Explore This IssueACEP Now: Vol 39 – No 04 – April 2020
Consider how patients will be transported from the waiting room through the emergency department to the isolation or precautions room. What route will they take to minimize exposure from the emergency department to the floor or unit dedicated within your hospital?
What route will patients take from the emergency department to the inpatient unit? Use security to facilitate clearing the route, hold the elevator, and ensure that the elevator is cleaned after patient transport.
What route will your used supplies take to be cleaned, and how will your nasal swabs be transported to the lab (eg, we are not using our tube system)?
Develop plans for terminal cleaning of CT scan rooms and other bedside diagnostic equipment (portable radiology, ultrasound, etc.). For example, will you have a dedicated ultrasound?
We have developed a process to perform portable radiographs through the door window for patients in isolation, reducing risk to staff and the need to clean portable units (see Figure 1). The radiographs have been found to be of acceptable quality for reading using this technique.
Plan to have a double backup system in place ensuring that if staff members are sick, there is an easy system to call in relief without having to scramble. This system also protects against staff members feeling remorse or hesitance about calling in sick and contributing to dangerous “presenteeism” and coming to work sick.
- Canceling communal food in meetings and care areas and moving to tele-education and online meetings.
- Updating staff flu shots.
- Requiring use of scrubs instead of wearing personal clothes to work and encouraging minimization of jewelry and personal items as fomites.
- Using gel-in/gel-out hand hygiene and redoubling efforts to ensure 100 percent compliance for all patients.
- Creating a hospital-wide plan for backup child care so physicians, nurses, and other staff are not staying home to care for their children if schools close.