-
https://repository.netecweb.org/files/original/933accd0939c5454fb8dd0197a71c2f6.png
3f501528330a5195fcab9cad4e0bb714
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Discover
Description
An account of the resource
<div style="background-color:#c7e5f8;">
<h2 style="background-color:#c7e5f8;"><span style="font-size:80%;line-height:24px;"><a href="https://repository.netecweb.org/exhibits/show/ncov/ncov"><button>COVID-19 Update</button></a><a href="https://repository.netecweb.org/news#Map"><button>Outbreak Map</button></a><a href="https://repository.netecweb.org/news#News"><button>Newsfeed</button></a><a href="https://repository.netecweb.org/exhibits/show/monkeypox/monkeypox"><button>Monkeypox 2021</button></a><a href="https://repository.netecweb.org/exhibits/show/drcebola2018/drcebola2018"><button>2020 Ebola Update</button></a><a href="https://repository.netecweb.org/ebolatimeline"><button>Ebola Timeline</button></a><a href="https://repository.netecweb.org/exhibits/show/mers/mers"><button>MERS</button></a><a href="https://repository.netecweb.org/exhibits/show/aerosol/aerosol"><button>Airborne Transmission</button></a></span></h2>
<h2 style="background-color:#c7e5f8;">Discover Background Data and Resources:</h2>
<ul><li>
<p><span style="line-height:24px;">Get introduced to NETEC through the interactive timeline of special pathogens below.* This timeline describes some significant special pathogen events in recent history.</span></p>
</li>
<li>
<p><span style="line-height:24px;">Find out more about the 2014 Ebola outbreak and the development of the ASPR/CDC-supported network of healthcare facilities preparing for the next outbreak through <em><a href="/ebolatimeline"><button>the Ebola timeline</button></a>.</em></span></p>
</li>
</ul><ul><li>
<p><span style="line-height:24px;">This NETEC Repository helps to provide training and educational resources to prepare for future special pathogen events. </span></p>
</li>
</ul><ul><li>
<p><span style="line-height:24px;">Explore the files BELOW THE TIMELINE to <em><strong>discover and learn</strong></em> more about Ebola and other Special Pathogens, an overview of special pathogens, clinically managing patients affected, and readying healthcare teams and systems to keep everyone safe.</span></p>
</li>
</ul><h2 style="background-color:#c7e5f8;">Timeline of Special Pathogens:</h2>
<a href="#click">Skip timeline</a>
<p style="margin-bottom:0;"><iframe width="100%" height="635" style="border:1px solid #000000;" src="https://cdn.knightlab.com/libs/timeline3/latest/embed/index.html?source=1AQiHJEzkhEi71uIi7wTWWgSFRwR6wRbRyfhbASrw3Ig&font=Default&lang=en&initial_zoom=2&height=650" title="Timeline of Special Pathogens"></iframe></p>
<h2 style="background-color:#c7e5f8;"><span style="font-size:70%;">*Click for <a href="/timeline2access"><button>a screen reader accessible table of this timeline</button></a>. </span></h2>
</div>
Publication
A peer reviewed publication.
Citation
Citation information for the publication itself.
Jones, Rachael M., Susan C. Bleasdale, Dayana Maita, Lisa M. Brosseau, and C. D. C. Prevention Epicenters Program. 2020. "A systematic risk-based strategy to select personal protective equipment for infectious diseases." American journal of infection control 48 (1):46-51.
Abstract
<div>
<div class="sec sec-first">
<h3>Background</h3>
<p id="__p2" class="p p-first-last">Personal protective equipment (PPE) is a primary strategy to protect health care personnel (HCP) from infectious diseases. When transmission-based PPE ensembles are not appropriate, HCP must recognize the transmission pathway of the disease and anticipate the exposures to select PPE. Because guidance for this process is extremely limited, we proposed a systematic, risk-based approach to the selection and evaluation of PPE ensembles to protect HCP against infectious diseases.</p>
</div>
<div class="sec">
<h3>Methods</h3>
<p id="__p3" class="p p-first-last">The approach used in this study included the following 4 steps: (1) job hazard analysis, (2) infectious disease hazard analysis, (3) selection of PPE, and (4) evaluation of selected PPE. Selected PPE should protect HCP from exposure, be usable by HCP, and fit for purpose.</p>
</div>
<div class="sec">
<h3>Results</h3>
<p id="__p4" class="p p-first-last">The approach was demonstrated for the activity of intubation of a patient with methicillin-resistant Staphylococcus aureus or Severe Acute Respiratory Syndrome coronavirus. As expected, the approach led to the selection of different ensembles of PPE for these 2 pathogens.</p>
</div>
<div class="sec">
<h3>Discussion</h3>
<p id="__p5" class="p p-first-last">A systematic risk-based approach to the selection of PPE will help health care facilities and HCP select PPE when transmission-based precautions are not appropriate. Owing to the complexity of PPE ensemble selection and evaluation, a team with expertise in infectious diseases, occupational health, the health care activity, and related disciplines, such as human factors, should be engaged.</p>
</div>
<div class="sec sec-last">
<h3>Conclusions</h3>
<p id="__p6" class="p p-first-last">Participation, documentation, and transparency are necessary to ensure the decisions can be communicated, critiqued, and understood by HCP.</p>
</div>
</div>
<div class="sec"><strong class="kwd-title">Key Words: </strong><span class="kwd-text">Job hazard analysis, High-consequence infections, Intubation, Infection prevention, Exposure, Industrial hygiene</span></div>
Accessibility
Information on accessibility of the document(s), such as university log-in necessary, request form, open access, etc.
Free online on journal site and PubMed Central.
URL
https://pubmed.ncbi.nlm.nih.gov/31358421/
Read Online
Online location of the resource.
https://www.ajicjournal.org/article/S0196-6553(19)30654-6/fulltext
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
A systematic risk-based strategy to select personal protective equipment for infectious diseases
Subject
The topic of the resource
Infection Control
Description
An account of the resource
Personal protective equipment (PPE) is a primary strategy to protect health care personnel (HCP) from infectious diseases. When transmission-based PPE ensembles are not appropriate, HCP must recognize the transmission pathway of the disease and anticipate the exposures to select PPE. Because guidance for this process is extremely limited, we proposed a systematic, risk-based approach to the selection and evaluation of PPE ensembles to protect HCP against infectious diseases.
Creator
An entity primarily responsible for making the resource
Jones, Rachael M., Susan C. Bleasdale, Dayana Maita, and Lisa M. Brosseau, for the C. D. C. Prevention Epicenters Program.
Date
A point or period of time associated with an event in the lifecycle of the resource
2020-01
Type
The nature or genre of the resource
Publication
Relation
A related resource
Y - PPE pos 81 qualtrics 302
Y - D0.1PPE/D0.2PPE Qualtrics # 302
Contributor
An entity responsible for making contributions to the resource
2023-12-04 by Jill Morgan/PPE Group
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
2026-12-04
Equipment and Supplies
Example
Infection Prevention and Control
Occupational Exposure
Personal Protective Equipment (PPE)
Preparedness
R-PPE
Supply Management
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Discover
Description
An account of the resource
<div style="background-color:#c7e5f8;">
<h2 style="background-color:#c7e5f8;"><span style="font-size:80%;line-height:24px;"><a href="https://repository.netecweb.org/exhibits/show/ncov/ncov"><button>COVID-19 Update</button></a><a href="https://repository.netecweb.org/news#Map"><button>Outbreak Map</button></a><a href="https://repository.netecweb.org/news#News"><button>Newsfeed</button></a><a href="https://repository.netecweb.org/exhibits/show/monkeypox/monkeypox"><button>Monkeypox 2021</button></a><a href="https://repository.netecweb.org/exhibits/show/drcebola2018/drcebola2018"><button>2020 Ebola Update</button></a><a href="https://repository.netecweb.org/ebolatimeline"><button>Ebola Timeline</button></a><a href="https://repository.netecweb.org/exhibits/show/mers/mers"><button>MERS</button></a><a href="https://repository.netecweb.org/exhibits/show/aerosol/aerosol"><button>Airborne Transmission</button></a></span></h2>
<h2 style="background-color:#c7e5f8;">Discover Background Data and Resources:</h2>
<ul><li>
<p><span style="line-height:24px;">Get introduced to NETEC through the interactive timeline of special pathogens below.* This timeline describes some significant special pathogen events in recent history.</span></p>
</li>
<li>
<p><span style="line-height:24px;">Find out more about the 2014 Ebola outbreak and the development of the ASPR/CDC-supported network of healthcare facilities preparing for the next outbreak through <em><a href="/ebolatimeline"><button>the Ebola timeline</button></a>.</em></span></p>
</li>
</ul><ul><li>
<p><span style="line-height:24px;">This NETEC Repository helps to provide training and educational resources to prepare for future special pathogen events. </span></p>
</li>
</ul><ul><li>
<p><span style="line-height:24px;">Explore the files BELOW THE TIMELINE to <em><strong>discover and learn</strong></em> more about Ebola and other Special Pathogens, an overview of special pathogens, clinically managing patients affected, and readying healthcare teams and systems to keep everyone safe.</span></p>
</li>
</ul><h2 style="background-color:#c7e5f8;">Timeline of Special Pathogens:</h2>
<a href="#click">Skip timeline</a>
<p style="margin-bottom:0;"><iframe width="100%" height="635" style="border:1px solid #000000;" src="https://cdn.knightlab.com/libs/timeline3/latest/embed/index.html?source=1AQiHJEzkhEi71uIi7wTWWgSFRwR6wRbRyfhbASrw3Ig&font=Default&lang=en&initial_zoom=2&height=650" title="Timeline of Special Pathogens"></iframe></p>
<h2 style="background-color:#c7e5f8;"><span style="font-size:70%;">*Click for <a href="/timeline2access"><button>a screen reader accessible table of this timeline</button></a>. </span></h2>
</div>
Publication
A peer reviewed publication.
