We need to be collaborating with local public health departments , laboratories and other healthcare facilities within our communities , not just other hospitals , but also long term care facilities and home health agencies . Maintaining open lines of communication allows us to share information , coordinate our responses , and address any gaps in our preparedness .” |
symptoms of infectious diseases , and they implement precautions accordingly ,” Kley said . “ We also must have protocols in place at points of entry for the risk assessment and triage ; we should be on the alert for patients who present with symptoms of infection , particularly fever and cough or fever and rash . We should also be screening for travel history and exposure to high-risk areas or contact with the suspected or confirmed EID case . We also must communicate recommended IP & C measures , and consider a rash hotline for patients presenting with fever and rash .”
Regarding diagnostic testing and rapid response , Kley acknowledged that there may not be an available test yet for an emerging pathogen , but whenever possible , clinicians should be using rapid diagnostic tests that can detect a wide range of pathogens , she advised . “ We should also have protocols in place for specimen handling , isolation , contact tracing and reporting to public health authorities .”
Kley emphasized the need to train healthcare personnel on EID symptom recognition , infection prevention and control measures and proper use of PPE . “ We should also provide education to our patients and our visitors ,” Kley added .
Regarding collaboration and communication , Kley noted that , “ We need to be collaborating with local public health departments , laboratories and other healthcare facilities within our communities , not just other hospitals , but also long-term care facilities and home health agencies . Maintaining open lines of communication allows us to share information , coordinate our responses , and address any gaps in our preparedness . For any communication that you all do prepare , you want to make sure that the rationale and the impact for the intended audience is crystal clear .”
The last screening consideration is infrastructure and resources . “ Hospital leaders , such as CEOs or CFOs , should be willing to invest in efficient screening , testing and isolation , as well as stockpiling of necessary supplies like PPE , test kits , medications for a prompt response to an outbreak . This is why it ’ s important that IPs know how to draft a solid business case so that they can get the things that they need for their IP & C programs .”
Kley then switched gears to address cleaning and disinfecting against EIDs .
“ Some considerations for cleaning and disinfecting against these pathogens include identifying a responsible party for cleaning ,” Kley said . “ Are you going to train your in-house staff or will you hire an outside vendor that specializes in high-risk cleaning ? You must also determine if an air exchange wait time is going to be necessary
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before your environmental services staff can enter the room to clean . Also be sure that staff are cleaning in a methodical manner to avoid cross-contamination and to ensure we don ’ t miss anything . Be sure that medical equipment or other items to be removed from the room are properly cleaned and disinfected . I recommend a double cleaning and disinfection . Also know the waste category of the pathogen ; for example , Ebola is category A waste and Mpox is category B waste . You also want to determine if manual cleaning and disinfection is going to be followed by some sort of adjunct technology like UV or vaporized hydrogen peroxide .”
Kley continued , “ Ensure that you have the appropriate disinfectant . Make sure you ’ re using an EPA-registered healthcare-grade disinfectant from the appropriate EPA list for the pathogen . For example , it ’ s list L for Ebola , list Q for Mpox or some other new pathogen . You ’ ll also want to observe for compliance with the directions for use for the disinfectant .”
Kley addressed PPE considerations for environmental services personnel , including ensuring appropriate PPE for the pathogen , having designated spaces for both donning and doffing PPE , and ensuring that staff have passed a competency assessment demonstrating that they can safely don and doff the PPE . “ You should have a trained observer for donning and doffing ,” she advised .
She also addressed the cleaning process for EIDs . “ Out of an abundance of caution , ensure that all surfaces , including walls , are cleaned and disinfected ,” Kley said . “ Be sure that special attention is being paid to high-touch surfaces . Make sure they ’ re changing those cleaning cloths frequently , and regardless of the product used , I do recommend a two-step cleaning and disinfecting process for EIDs . Use a checklist so that nothing gets missed . With some exceptions , we don ’ t routinely disinfect floors in healthcare but when dealing with a high-consequence pathogen , it ’ s actually recommended . Ensure the use of the correct solution , and when discarding the remaining floor cleaning solution , you want to make sure they ’ re doing it safely by using a no-splash method .”
Torres wrapped up the presentation by noting , “ Infectious diseases are increasing , they travel fast , they don ’ t need a ticket as we do to travel , so we really need to act collectively , in that we need timely identification , communication and implementation of the appropriate IP & C measures . Having an emerging plan is a regulatory requirement and screening is key for early identification because we know what happened with COVID-19 .”
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Hospital leaders , such as CEOs or CFOs , should be willing to invest in efficient screening , testing and isolation , as well as stockpiling of necessary supplies like PPE , test kits , medications for a prompt response to an outbreak . This is why it ’ s important that IPs know how to draft a solid business case so that they can get the things that they need for their IP & C programs .” |