out extensive engineering modifications to existing structures. 22,[36][37][38] Those lacking such facilities and resources responded with innovative solutions. Three examples were: hospital staff attempting to create negative-pressure relative to hallways by using fans and windows opening to the exterior; the development of guidelines to enable the re-use of respirators; and the erection of glass walls in hallways to create anterooms to patients' rooms. ...
Article
Severe Acute Respiratory Syndrome (SARS) emerged recently as a new infectious disease that was transmitted efficiently in the healthcare setting and particularly affected healthcare workers (HCWs), patients and visitors. The efficiency of transmission within healthcare facilities was recognised following significant hospital outbreaks of SARS in Canada, China, Hong Kong, Singapore, Taiwan and Vietnam. The causative agent of SARS was identified as a novel coronavirus, the SARS coronavirus. This was largely spread by direct or indirect contact with large respiratory droplets, although airborne transmission has also been reported. High infection rates among HCWs led initially to the theory that SARS was highly contagious and the concept of 'super-spreading events'. Such events illustrated that lack of infection control (IC) measures or failure to comply with IC precautions could lead to large-scale hospital outbreaks. SARS was eventually contained by the stringent application of IC measures that limited exposure of HCWs to potentially infectious individuals. As the 'global village' becomes smaller and other microbial threats to health emerge, or re-emerge, there is an urgent need to develop a global strategy for infection control in hospitals. This paper provides an overview of the main IC practices employed during the 2003 SARS outbreak, including management measures, dedicated SARS hospitals, personal protective equipment, isolation, handwashing, environmental decontamination, education and training. The psychological and psychosocial impact on HCWs during the outbreak are also discussed. Requirements for IC programmes in the post-SARS period are proposed based on the major lessons learnt from the SARS outbreak.
... Few hospitals would be prepared to dedicate and staff a ward or a wing for one or a few patients, and creating special isolation accommodations on short notice would be inefficient and potentially very costly. 3 In addition, as the national effort directs more research funding to the study of the agents of bioterrorism, the likelihood of an occupational exposure to one of these illnesses will increase. 4 When such events have occurred in the past, institutional responses were generally guided by compromises using in-place procedures and resources. ...
... 4 When such events have occurred in the past, institutional responses were generally guided by compromises using in-place procedures and resources. 3,5,6 Laboratory tests were deferred or laboratories experienced disruptions of work flow to accommodate laboratory testing for A complete list of authors and their affiliations can be found at the end of this article (Appendix 1). The views, opinions, and findings contained herein are those of the authors and should not be construed as official U.S. Department of the Army, Department of the Air Force, Department of Defense, Department of Health and Human Services, or U.S. government position, policy, or decision, unless so designated by other documentation. ...
Article
Full-text available
In spite of great advances in medicine, serious communicable diseases are a significant threat. Hospitals must be prepared to deal with patients who are infected with pathogens introduced by a bioterrorist act (e.g., smallpox), by a global emerging infectious disease (e.g., avian influenza, viral hemorrhagic fevers), or by a laboratory accident. One approach to hazardous infectious diseases in the hospital setting is a biocontainment patient care unit (BPCU). This article represents the consensus recommendations from a conference of civilian and military professionals involved in the various aspects of BPCUs. The role of these units in overall U.S. preparedness efforts is discussed. Technical issues, including medical care issues (e.g., diagnostic services, unit access); infection control issues (e.g., disinfection, personal protective equipment); facility design, structure, and construction features; and psychosocial and ethical issues, are summarized and addressed in detail in an appendix. The consensus recommendations are presented to standardize the planning, design, construction, and operation of BPCUs as one element of the U.S. preparedness effort.
... The severe acute respiratory syndrome (SARS) outbreak of Southeast Asia in 2003 had brought a serious impact and even disaster to entire society, healthcare practitioners, healthcare institutions, and public works personnel worldwide (Esswein, Kiefer, Wallingford, Burr, Lee & Wang 2004). In recent years, numerous nature disasters always accompany a massive prevalence of contagious diseases. ...