Citation
Citation information for the publication itself.
Wang, Xu, Wenhui Wu, Peipei Song, and Jiangjiang He. 2020. "An international comparison analysis of reserve and supply system for emergency medical supplies between China, the United States, Australia, and Canada." BioScience Trends 14 (4):231-40.
Abstract
Coronavirus disease 19 (COVID-19) has become a pandemic around the world. With the explosive growth of confirmed cases, emergency medical supplies are facing global shortage, which restricts the treatment of seriously ill patients and protection of medical staff. Taking China, the United States, Australia, and Canada as examples, this study compares and analyzes the reserve and supply systems of emergency medical supplies and problems exposed in response to the COVID-19 epidemic. Some common problems were found, such as insufficient types and quantities of emergency medical supplies in reserve, insufficient emergency production capacity, and imperfect command mechanism for emergency supplies deployment and transportation. A sound reserve system of emergency medical supplies is the basis and guarantee for dealing with public health emergencies such as major outbreaks. Based on the comparison of systems and practical experience, countries around the world should further improve the reserve and supply system of emergency medical supplies, and improve the coordination and cooperation mechanism for emergency supplies for international public health emergencies, so as to cope with increasingly severe public health emergencies in the context of globalization.
Accessibility
Information on accessibility of the document(s), such as university log-in necessary, request form, open access, etc.
Free online, Free Access, 2020 Volume 14 Issue 4 Pages 231-240
URL
https://www.jstage.jst.go.jp/article/bst/14/4/14_2020.03093/_article
Read Online
Online location of the resource.
https://www.jstage.jst.go.jp/article/bst/14/4/14_2020.03093/_pdf/-char/en
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
An international comparison analysis of reserve and supply system for emergency medical supplies between China, the United States, Australia, and Canada
Subject
The topic of the resource
Research
Description
An account of the resource
Coronavirus disease 19 (COVID-19) has become a pandemic around the world. With the explosive growth of confirmed cases, emergency medical supplies are facing global shortage, which restricts the treatment of seriously ill patients and protection of medical staff. Taking China, the United States, Australia, and Canada as examples, this study compares and analyzes the reserve and supply systems of emergency medical supplies and problems exposed in response to the COVID-19 epidemic.
Creator
An entity primarily responsible for making the resource
Wang, Xu, Wenhui Wu, Peipei Song, and Jiangjiang He.
Date
A point or period of time associated with an event in the lifecycle of the resource
2020-09-20
Type
The nature or genre of the resource
Publication
2019-nCoV
Coronavirus
COVID-19
Emergency Management
Epidemic
Equipment and Supplies
Pandemic
R-Res&Pub
-
https://repository.netecweb.org/files/original/34243d3a9fe410401150468e61b55255.pdf
09b4ec7ef701d3346d4b05475012a76b
PDF Text
Text
NETEC COVID-19 Webinar Series:
Supply Management and Inventory Control
During COVID-19 – Part Two
�Content Outline (TOC)
Welcome
Sharon Vanairsdale, DNP, APRN, ACNS-BC, NP-C, CEN, FAEN, FAAN
�Overview
Welcome: Sharon Vanairsdale, DNP, APRN, ACNS-BC, NP-C, CEN, FAEN, FAAN
Supply Management and Inventory Control During COVID-19:
Emory Healthcare: Kari Love, MS, RN, CIC, FAPIC, Program Director Infection Prevention
Supply Management and Inventory Control During COVID-19:
Nebraska Medicine / University of Nebraska Medical Center:
Brian Spencer, AIA, Director Facilities & Clinical Space Planning
NETEC Resources: Sharon Vanairsdale, DNP, APRN, ACNS-BC, NP-C, CEN, FAEN, FAAN
Questions and Answers with NETEC
�Welcome
National Emerging Special Pathogens
Training and Education Center
Mission Statement
To increase the capability of the United States public health and
health care systems to safely and effectively manage individuals
with suspected and confirmed special pathogens
For more information
Please visit us at www.netec.org
or email us at info@netec.org
�NETEC Overview
Assessment
Education
Technical
Assistance
Research
Network
Empower hospitals to gauge
their readiness using
Provide self-paced
education through
Onsite & Remote
Guidance
Online Repository
Self-Assessment
Measure facility and
healthcare worker
readiness using
Metrics
Meet Fred
Online Trainings
Compile
Online Repository
Deliver didactic and handson simulation training via
In-Person Courses
of tools and resources
Develop customizable
Exercise Templates
based on the HSEEP model
Provide direct feedback
to hospitals via
On-Site
Assessment
COVID-19 focused
Webinars
Built for rapid implementation
of clinical research protocols
Provide
Emergency On-Call
Mobilization
Cross-Cutting, Supportive Activities
Develop Policies,
Procedures and
Data Capture Tools
to facilitate research
Create infrastructure for a
Specimen
Biorepository
�Content Outline (TOC)
Supply Management and Inventory Control
During COVID-19:
Emory Healthcare
Kari Love, MS, RN, CIC, FAPIC
Program Director Infection Prevention
�Supply Management and Inventory Control
During COVID-19
PPE and Donated Supplies
Articulate creative ways in managing reusable and disposable supplies
and how to approach the need for substitution amid the pandemic crisis
Describe vetting processes for supplies received including how to manage
donations while maintaining safety and infection control measures
�The First Needs
Hand Sanitizer was one of the first items we
felt like we had to scramble to procure
Worked with medical students to create hand
sanitizer in the chemistry lab
r
• Used WHO recipe
Seriously considered using
sheet protectors for face
shields as demonstrated
by Sharon Vanairsdale
�Supply Management and Inventory Control
During COVID-19
Develop a Process for Disinfecting CAPR Cuffs/Lenses
Developed disinfection protocol for the CAPR lens as part of the doffing
process so that it could be reused by a HCW
�Face Shields
Partnered with Georgia Tech (GT) to
develop multiple prototypes
Disposable
Disinfected and reused until the
headband disintegrated
Reusable
Headband and shield dedicated to each HCW
– shields can be replaced if damaged
r
�PPE Tailored to Fit
Reusable face shields created by
Georgia Tech had input from three
different health systems
Feedback from Emory - difficult to
hear and the shield was too long
The other two health systems
did not want to re-design the
shield
Created a pattern with feedback
from front line staff members
– it can be trimmed to fit
r
�Isolation Gowns
Purchased material made of 40 GSM polypropylene
Local companies took material, used an isolation gown pattern and made gowns
Since the material was not rated as AAMI Level 2 etc., we did some of our own testing
with diet coke, water and other fluids to determine fluid resistance
r
�Cloth Gowns, Surgical Gowns and Coveralls
Cloth isolation gowns
• Having cloth isolation gowns
laundered
• Good for 100 wash cycles
Disposable surgical gowns
• Laundered 3x and the
gowns were still intact
r
Coveralls
• Not optimal but were able to
use them at the testing centers
• Staff wore PAPRs and
coveralls for 4 hour shifts in
the drive-up testing clinic
�Donation Center
Amazing community response
Found a building on campus where donations could be
received
• Overwhelmed the dock and the supply warehouse
Took a full-time team just to manage rdonations
• VP of Performance Improvement utilized
management engineers to categorize, organize
and distribute
Developed and posted criteria for items that we could
accept
Also assisted with pulling supplies out of the
emergency management pods
�Reprocessing N95 Respirators and PAPR Hoods
UV disinfection of N95s
Bioquell – PAPR hoods
• Achieved > 6 log kill INSIDE the hood
Once EUA received – N95s reprocessed in sterile
processing
r
�Supply Management and Inventory Control
During COVID-19
Ready to Swab
Gowns sewn by Mohawk Flooring
Face shields produced by TSG
�Resources
r
https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/default.html
�Resources
r
https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html
�Content Outline (TOC)
Supply Management and Inventory Control
During COVID-19:
Nebraska Medicine
University of Nebraska Medical Center
Brian Spencer, AIA
Director Facilities & Clinical Space Planning
�Supply Management and Inventory Control
During COVID-19
Decision Making: Quick/Slow
Decision making in an organization under extreme stress often
resorts to one of two models:
Very quick and not always knowledge based
Very slow and very safe
HICS exists, in part, to help combat moving to these extremes
Our job as we continue to manage the pandemic is to help bring balance
Launch more than one balloon!
