Management of patients infected with airborne-spread diseases: An algorithm for infection control professionals

Abstract

The threat of bioterrorism and emerging infections increases health care's need for negative-pressure and/or protective environments. The algorithm outlines appropriate response steps to decrease transmission risk until an ideal protective environment can be utilized. Using this algorithm will prepare infection control professionals to respond more effectively during a surge of potentially infectious patients following a bioterrorism attack or emerging infectious disease outbreak.

APIC State-of-the-art Report: The role of the infection preventionist in emergency management

“…IPs need to be involved in assessing all aspects of readiness for mass casualty events as it relates to potential disease transmission. 6,9,[11][12][13][14]28,29,[37][38][39][40] This includes being involved in preparedness efforts at the personal, facility, and community level for all types of mass casualty events. An all-hazards approach to emergency management should be used because all types of mass casualty incidents can result in infectious disease implications and the type of emergency that might occur cannot always be anticipated.…”

“…At the facility level, IPs need to be involved in assessing mass casualty event readiness, including being involved in the facility hazard vulnerability assessment. 6,9,[11][12][13]31,32,34,37,38 Health care facilities need to assess all components of their all-hazards emergency management plan. Infection prevention-related aspects of the emergency management plan are only a small piece of the overall plan, but these issues require IP input to guide decision making.…”

“…[11][12][13] Some components of an emergency management plan that require IP input have been outlined, including surveillance, triage, patient placement, and isolation. [8][9][10][11][12][13]25,26,32,38,39 Although a comprehensive list of topics that require IP input have not been delineated in the literature, some issues that may affect infection transmission during disasters are listed in Table 1. It is important that every health care facility have an IP as a member of the emergency management planning team to consult on issues that affect infection transmission in the health care setting during mass casualty events.…”

“…[11][12][13]16,29,39 IP input will be vital in developing prioritization plans for therapy, prophylaxis, and vaccination when doses are limited 9,[11][12][13]26,39 ; allocation of PPE when resources are insufficient or unavailable 6,[11][12][13]16,26,29,37,39 ; and safe patient placement when isolation rooms are depleted. 6,[8][9][10][11][12][13][14]17,25,35,[37][38][39] A recent development in emergency management is the recognition that IP input is needed in community emergency management planning. Community disaster planners will need infection prevention guidance when setting up and running alternative care sites and shelters for displaced individuals.…”

“…Having around the clock infection control coverage 27,29,47 Facility assessment/hazard vulnerability assessment 9,[11][12][13] Participation in disaster drills involving a biologic agent 6,9,[11][12][13]28,29,39 Strategies for receiving and posting health alert messages within the facility 29 Negative-pressure surge capacity 27,29,38,39 Safe patient specimen collection procedures 9,11,32 Patient management 6,9,[11][12][13]38,39 Food safety 6,[11][12][13]39 Water management 6,12,13,28,39 Sanitation control 12,13,39 Pet management 39 Environmental decontamination 6,9,[11][12][13]28,...…”