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Creation and impact of containment units with high-risk zones during the coronavirus disease 2019 (COVID-19) pandemic

Published online by Cambridge University Press:  17 June 2022

Natalie A. Schnell*
Affiliation:
Infection Prevention, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, North Carolina
Brooke Brewer
Affiliation:
Infection Prevention, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, North Carolina
Kimberly Young
Affiliation:
Performance Improvement, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, North Carolina
Turkeisha S. Brown
Affiliation:
University of North Carolina at Chapel Hill Medical Center, Chapel Hill, North Carolina
Shannon S. Carson
Affiliation:
Division of Pulmonary and Critical Care Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
Loc Culp
Affiliation:
University of North Carolina at Chapel Hill Medical Center, Chapel Hill, North Carolina
Cynthia Culbreth
Affiliation:
Infection Prevention, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, North Carolina
Lauren M. DiBiase
Affiliation:
Infection Prevention, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, North Carolina Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
William A. Fischer
Affiliation:
Division of Pulmonary and Critical Care Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
Katherine M. Schultz
Affiliation:
Infection Prevention, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, North Carolina
Emily E. Sickbert-Bennett
Affiliation:
Infection Prevention, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, North Carolina Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
Lisa Stancill
Affiliation:
Infection Prevention, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, North Carolina
David J. Weber
Affiliation:
Infection Prevention, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, North Carolina Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
Erica Wolak
Affiliation:
University of North Carolina at Chapel Hill Medical Center, Chapel Hill, North Carolina
Lisa J. Teal
Affiliation:
Infection Prevention, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, North Carolina
*
Author for correspondence: Natalie A. Schnell, E-mail: natalie.schnell@unchealth.unc.edu

Abstract

Background:

The rapid spread of coronavirus disease 2019 (COVID-19) required swift preparation to protect healthcare personnel (HCP) and patients, especially considering shortages of personal protective equipment (PPE). Due to the lack of a pre-existing biocontainment unit, we needed to develop a novel approach to placing patients in isolation cohorts while working with the pre-existing physical space.

Objectives:

To prevent disease transmission to non–COVID-19 patients and HCP caring for COVID-19 patients, to optimize PPE usage, and to provide a comfortable and safe working environment.

Methods:

An interdisciplinary workgroup developed a combination of approaches to convert existing spaces into COVID-19 containment units with high-risk zones (HRZs). We developed standard workflow and visual management in conjunction with updated staff training and workflows. The infection prevention team created PPE standard practices for ease of use, conservation, and staff safety.

Results:

The interventions resulted in 1 possible case of patient-to-HCP transmission and zero cases of patient-to-patient transmission. PPE usage decreased with the HRZ model while maintaining a safe environment of care. Staff on the COVID-19 units were extremely satisfied with PPE availability (76.7%) and efforts to protect them from COVID-19 (72.7%). Moreover, 54.8% of HCP working in the COVID-19 unit agreed that PPE monitors played an essential role in staff safety.

Conclusions:

The HRZ model of containment unit is an effective method to prevent the spread of COVID-19 with several benefits. It is easily implemented and scaled to accommodate census changes. Our experience suggests that other institutions do not need to modify existing physical structures to create similarly protective spaces.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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