�Decision Making: Balloons
Example
Germicidal wipes burn rate was up, we were on allocation, shipments were
delayed, and it appeared we would run out in the short term and have long
term sustainability issues
The team quickly launched several balloons:
r
•
•
•
•
Infection Control team toured to
understand burn very deeply
Supply chain worked to see what WAS
available in the market – even parts
(tubs)
Pharmacy and Sterile Processing
began testing ‘home rolled’ solutions
Deployed home roll solutions to low
burn and low risk areas to test.
�Vetting
Phase 1
Emergency issues and shortages
Phase 2
This is going to last a while and we need to capture good
ideas and innovation
Phase 3
This is REALLY going tor last a while and we need to have a
framework for increasingly complex shortages
�Vetting Team
Phase 1
As we worked through Phase 1 it became clear we
needed a team….
qGrabbed a very small group – IC, ID, Safety, Legal, CIO, Logistics
qCommon inbox for all ideas
r
qMet almost daily in the beginning
and have settled to bi-weekly
�Vetting Process: Hand Sanitizer Example
Phase 1
Emergency deploy portable hand
sinks at entries, pull product from
office areas, send people home
Phase 2
Work with existing vendorsr and
local alternate folks (distillers,
college pharmacy department) to
get something coming
Phase 3
Worked with vendors to stabilize and
refill existing bags. Develop stands to
deploy more broadly for increased
hand sanitation based on available
materials, bags, dispensers, etc
�Vetting Process: Intubation Boxes Example
Phase 1
Emergency shortage of masks and
other PPE, put out word in
institution looking for safer way to
intubate for aerosol producing
procedures
Phase 2
Work with ‘weekend warriors’
to get
r
samples made and into test rotation.
Develop accepted standard and have
small batch made
Phase 3
Working with legal and innovation
groups on IP rights and bringing to
larger market
�Content Outline (TOC)
NETEC Resources
Sharon Vanairsdale, DNP, APRN, ACNS-BC, NP-C, CEN, FAEN, FAAN
�Resources: NETEC
NETEC is Here to Help
NETEC will continue to build resources, develop online education,
and deliver technical training to meet the needs of our partners
Ask for help!
Send questions to info@netec.org - they will be answered by NETEC SMEs
Submit a Technical Assistance request at NETEC.org
�Questions
and
Answers
�Contact
NETEC eLearning Center
NETEC Skill videos
courses.netec.org
youtube.com/thenetec
Join the Conversation!
@theNETEC
@the_NETEC
Use hashtag: #NETEC
Website
Repository
Email
netec.org
repository.netecweb.org
info@netec.org
��
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Deploy
Description
An account of the resource
<h2><span>These files will help you <strong><em>develop</em></strong> your program and plans based on what you have discovered.</span></h2>
<p style="font-size:120%;">Find model protocols and procedures and more in-depth training resources. You can go to the <a href="/exhibits/show/leadership"><button>Leadership Toolbox</button></a> or the <a href="https://repository.netecweb.org/exhibits/show/specialpopulations"><button>Special Populations</button></a> section. You can also go to the <a href="https://repository.netecweb.org/exhibits/show/netec-education/justintime"><button> Just in Time Training</button></a> page, the <a href="https://repository.netecweb.org/exhibits/show/ppe101/ppe"><button> PPE</button></a> page, or the <a href="https://repository.netecweb.org/exhibits/show/ems/prehospital"><button>EMS</button></a> page. <span>Subscribe to the NETEC <a href="https://www.youtube.com/channel/UCDpHc1LkcEpiWR0q7ll5eZQ" target="_blank" rel="noreferrer noopener"><button>Youtube Channel</button></a> to get all new Skills videos!</span></p>
Webinar
Portal access to a webinar
Duration
Length of time involved (seconds, minutes, hours, days, class periods, etc.)
Friday, August 7, 2020 | 1:00 PM EST
Event Type
Webinar, watch at link below.
URL
https://youtu.be/knJfoS366TY
Player
Field for the html for a video player.
<br /><iframe width="560" height="315" title="Supply Management webinar" src="https://www.youtube.com/embed/knJfoS366TY?autoplay=0" frameborder="0"></iframe>
Alternate URL
Other URLs if necessary.
CEU online course: <a href="http://courses.netec.org/courses/20-web-supply2" target="_blank" rel="noreferrer noopener">http://courses.netec.org/courses/20-web-supply2</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
NETEC COVID-19 Webinar Series (8/07/20)/Online Course: Supply Management & Inventory Control – Part 2
Subject
The topic of the resource
Physical Infrastructure
Description
An account of the resource
In this webinar, participants will discuss the principles of the Hospital Incident Command System (HICS) and other innovative approaches to assist with making informed decisions related to COVID-19 preparedness, mitigation, and response. Participants will also learn how to articulate creative ways to manage reusable and disposable supplies and how to approach the need for substitution during the pandemic crisis. The vetting processes for supplies received, including managing donations while maintaining safety and infection control measures, will also be discussed.<br /><br />Webinar slides attached.<br />
<h2>Get educational credit for this webinar through <a href="http://courses.netec.org/courses/20-web-supply2" target="_blank" rel="noreferrer noopener">Courses.netec.org</a>.</h2>
Creator
An entity primarily responsible for making the resource
NETEC
Date
A point or period of time associated with an event in the lifecycle of the resource
2020-08-07
Relation
A related resource
Y - PPE pos 82 qualtrics 303; PPE pos 88 qualtrics 309
Y - D0.1PPE/D0.2PPE Qualtrics # 303
Y - D0.1PPE/D0.2PPE Qualtrics # 309
Contributor
An entity responsible for making contributions to the resource
2023-08-31 by Shawn Gibbs - PhysInfr General Review
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
2024-08-31
Type
The nature or genre of the resource
Webinar and Online Course
2019-nCoV
CEU
CEUs
Contingency and crisis capacities
Coronavirus
COVID-19
Equipment and Supplies
Infection Prevention and Control
Online Course
Personal Protective Equipment (PPE)
R-PhIn
R-PPE
-
https://repository.netecweb.org/files/original/68201dc38aa9c032a12151769cdebbff.pdf
67d89c9f3b95180fdbdfd4b2b04430f6
PDF Text
Text
NETEC COVID-19 Webinar Series:
Supply Management and Inventory Control
During COVID-19 – Part One
�Content Outline (TOC)
Welcome
Sharon Vanairsdale, DNP, APRN, ACNS-BC, NP-C, CEN, FAEN, FAAN
�Overview
Welcome: Sharon Vanairsdale, DNP, APRN, ACNS-BC, NP-C, CEN, FAEN, FAAN
Supply Management and Inventory Control During COVID-19:
Providence Sacred Heart Medical Center:
Bethany White, Manager of Materials Management Supply Chain Operations
Christa Arguinchona, MSN, RN, CCRN
Supply Management and Inventory Control During COVID-19:
NYC H+H Bellevue: John Maharaj, Associate Executive Director of Support Services
Trish Tennill, RN, BSN
NETEC Resources: Sharon Vanairsdale, DNP, APRN, ACNS-BC, NP-C, CEN, FAEN, FAAN
Questions and Answers with NETEC
�Welcome
National Emerging Special Pathogens
Training and Education Center
Mission Statement
To increase the capability of the United States public health and
health care systems to safely and effectively manage individuals
with suspected and confirmed special pathogens
For more information
Please visit us at www.netec.org
or email us at info@netec.org
�NETEC Overview
Assessment
Education
Technical
Assistance
Research
Network
Empower hospitals to gauge
their readiness using
Provide self-paced
education through
Onsite & Remote
Guidance
Online Repository
Self-Assessment
Measure facility and
healthcare worker
readiness using
Metrics
Meet Fred
Online Trainings
Compile
Online Repository
Deliver didactic and handson simulation training via
In-Person Courses
of tools and resources
Develop customizable
Exercise Templates
based on the HSEEP model
Provide direct feedback
to hospitals via
On-Site
Assessment
COVID-19 focused
Webinars
Built for rapid implementation
of clinical research protocols
Provide
Emergency On-Call
Mobilization
Cross-Cutting, Supportive Activities
Develop Policies,
Procedures and
Data Capture Tools
to facilitate research
Create infrastructure for a
Specimen
Biorepository
�Content Outline (TOC)
Supply Management and Inventory Control
During COVID-19:
Providence Sacred Heart Medical Center
Bethany White, Manager of Materials Management Supply Chain Operations
Christa Arguinchona, MSN, RN, CCRN
�Supply Management and Inventory Control
During COVID-19
Providence Sacred Heart Medical Center
Providence St. Joseph Health (PSJH)
• 51 hospitals in 7 states (WA, OR, MT, AK, CA, NM and TX)
Providence Health Care
• Providence Sacred Heart Medical Center (Region 10 RESPTC)
• 4 total hospitals
�Acquiring PPE
Challenges:
• Hoarding/stealing, fear-based, inappropriate usage
• Availability of PPE nationwide
• Vendor allocations
• Multiple planning meetings
Approaches:
• State Department of Health allocated PPE
r
• Donations from multiple sources
• Local purchases
• Providence St. Joseph System
• Central Planning Team distributed PPE resources
• PSHMC HUB for our region
• Hospitals, Clinics, Urgent Cares
• Pre-ordering for pandemic preparedness
• Sharing amongst all facilities
• Donated to local charities in need
�Supply Management and Inventory Control
During COVID-19
PPE Changes/Substitutions
New PPE (different/unfamiliar products)
• Approval process with Infection Prevention
• Develop new product number
• Develop “no-charge” purchase order for tracking
• Daily inventory counts/reporting of all PPE
Collaboration with nursing leadership
• Approaches/substitutions
• Flexibility and adaptability
Processes/policies
constantly changing
=
Daily changes
in PPE use
=
New headache every day!
