Surge capacity stuff includes durable equipment such as ventilators , oxygen masks , oximeters , defibrillators , intravenous ( IV ) pumps , blood glucose and INR monitors , cardiac monitors , hospital beds and wheelchairs . In addition , patient supplies include medications , IV catheters and fluids , oxygen , syringes , sutures , sterile dressings and PPE . Shortages are expected when a pandemic of epic proportions takes over a nation and unanticipated supplies are needed .
Structure
Hospitals will need to be reconfigured including utilizing rooms that are not typically patient-care rooms , converting positive- into negative-pressure rooms , use of the operating rooms with anesthesia machines for critical patients and rearranging the emergency department . Outpatient clinics could be used as a satellite emergency department . Designating COVID-19 units and COVID-free units is essential . Staff should be dedicated to both . During epic pandemics , these needs will most likely be impossible to fulfill , especially at the beginning of the wave .
Systems
Systems include a clear chain of command for different activities . This chain of command should have a commander available day and night and be a good communicator with an effective communication strategy inside and outside the facility . The ability to share information among staff , the media , patients or residents and families is essential . Systems include written policies , procedures and protocols as well as education of personnel . Systems also include designating personnel to be responsible for “ stuff ” including PPE and reporting issues to the chain of command .
Summary
COVID-19 challenges during the past nine months have forever changed the focus of emergency planning . Surge capacity and planning for future disasters will require ongoing dedication and determination across the continuum of healthcare . The combination of tremendous teamwork , flexibility , creativity and coping skills inherent in healthcare professionals is evident several months into the disaster and as we prepare for the “ winter wave ” combined with influenza , facilities including acute , long-term and outpatient care are ready to : face existing and new challenges with strength and determination .
Phenelle Segal , RN , CIC , FAPIC , is president of Infection Control Consulting Services .
References :
2 . Exploring the Concept of Surge Capacity . OJIN : The Online Journal of Issues in Nursing ; Vol . 14 No . 2 . DOI : 10.3912 / OJIN . Vol14No02PPT03
3 . How to Surge to Face the SARS-CoV-2 Outbreak : Lessons learned from Lombardy , Italy . Disaster Med Public Health Prep 2020 Apr 1 : 1-3 . doi :
10.1017 / dmp . 2020.64