Article
Several healthcare disasters have arisen in the past decade. The application requirements for such a system include effective, coordinated responses to disease and injury, accurate surveillance of area hospitals and efficient management of clinical and research information. Based on the application requirements, this work describes a health information federation that monitors and detects national infectious events using GIS, RFID and grid computing technology. This system is fault-tolerant, highly secure, flexible and extensible. It has a low cost of deployment, and is designed for large-scale and quick responses. Owing to the federation nature of the network, no central server or data center needs to be built. To reinforce the responsiveness of the national health information federation, this work proposes a practical, tracking-based, spatially-aware, steady-to-use and flexible architecture, based on GIS and RFID, for developing successful infectious disaster management plans to tackle technical issues. The proposed architecture achieves a common understanding of spatial data and processes. Therefore, the proposed system can efficiently and effectively share, compare and federate yet integrate most local health information providers and results for more informed planning and better outcomes.
Article
Full-text available
The emergence of SARS-CoV2 in 2019 showed again that the world's healthcare system is not fully equipped and well-designed for preventing the transmission of nosocomial respiratory infections. One of the great tools for preventing the spread of infectious organisms in hospitals is the anteroom. Several articles have investigated the role of the anteroom in disease control but the lack of a comprehensive study in this field prompted us to provide more in-depth information to fill this gap. Also, this study aimed to assess the necessity to construct an anteroom area for hospital staff members at the entrance of each ward of the hospital, and specify the equipment and facilities which make the anteroom more efficient. Articles were identified through searches of Scopus, Web of Sciences, PubMed, and Embase for studies published in English until May 2020 reporting data on the effect of the anteroom (vestibule) area in controlling hospital infections. Data from eligible articles were extracted and presented according to PRISMA's evidence-based data evaluation search strategy. Also, details around the review aims and methods were registered with the PROSPERO. From the database, 209 articles were identified, of which 25 studies met the study criteria. Most studies demonstrated that an anteroom significantly enhances practical system efficiency. The results showed that the equipment such as ventilation system, high-efficiency particulate absorption filter, hand dispensers, alcohol-based disinfection, sink, mirror, transparent panel, UVC disinfection, and zone for PPE change, and parameters like temperature, door type, pressure, and size of the anteroom are factors that are effective on the safety of the hospital environment. Andalib et al. The Effectiveness of the Anteroom on Hospital Infection Control Studies demonstrated that providing an anteroom for changing clothing and storing equipment may be useful in reducing the transmission of airborne infections in hospitals. Since the transmission route of SARS-CoV2 is common with other respiratory infectious agents, it can be concluded that a well-designed anteroom could potentially decrease the risk of SARS-CoV2 transmission during hospitalization as well.
Article
With the onset of the COVID-19 pandemic, hospitals nationwide have been presented with a number of potential challenges, including possible increased volume of patient attendances, acuity of illness and potential for patients to present with an infection that requires isolation. At the Bristol Royal Infirmary, an innercity teaching hospital that manages patients aged 16 and over, we present our response to these projected changes in ED attendances, with the initiation of the incident triage area (ITA). The ITA is a triage station situated outside the ED and staffed by a senior clinician, healthcare assistant and patient flow coordinator. It receives patients presenting as walk-in or via ambulance, and on their arrival aims to establish their risk of COVID-19 and their acuity of illness. This allows for triage of the patient to one of the four zones of the hospital, as well as providing clinical guidance on any initial interventions that patients may require. The benefits of the ITA are that it enables an early senior review of patients to establish their acuity of illness and initiate time-critical medical intervention as required. In addition, patients are immediately cohorted to zones within the hospital based on their infection risk, thereby reducing patient footfall throughout the hospital. Its aim is to reduce the spread of infection, by efficiently triaging and streaming patients who present to the hospital prior to them entering clinical areas, while maintaining patient safety and flow through the ED and initiating rapid management of acutely unwell patients.