�Innovative Approach to Inventory Control
Lock down of PPE
• Securely stored all bulk PPE in Supply Chain
• Removed PPE from unit stock carts
• Identified locked storage area in each unit
• Daily order for each unit
• Assigned daily PPE ordering levels rfor each unit
based off usage
• Staffed PPE room 24/7 to ensure it was secured and
departments got what they needed
• Items returned to supply carts based on availability
• Challenges:
• Supply chain staff = police
• Consistency of process
�Innovative Approach to Inventory Control
PAPR Management Plan
• Appointed a clear owner to develop and manage the plan
• PAPR tracking spreadsheet
• Share point
• Department, manager, inventory date, repair/reason, serial #,
inventory date, filter change date:
r
• Developed PAPR repair process
• Increase use = increase in needed repairs
• Innovative Clinical Engineering expert!
• Utilize online request for repair, allows tracking
• Allocation plan for prioritization of use
�Innovative Approach to Inventory Control
PAPR accessory conservation strategies:
•
•
•
•
No accessory orders filled for 7 months
Assigned shields and headbands for reuse
Unit responsibility to develop storage plan
Job aid developed and distributed
Strengths
r
Extended use, staff preference/comfort
It worked! No known staff acquired infections
Challenges
Which disinfectant?
Increased use from training
Decreased visualization from multiple cleanings
CAPR DISINFECTION PROCESS (MaxAir with Lens Cuff)
Lens cuff will be reused until its’ integrity is compromised. Care must be taken when applying and
removing to extend the life of the lens cuff. Lens cuff will be stored in a bag in designated location on
unit.
Comfort strip will be issued to each caregiver, name written on side that adheres to Velcro, removed after
use and stored in a bag with name on it in designated place on unit.
1. After doffing process occurs in patient room, caregiver will have clean gloves on and will use a
disinfectant wipe to proceed through the door into the hallway and proceed to CAPR doffing
area.
2. Doff CAPR
a. Remove disinfectant wipe and have ready
b. Remove CAPR by grabbing back knob and thoroughly disinfect all components with
wipe, including lens cuff and cord
c. Place on surface to have appropriate contact time dependent on disinfectant wipe used
d. Place in clear white bag, tie up bag and write name on bag with Sharpie to reuse CAPR
and lens cuff throughout shift (unless end of shift, then remove lens cuff and place in a
bag and label with name to be used during next shift. Place comfort strip in bag with
name to be reused.)
e. Doff belt and battery and disinfect with wipe
3. Perform hand hygiene
4. Doff gloves using glove in glove technique
5. Perform hand hygiene
6. Return bagged CAPR to cart to reuse throughout shift
7. Return belt and battery to cart and plug in battery to charge
P or
initials
�Supply Management and Inventory Control
During COVID-19
Supply Chain/Nursing Coordination
Approval needed for accessory item orders
• Able to identify departments needing more education
• Prioritized high risk departments
• Established clear request process
Constant Communication
• Awareness of inventory
• POC for supply chain staff
• Coordinated approach based on changing circumstances
• Improved collaboration amongst involved leadership
�Innovative Approach to Inventory Control
q CNO: 5 Things to Know this Week
q Huddle Highlights
q Safety Huddle Announcements
q Weekly system staff communications
q COVID Circle One communications
r
q Reassurance regarding changes in PPE pieces
q Different colored masks, gowns, gloves
q Focus on fact that we have PPE
Everyone needs to hear the rationale!!
Be transparent!!
�Content Outline (TOC)
Supply Management and Inventory Control
During COVID-19:
NYC H+H Bellevue
John Maharaj, Associate Executive Director of Support Services
Trish Tennill, RN, BSN
�Supply Management and Inventory Control
During COVID-19
NYC H+H Bellevue
Bellevue Hospital is part of the greater H+H
public health system
• Includes 11 acute care hospitals
• 5 post acute/long-term care facilities
• Shared supply chain
• Centralized ordering and storage
locations for PPE stores
�Supply Management and Inventory Control
During COVID-19
PPE Needs - In the Beginning
PPE
• PPE was in accordance to CDC COVID-19 guidelines
Initially
• PPE distribution started with three carts based on our
initial predictions - 1:1 patient to cart
• Using existing crash carts allowed the PPE to be portable
• Supplies were acquired from central stores, then taken to
satellite PPE room
• Labor
• Restocked during the day by central stores staff
• Three in-house staff members operated the night shifts
�PPE Needs – As the Pandemic Numbers Increase
PPE demands increased as:
• The number of patients increased
• There was an influx of outside staff
• Protocols changed
r
�Supply Management and Inventory Control
During COVID-19
PPE Supply
PPE changed from day to day:
• PPE varied from different supply chains
• Donations
All PPE was approved by either
• H+H Central Infection Control
• Bellevue Infection Control
�PPE Supply Chain and Delivery Services
Strengths
In house labor pool
Outside vendor support
Challenges
Hard to keep tight inventory control with the r
number of patients, care teams, and new staff
Could not keep up with burn rate
Sizing
Benefits
Could borrow from our sister facilities
Corporation had a large off-site warehouse
�Supply Management and Inventory Control
During COVID-19
State of Preparedness
Where do we go from here
• Low Covid census gives us a chance to
do inventory
Implementation of a 90-day supply of PPE
• This is across the corporation
Standardization of respiratory protection
• Will assure its availability
�Supply Management and Inventory Control
During COVID-19
State of Preparedness
Tracking of valuable resources
• N95 respirators
• PAPRs
• DLC lenses
Restructured PPE delivery
• From 24/7 delivery to M-F 7a-7p
�Supply Management and Inventory Control
During COVID-19
Conservation Strategies
Personal Protective Equipment:
qBundling care
Reuse of Respiratory Protection:
qN95 respirators
qPAPR DLC lenses
qFace shields
�Supply Management and Inventory Control
During COVID-19
Education Strategies
More is not better
Initial PPE training
• Reinforcement that gowns, gloves, and
respiratory protection may change
Making staff feel safe and secure
• Going into the room with them
More is not better
• Adding more can complicate donning
and doffing
�Content Outline (TOC)
NETEC Resources
Sharon Vanairsdale, DNP, APRN, ACNS-BC, NP-C, CEN, FAEN, FAAN
�Resources: NETEC
NETEC is Here to Help
NETEC will continue to build resources, develop online education,
and deliver technical training to meet the needs of our partners
Ask for help!
Send questions to info@netec.org - they will be answered by NETEC SMEs
Submit a Technical Assistance request at NETEC.org
�Questions
and
Answers
�Contact
NETEC eLearning Center
NETEC Skill videos
courses.netec.org
youtube.com/thenetec
Join the Conversation!
@theNETEC
@the_NETEC
Use hashtag: #NETEC
Website
Repository
Email
netec.org
repository.netecweb.org
info@netec.org
��
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Deploy
Description
An account of the resource
<h2><span>These files will help you <strong><em>develop</em></strong> your program and plans based on what you have discovered.</span></h2>
<p style="font-size:120%;">Find model protocols and procedures and more in-depth training resources. You can go to the <a href="/exhibits/show/leadership"><button>Leadership Toolbox</button></a> or the <a href="https://repository.netecweb.org/exhibits/show/specialpopulations"><button>Special Populations</button></a> section. You can also go to the <a href="https://repository.netecweb.org/exhibits/show/netec-education/justintime"><button> Just in Time Training</button></a> page, the <a href="https://repository.netecweb.org/exhibits/show/ppe101/ppe"><button> PPE</button></a> page, or the <a href="https://repository.netecweb.org/exhibits/show/ems/prehospital"><button>EMS</button></a> page. <span>Subscribe to the NETEC <a href="https://www.youtube.com/channel/UCDpHc1LkcEpiWR0q7ll5eZQ" target="_blank" rel="noreferrer noopener"><button>Youtube Channel</button></a> to get all new Skills videos!</span></p>
Webinar
Portal access to a webinar
Duration
Length of time involved (seconds, minutes, hours, days, class periods, etc.)
Wednesday, August 5, 2020 | 1:00 PM EST
Event Type
Webinar, watch at link below.
URL
https://youtu.be/S3tzcp8yuJE
Player
Field for the html for a video player.
<br /><iframe width="560" height="315" title="Supply Management webinar" src="https://www.youtube.com/embed/S3tzcp8yuJE?autoplay=0" frameborder="0"></iframe>
Alternate URL
Other URLs if necessary.
CEU online course: <a href="http://courses.netec.org/courses/20-web-supply1" target="_blank" rel="noreferrer noopener">http://courses.netec.org/courses/20-web-supply1</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
NETEC COVID-19 Webinar Series (8/05/20)/Online Course: Supply Management & Inventory Control – Part 1
Subject
The topic of the resource
Physical Infrastructure
Description
An account of the resource
In this webinar, participants will foster effective team strategies to assist in problem-solving to collectively control inventory and supply chain needs during the coronavirus pandemic, integrate approaches for optimizing PPE supply when caring for patients with COVID-19 including CAPRs/ PAPRs, masks, face shields, and other essential supplies and discuss options for product substitution while maintaining a safe clinical environment as derived from case-based scenarios.<br /><br />Webinar slides attached.<br />
<h2>Get educational credit for this webinar through <a href="http://courses.netec.org/courses/20-web-supply1" target="_blank" rel="noreferrer noopener">Courses.netec.org</a>.</h2>
Creator
An entity primarily responsible for making the resource
NETEC
Date
A point or period of time associated with an event in the lifecycle of the resource
2020-08-05
Relation
A related resource
Y - PPE pos 82 qualtrics 303; PPE pos 88 qualtrics 309
Y - D0.1PPE/D0.2PPE Qualtrics # 303
Y - D0.1PPE/D0.2PPE Qualtrics # 309
Contributor
An entity responsible for making contributions to the resource
2023-08-31 by Shawn Gibbs - PhysInfr General Review
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
2024-08-31
Type
The nature or genre of the resource
Webinar and Online Course
2019-nCoV
CEU
CEUs
Contingency and crisis capacities
Coronavirus
COVID-19
Equipment and Supplies
Mask
Masks
N95
Online Course
Personal Protective Equipment (PPE)
R-PhIn
R-PPE
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Discover
Description
An account of the resource
<div style="background-color:#c7e5f8;">
<h2 style="background-color:#c7e5f8;"><span style="font-size:80%;line-height:24px;"><a href="https://repository.netecweb.org/exhibits/show/ncov/ncov"><button>COVID-19 Update</button></a><a href="https://repository.netecweb.org/news#Map"><button>Outbreak Map</button></a><a href="https://repository.netecweb.org/news#News"><button>Newsfeed</button></a><a href="https://repository.netecweb.org/exhibits/show/monkeypox/monkeypox"><button>Monkeypox 2021</button></a><a href="https://repository.netecweb.org/exhibits/show/drcebola2018/drcebola2018"><button>2020 Ebola Update</button></a><a href="https://repository.netecweb.org/ebolatimeline"><button>Ebola Timeline</button></a><a href="https://repository.netecweb.org/exhibits/show/mers/mers"><button>MERS</button></a><a href="https://repository.netecweb.org/exhibits/show/aerosol/aerosol"><button>Airborne Transmission</button></a></span></h2>
<h2 style="background-color:#c7e5f8;">Discover Background Data and Resources:</h2>
<ul><li>
<p><span style="line-height:24px;">Get introduced to NETEC through the interactive timeline of special pathogens below.* This timeline describes some significant special pathogen events in recent history.</span></p>
</li>
<li>
<p><span style="line-height:24px;">Find out more about the 2014 Ebola outbreak and the development of the ASPR/CDC-supported network of healthcare facilities preparing for the next outbreak through <em><a href="/ebolatimeline"><button>the Ebola timeline</button></a>.</em></span></p>
</li>
</ul><ul><li>
<p><span style="line-height:24px;">This NETEC Repository helps to provide training and educational resources to prepare for future special pathogen events. </span></p>
</li>
</ul><ul><li>
<p><span style="line-height:24px;">Explore the files BELOW THE TIMELINE to <em><strong>discover and learn</strong></em> more about Ebola and other Special Pathogens, an overview of special pathogens, clinically managing patients affected, and readying healthcare teams and systems to keep everyone safe.</span></p>
</li>
</ul><h2 style="background-color:#c7e5f8;">Timeline of Special Pathogens:</h2>
<a href="#click">Skip timeline</a>
<p style="margin-bottom:0;"><iframe width="100%" height="635" style="border:1px solid #000000;" src="https://cdn.knightlab.com/libs/timeline3/latest/embed/index.html?source=1AQiHJEzkhEi71uIi7wTWWgSFRwR6wRbRyfhbASrw3Ig&font=Default&lang=en&initial_zoom=2&height=650" title="Timeline of Special Pathogens"></iframe></p>
<h2 style="background-color:#c7e5f8;"><span style="font-size:70%;">*Click for <a href="/timeline2access"><button>a screen reader accessible table of this timeline</button></a>. </span></h2>
</div>
Publication
A peer reviewed publication.
Citation
Citation information for the publication itself.
Zeidel, Mark L., Carolyn Kirk, and Ben Linville-Engler. 2020. "Opening Up New Supply Chains." New England Journal of Medicine 382 (21):e73.
Accessibility
Information on accessibility of the document(s), such as university log-in necessary, request form, open access, etc.
Free online on NEJM
URL
https://www.nejm.org/doi/full/10.1056/NEJMc2009432
Read Online
Online location of the resource.
https://www.nejm.org/doi/full/10.1056/NEJMc2009432
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Opening Up New Supply Chains
Subject
The topic of the resource
Emergency Management
Description
An account of the resource
The Covid-19 pandemic has forced health care providers to dramatically increase their use of swabs, protective gear, ventilators, and other medical devices. This rapid increase in demand, coupled with the destabilizing effect of the crisis on society and the global economy, has disrupted normal sources of supply and led to critical shortages.
Creator
An entity primarily responsible for making the resource
Zeidel, Mark L., Carolyn Kirk, and Ben Linville-Engler.
Date
A point or period of time associated with an event in the lifecycle of the resource
2020-05-21
Type
The nature or genre of the resource
Publication
Contributor
An entity responsible for making contributions to the resource
2023-08-31 by Shawn Gibbs - PhysInfr General Review
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
2026-08-31
2019-nCoV
Contingency and crisis capacities
Coronavirus
COVID-19
Equipment and Supplies
Example
Physical Infrastructure
R-PhIn
R-Res&Pub
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Discover
Description
An account of the resource
<div style="background-color:#c7e5f8;">
<h2 style="background-color:#c7e5f8;"><span style="font-size:80%;line-height:24px;"><a href="https://repository.netecweb.org/exhibits/show/ncov/ncov"><button>COVID-19 Update</button></a><a href="https://repository.netecweb.org/news#Map"><button>Outbreak Map</button></a><a href="https://repository.netecweb.org/news#News"><button>Newsfeed</button></a><a href="https://repository.netecweb.org/exhibits/show/monkeypox/monkeypox"><button>Monkeypox 2021</button></a><a href="https://repository.netecweb.org/exhibits/show/drcebola2018/drcebola2018"><button>2020 Ebola Update</button></a><a href="https://repository.netecweb.org/ebolatimeline"><button>Ebola Timeline</button></a><a href="https://repository.netecweb.org/exhibits/show/mers/mers"><button>MERS</button></a><a href="https://repository.netecweb.org/exhibits/show/aerosol/aerosol"><button>Airborne Transmission</button></a></span></h2>
<h2 style="background-color:#c7e5f8;">Discover Background Data and Resources:</h2>
<ul><li>
<p><span style="line-height:24px;">Get introduced to NETEC through the interactive timeline of special pathogens below.* This timeline describes some significant special pathogen events in recent history.</span></p>
</li>
<li>
<p><span style="line-height:24px;">Find out more about the 2014 Ebola outbreak and the development of the ASPR/CDC-supported network of healthcare facilities preparing for the next outbreak through <em><a href="/ebolatimeline"><button>the Ebola timeline</button></a>.</em></span></p>
</li>
</ul><ul><li>
<p><span style="line-height:24px;">This NETEC Repository helps to provide training and educational resources to prepare for future special pathogen events. </span></p>
</li>
</ul><ul><li>
<p><span style="line-height:24px;">Explore the files BELOW THE TIMELINE to <em><strong>discover and learn</strong></em> more about Ebola and other Special Pathogens, an overview of special pathogens, clinically managing patients affected, and readying healthcare teams and systems to keep everyone safe.</span></p>
</li>
</ul><h2 style="background-color:#c7e5f8;">Timeline of Special Pathogens:</h2>
<a href="#click">Skip timeline</a>
<p style="margin-bottom:0;"><iframe width="100%" height="635" style="border:1px solid #000000;" src="https://cdn.knightlab.com/libs/timeline3/latest/embed/index.html?source=1AQiHJEzkhEi71uIi7wTWWgSFRwR6wRbRyfhbASrw3Ig&font=Default&lang=en&initial_zoom=2&height=650" title="Timeline of Special Pathogens"></iframe></p>
<h2 style="background-color:#c7e5f8;"><span style="font-size:70%;">*Click for <a href="/timeline2access"><button>a screen reader accessible table of this timeline</button></a>. </span></h2>
</div>
Publication
A peer reviewed publication.
Citation
Citation information for the publication itself.
Truog, Robert D., Christine Mitchell, and George Q. Daley. 2020. "The Toughest Triage — Allocating Ventilators in a Pandemic." New England Journal of Medicine.
Accessibility
Information on accessibility of the document(s), such as university log-in necessary, request form, open access, etc.
Free online at NEJM
URL
https://www.nejm.org/doi/full/10.1056/NEJMp2005689
Read Online
Online location of the resource.
https://www.nejm.org/doi/full/10.1056/NEJMp2005689
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
The Toughest Triage — Allocating Ventilators in a Pandemic
Subject
The topic of the resource
Emergency Management
Description
An account of the resource
The Covid-19 pandemic has led to severe shortages of many essential goods and services, from hand sanitizers and N-95 masks to ICU beds and ventilators. Although rationing is not unprecedented, never before has the American public been faced with the prospect of having to ration medical goods and services on this scale.
Creator
An entity primarily responsible for making the resource
Truog, Robert D., Christine Mitchell, and George Q. Daley.
Date
A point or period of time associated with an event in the lifecycle of the resource
2020-03-23
Type
The nature or genre of the resource
Publication
Contributor
An entity responsible for making contributions to the resource
2024-03-27 Emergency Management skipped in review – bump to next quarter
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
2024-07-27
2019-nCoV
Coronavirus
COVID-19
Equipment and Supplies
Pandemic
R-EM
R-Res&Pub
SARS-CoV-2
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Discover
Description
An account of the resource
<div style="background-color:#c7e5f8;">
<h2 style="background-color:#c7e5f8;"><span style="font-size:80%;line-height:24px;"><a href="https://repository.netecweb.org/exhibits/show/ncov/ncov"><button>COVID-19 Update</button></a><a href="https://repository.netecweb.org/news#Map"><button>Outbreak Map</button></a><a href="https://repository.netecweb.org/news#News"><button>Newsfeed</button></a><a href="https://repository.netecweb.org/exhibits/show/monkeypox/monkeypox"><button>Monkeypox 2021</button></a><a href="https://repository.netecweb.org/exhibits/show/drcebola2018/drcebola2018"><button>2020 Ebola Update</button></a><a href="https://repository.netecweb.org/ebolatimeline"><button>Ebola Timeline</button></a><a href="https://repository.netecweb.org/exhibits/show/mers/mers"><button>MERS</button></a><a href="https://repository.netecweb.org/exhibits/show/aerosol/aerosol"><button>Airborne Transmission</button></a></span></h2>
<h2 style="background-color:#c7e5f8;">Discover Background Data and Resources:</h2>
<ul><li>
<p><span style="line-height:24px;">Get introduced to NETEC through the interactive timeline of special pathogens below.* This timeline describes some significant special pathogen events in recent history.</span></p>
</li>
<li>
<p><span style="line-height:24px;">Find out more about the 2014 Ebola outbreak and the development of the ASPR/CDC-supported network of healthcare facilities preparing for the next outbreak through <em><a href="/ebolatimeline"><button>the Ebola timeline</button></a>.</em></span></p>
</li>
</ul><ul><li>
<p><span style="line-height:24px;">This NETEC Repository helps to provide training and educational resources to prepare for future special pathogen events. </span></p>
</li>
</ul><ul><li>
<p><span style="line-height:24px;">Explore the files BELOW THE TIMELINE to <em><strong>discover and learn</strong></em> more about Ebola and other Special Pathogens, an overview of special pathogens, clinically managing patients affected, and readying healthcare teams and systems to keep everyone safe.</span></p>
</li>
</ul><h2 style="background-color:#c7e5f8;">Timeline of Special Pathogens:</h2>
<a href="#click">Skip timeline</a>
<p style="margin-bottom:0;"><iframe width="100%" height="635" style="border:1px solid #000000;" src="https://cdn.knightlab.com/libs/timeline3/latest/embed/index.html?source=1AQiHJEzkhEi71uIi7wTWWgSFRwR6wRbRyfhbASrw3Ig&font=Default&lang=en&initial_zoom=2&height=650" title="Timeline of Special Pathogens"></iframe></p>
<h2 style="background-color:#c7e5f8;"><span style="font-size:70%;">*Click for <a href="/timeline2access"><button>a screen reader accessible table of this timeline</button></a>. </span></h2>
</div>
Publication
A peer reviewed publication.
Citation
Citation information for the publication itself.
Emanuel, Ezekiel J., Govind Persad, Ross Upshur, Beatriz Thome, Michael Parker, Aaron Glickman, Cathy Zhang, Connor Boyle, Maxwell Smith, and James P. Phillips. 2020. "Fair Allocation of Scarce Medical Resources in the Time of Covid-19." New England Journal of Medicine.
Accessibility
Information on accessibility of the document(s), such as university log-in necessary, request form, open access, etc.
Free online on NEJM.
URL
https://www.nejm.org/doi/full/10.1056/NEJMsb2005114
Read Online
Online location of the resource.
https://www.nejm.org/doi/full/10.1056/NEJMsb2005114
Dublin Core
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Title
A name given to the resource
Fair Allocation of Scarce Medical Resources in the Time of Covid-19
Subject
The topic of the resource
Emergency Management
Description
An account of the resource
Covid-19 is officially a pandemic. It is a novel infection with serious clinical manifestations, including death, and it has reached at least 124 countries and territories.
Creator
An entity primarily responsible for making the resource
Emanuel, Ezekiel J., Govind Persad, Ross Upshur, Beatriz Thome, Michael Parker, Aaron Glickman, Cathy Zhang, Connor Boyle, Maxwell Smith, and James P. Phillips.
Date
A point or period of time associated with an event in the lifecycle of the resource
2020-03-23
Type
The nature or genre of the resource
Publication
Contributor
An entity responsible for making contributions to the resource
2024-03-27 Emergency Management skipped in review – bump to next quarter
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
2024-07-27
2019-nCoV
Coronavirus
COVID-19
Equipment and Supplies
Pandemic
R-EM
R-Res&Pub
SARS-CoV-2
Treatment and Care
-
https://repository.netecweb.org/files/original/392d87f792e5d921c1a6fa77ce6e53b7.png
fc24682d7da998341c42059d6dc9affc
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Develop
Description
An account of the resource
<h2><span>These files will help you <strong><em>develop</em></strong> your program and plans based on what you have discovered.</span></h2>
<p style="font-size:120%;">Find model protocols and procedures and more in-depth training resources. You can go to the <a href="/exhibits/show/leadership"><button>Leadership Toolbox</button></a> or the <a href="https://repository.netecweb.org/exhibits/show/specialpopulations"><button>Special Populations</button></a> section. You can also go to the <a href="https://repository.netecweb.org/exhibits/show/netec-education/justintime"><button> Just in Time Training</button></a> page, the <a href="https://repository.netecweb.org/exhibits/show/ppe101/ppe"><button> PPE</button></a> page, or the <a href="https://repository.netecweb.org/exhibits/show/ems/prehospital"><button>EMS</button></a> page. <span>Subscribe to the NETEC <a href="https://www.youtube.com/channel/UCDpHc1LkcEpiWR0q7ll5eZQ" target="_blank" rel="noreferrer noopener"><button>Youtube Channel</button></a> to get all new Skills videos!</span></p>
Webinar
Portal access to a webinar
Duration
Length of time involved (seconds, minutes, hours, days, class periods, etc.)
00:27:08
Objectives
This instructional series was created by the University of Maryland Baltimore County (UMBC), Department of Emergency Health Services, with assistance from the Maryland Department of Health, and funding from the U.S. Centers for Disease Control and Prevention.
This program is designed to meet the needs of first responders who are expected to deal with the health needs of people who find themselves in health emergencies they cannot manage on their own. These first responders are typically emergency medical services personnel, such as EMTs and paramedics, but can also be first-aid trained fire fighters, law enforcement personnel, and volunteers such as Red Cross disaster workers. Health officers in summer camps, youth clubs, and other organizations that work with groups of people who may have some vulnerability may also benefit from this program.
Event Type
Instructional series
URL
https://eid4emt.umbc.edu/courses/index.php?courseNum=8
Player
Field for the html for a video player.
<br /><iframe width="560" height="315" title="Module 7: Infectious Waste Disposal and Equipment Decontamination" src="https://www.youtube.com/embed/etjdqfwoO24" frameborder="0"></iframe>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Module 7: Infectious Waste Disposal and Equipment Decontamination
Subject
The topic of the resource
Infection Control
Description
An account of the resource
EID 4 EMT Free Video Training Series -
Emerging Infectious Diseases Videos for Prehospital Providers -
Infectious Waste Disposal and Equipment Decontamination
Creator
An entity primarily responsible for making the resource
University of Maryland, Baltimore County (UMBC)
Date
A point or period of time associated with an event in the lifecycle of the resource
2018-05-15
Contributor
An entity responsible for making contributions to the resource
2022-12-07 general asset review - IPC
2024-03-28 by J. Mundy – IPC review 2023 (Q2) skipped – bumping to 2024 (Q4)
Relation
A related resource
Y
Y - D0.1IC/D0.2IC Qualtrics # 217, original # 8a
Y - D0.1IC/D0.2IC Qualtrics # 218, original # 9
Y - D0.1IC/D0.2IC Qualtrics # 222, original # 10
Y - D0.1IC/D0.2IC Qualtrics # 223, original # 11
Y - D0.1IC/D0.2IC Qualtrics # 225, original # 12
Y - D0.1IC/D0.2IC Qualtrics # 229, original # 16
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
2024-06-10
Identifier
An unambiguous reference to the resource within a given context
Infection Prevention and Control
Decontamination
Equipment and Supplies
Pre-Hospital
R-IPC
Waste
Waste Management
-
https://repository.netecweb.org/files/original/c97d0df20340e6de1e0b78ec231aa93f.pdf
aecf072d89a68c82ea4a86d992ff4b2d
PDF Text
Text
Section:
POLICIES AND PROCEDURES M ANUAL
System
Department
Subject:
Biocontainment Unit
Handling of Category A Infectious Human
Remains (BioSeal
System)
Number:
1005
Attachments:
Date Effective:
Supersedes:
Date Reviewed:
June 2006
January 2008; March 2009; June 2010, February 2013;
June 2015, June 2016; October 2017; July 2018;
November 2018, March 2021
Nebraska Biocontainment Unit
Policy:
NBU leadership shall consult with Douglas County Public Health to determine the disposition of patient remains.
NBU staff shall prepare the patient remains for transfer from Nebraska Medicine.
Purpose:
To provide a safe method for the removal of infectious human remains from the Nebraska Biocontainment Unit
(NBU).
Notifications:
NBU leadership shall inform:
•
Douglas County Public Health Department.
•
Hospital Infection control and Epidemiology.
•
Travis McCumber, Director of Gross Anatomy Lab, 402-559-7833 to arrange cremation.
•
Nebraska Medicine morgue to inform them of potential transfer of human remains.
•
Security to deliver the morgue cart to the NBU Vestibule.
o
Upon arrival security will dismantle the morgue cart canopy and leave it in the NBU
vestibule to be reassembled prior to exiting.
Planning:
NBU leadership in consultation with relevant others shall determine:
•
Route from the NBU to the transportation vehicle.
•
Route from Nebraska Medicine to the crematorium.
Required Materials:
• Appropriate PPE as required for the specific disease
• 4 mortuary bags
o Bag 1: plastic mortuary shroud
Must be cremation compatible (chlorine free material)
6 ml thickness with factory sealed seams (heat welded)
Must be impervious to fluids with a zipper on top
o Bag 2: required length of heat sealable (BioSeal) material
Must be cremation compatible (chlorine free material)
o Bags 3 & 4: 2 Heavy duty morgue bags
Must be cremation compatible (chlorine free material)
Last printed 4/27/2022 12:23 PM
Page 1 of 6
�
•
•
•
•
•
•
•
•
•
•
•
18 mil thickness laminated vinyl or other chlorine free material
Must have handles that are riveted, not sewn, and reinforced with handle straps
that run under the pouch
Must be impervious to fluids
Must have a lockable zipper on top
1 heat wand
2 - 4 Clamps
1 patient cart
1 morgue cart
1 slide board
Approved disinfectant wipes
Biohazard labels
Permanent marker pen
Scissors
Body ID tag (this is to be filled in and remain in the clean zone)
2 zip ties
Staffing:
•
•
Assemble 8 team members and divide into 3 teams
o Patient Care Room Team (4) –
o Warm Zone Team (2)
o Clean Zone Team (2)
The staff member observing from the nurse’s station will call out the steps and observe for
safety and accurateness of each step.
o If the audio-visual equipment is unavailable in the patient care room, another team
member will be required to perform this role in the room.
Equipment required in the patient care room:
• Required length of BioSeal (should be 2 feet longer than the patient’s height)
• 2 – 4 clamps
• Heat wand
• Plastic Shroud
• Biohazard Label
• Permanent Marker Pen
• Scissors
• Disinfectant Wipes
Procedure Inside the Patient Care Room
•
•
Before beginning the procedure:
o
Ensure NBU leadership have provided the permission to begin the procedure.
o
Check identity of the patient using the armband and comparing it to the EMR.
Plug in the heat wand and set it in a safe place to prevent inadvertent burns to staff or
furnishings.
•
Prepare the body/ bed:
o
Disconnect medical devices and move them away from the work area (IV pumps,
ventilator etc.).
Last printed 4/27/2022 12:23 PM
Page 2 of 6
�o
Do not remove any inserted medical devices (lines, tubes, dressings etc.).
o
Remove the head and footboards from the bed.
o
Wrap the body in the bed linens including the pillow.
o
Place the linen wrapped body into the plastic shroud.
o
Fasten the zipper securely being careful not to actively express air from inside the bag.
Prepare to seal the remains in the BioSeal Material:
•
Roll the shrouded body to one side of the bed and wipe with disinfectant wipes to disinfect the
mattress and underside of the shroud.
•
Repeat the above by rolling the shrouded body to the other side.
•
Remove outer gloves and apron, perform hand hygiene and don clean gloves and apron.
•
Open the BioSeal material and fold the first approximately 12 inches under itself so the green
side is visible on top and bottom.
•
Roll the shrouded body to one side and place the folded edge of the BioSeal
material onto the bed, getting it as far under the body as possible but not losing sight of your
hands.
o
Note: attention must be given to the placement of the factory sealed seam, leaving
enough space in which to heat seal this seam when the body is returned to a
supine position.
•
Roll the shrouded body onto the BioSeal material.
•
Unfold the 12 inches of the BioSeal material and ensure the body is centered on the bottom half
of the BioSeal material.
•
Lay the top half of the BioSeal material over the shrouded body lining up the edges and securing
the section that will be sealed with the clamps.
Perform the sealing process:
•
Use the heat wand to apply heat and pressure to seal the top and bottom layers together at a
depth of about 2 inches from the outer edge of all four sides (including the factory sealed edge).
o
Note: Disregard markings on the BioSeal material that indicates where to seal and
cut. These instructions are not intended for biocontainment purposes.
•
o
Ensure the area where the seal has been made has a ridged appearance.
o
Do not touch the sealed edge until it has time to cool down.
Repeat the entire sealing process by creating a second seal parallel to the first at a depth of
approximately 1 inch from the BioSeal material edge.
•
Make an angled double seal at each corner.
•
Unplug the heat wand and place it in a safe place within the patient care room to cool
o
•
Note: Do not remove it from the room without NBU leadership consultation.
Using scissors, carefully cut down the center of the outer seal to remove the open edges of the
Last printed 4/27/2022 12:23 PM
Page 3 of 6
�BioSeal material.
•
Perform hand hygiene, remove outer gloves and apron, perform hand hygiene and don clean
gloves and a clean apron.
•
Disinfect the entire top of the sealed pouch with disinfectant wipes.
•
Roll the sealed pouch to one side, wipe as much of the underside as can be reached. Repeat for
the other side. Also wipe the top, sides, headboard and footboard of the bed.
Prepare to transfer the remains out of the patient care room:
•
Write patient information (PATIENT NAME, DATE OF BIRTH, DATE AND TIME OF DEATH,
MEDICAL RECORD NUMBER) on the BioSeal material with a permanent marker.
•
Attach a biohazard label to the pouch.
•
Position the bed with the foot of the bed towards the door leaving space to open the door.
•
Indicate to the team outside the room when ready to transfer the remains out of the room.
Receiving patient remains outside patient care room:
•
Prepare a patient cart with an opened heavy-duty mortuary bag on top.
•
Place a slide board on top of the mortuary bag overhanging the end positioned towards the
patient care room.
•
Place the cart and slider board in-line with the bed
o
•
Note: at this point the patient room door is closed.
When the team inside the room indicate they are ready to transfer the patient remains out of the
room, indicate with a thumbs up that you are ready to receive them.
•
The team inside the room will open the patient room door and position the bed about 6 inches in
from the door threshold.
•
The team outside the patient room will position the prepared cart about 12 inches from the foot of
the patient bed taking care not to push the cart into the patient room or to allow it to touch the
bed.
•
Apply brakes to the bed and cart.
•
Push the slider board into the room so that it sits under the lower portion of the remains and
creates a bridge to the patient cart.
•
Slide the BioSeal bag onto the cart and into the heavy-duty mortuary bag,
o
•
Note: Do not grasp the Bioseal by the sealed edges as this may cause them to tear.
As soon as the remains are positioned onto the cart, the team inside the patient room will:
o
Pull the slider board into the patient room.
o
Pull the bed away from the door
o
Disinfect the outside of the patient care room door with approved disinfectant wipes then
allow the door to close.
Last printed 4/27/2022 12:23 PM
Page 4 of 6
�•
The staff members outside the room will:
o
Fasten the heavy-duty mortuary bag zipper
o
Secure the two zipper tabs with a zip tie.
o
Wipe the patient cart and external surfaces of the morgue bag with approved disinfectant
wipes.
o
Apply a biohazard sticker to the top of the heavy-duty mortuary bag.
o
Prepare to transfer the patient remains to the warm/ clean zone doors.
Transferring the patient remains from the warm zone to the clean zone:
•
In the clean zone by the warm/clean zone doors, place an opened heavy-duty mortuary bag on
top the morgue cart that was delivered by security.
•
Place a slider board on top of the mortuary bag overhanging the end by approximately half its
length.
•
Roll the cart with the patient remains encased in the first heavy duty mortuary bag towards the
doors.
•
When staff in both the clean and warm zones indicate readiness, the tasker will open the doors
until they lock in place.
•
Both teams will position their carts about 12 inches from each other, taking care not to push the
mortuary cart into the warm zone or allow the patient cart and the morgue cart to touch.
•
The warm zone team will lift the bottom portion of the sealed morgue bag to allow the
overhanging slider board to be placed under the patient remains.
•
The warm team will slide the bagged remains from the patient cart towards the morgue cart.
The clean team will assist by pulling the remains into the second heavy-duty mortuary bag.
•
As soon as the remains are in position on the morgue cart, the slider board will be pulled onto
the patient cart.
•
Roll the patient cart back towards outside the patient care room to await cleaning and
decontamination.
•
Staff members in the clean zone will close and secure the morgue bag zipper, apply a zip tie
and pull the cart away from the doors to allow them to close.
•
Wipe the external surfaces of the morgue bag and cart with approved disinfectant wipes.
Transferring the patient remains out of the NBU:
•
NBU staff and mortuary personnel shall wear gloves.
•
Attach a completed body ID tag and biohazard label to the outside of the second morgue bag.
•
Transfer the morgue cart to the NBU vestibule and reassemble the morgue cart canopy.
•
Mortuary Personnel or Security will collect the remains at the NBU main door unless other
Last printed 4/27/2022 12:23 PM
Page 5 of 6
�arrangements have been made.
Transporting the patient remains to the final destination:
•
Follow instructions from NBU leadership on how to proceed.
o
This will include details on the transfer route within the hospital and transportation to the
final destination.
•
If directed, a NBU staff member will accompany the remains to the final destination wearing
gloves and carrying a spill kit with additional PPE for unplanned events.
Staff Accountability:
Nebraska Biocontainment Unit Leadership
Nebraska Biocontainment Unit Policy and Procedure Workgroup
Department Approval
Signed | s |:
Title:
Department:
Last printed 4/27/2022 12:23 PM
Administrative Approval
Signed | s |:
Title:
Page 6 of 6
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Develop
Description
An account of the resource
<h2><span>These files will help you <strong><em>develop</em></strong> your program and plans based on what you have discovered.</span></h2>
<p style="font-size:120%;">Find model protocols and procedures and more in-depth training resources. You can go to the <a href="/exhibits/show/leadership"><button>Leadership Toolbox</button></a> or the <a href="https://repository.netecweb.org/exhibits/show/specialpopulations"><button>Special Populations</button></a> section. You can also go to the <a href="https://repository.netecweb.org/exhibits/show/netec-education/justintime"><button> Just in Time Training</button></a> page, the <a href="https://repository.netecweb.org/exhibits/show/ppe101/ppe"><button> PPE</button></a> page, or the <a href="https://repository.netecweb.org/exhibits/show/ems/prehospital"><button>EMS</button></a> page. <span>Subscribe to the NETEC <a href="https://www.youtube.com/channel/UCDpHc1LkcEpiWR0q7ll5eZQ" target="_blank" rel="noreferrer noopener"><button>Youtube Channel</button></a> to get all new Skills videos!</span></p>
Protocol
Protocol documentation
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Handling Infectious Human Remains (BioSeal System)
Subject
The topic of the resource
Decedent Management
Creator
An entity primarily responsible for making the resource
University of Nebraska Medical Center / Nebraska Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2021-03
Description
An account of the resource
Policies and Procedures Manual: To provide a safe method for the removal of infectious human remains from the Nebraska Biocontainment Unit (NBU).
Contributor
An entity responsible for making contributions to the resource
2022-04-27 by Kate Boulter - file updated
2022-12-07 general asset review - IPC
2024-03-27 Decedent Management never returned – bump to next review
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
2024-08-10
Relation
A related resource
Y
Y - D0.1IC/D0.2IC Qualtrics # 213, original # 7 (additional resources)
Decedent Management
Decontamination
Equipment and Supplies
Infection Prevention and Control
Protocol
Public Health
R-DM
Standard Operating Procedure (SOP)
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Discover
Description
An account of the resource
<div style="background-color:#c7e5f8;">
<h2 style="background-color:#c7e5f8;"><span style="font-size:80%;line-height:24px;"><a href="https://repository.netecweb.org/exhibits/show/ncov/ncov"><button>COVID-19 Update</button></a><a href="https://repository.netecweb.org/news#Map"><button>Outbreak Map</button></a><a href="https://repository.netecweb.org/news#News"><button>Newsfeed</button></a><a href="https://repository.netecweb.org/exhibits/show/monkeypox/monkeypox"><button>Monkeypox 2021</button></a><a href="https://repository.netecweb.org/exhibits/show/drcebola2018/drcebola2018"><button>2020 Ebola Update</button></a><a href="https://repository.netecweb.org/ebolatimeline"><button>Ebola Timeline</button></a><a href="https://repository.netecweb.org/exhibits/show/mers/mers"><button>MERS</button></a><a href="https://repository.netecweb.org/exhibits/show/aerosol/aerosol"><button>Airborne Transmission</button></a></span></h2>
<h2 style="background-color:#c7e5f8;">Discover Background Data and Resources:</h2>
<ul><li>
<p><span style="line-height:24px;">Get introduced to NETEC through the interactive timeline of special pathogens below.* This timeline describes some significant special pathogen events in recent history.</span></p>
</li>
<li>
<p><span style="line-height:24px;">Find out more about the 2014 Ebola outbreak and the development of the ASPR/CDC-supported network of healthcare facilities preparing for the next outbreak through <em><a href="/ebolatimeline"><button>the Ebola timeline</button></a>.</em></span></p>
</li>
</ul><ul><li>
<p><span style="line-height:24px;">This NETEC Repository helps to provide training and educational resources to prepare for future special pathogen events. </span></p>
</li>
</ul><ul><li>
<p><span style="line-height:24px;">Explore the files BELOW THE TIMELINE to <em><strong>discover and learn</strong></em> more about Ebola and other Special Pathogens, an overview of special pathogens, clinically managing patients affected, and readying healthcare teams and systems to keep everyone safe.</span></p>
</li>
</ul><h2 style="background-color:#c7e5f8;">Timeline of Special Pathogens:</h2>
<a href="#click">Skip timeline</a>
<p style="margin-bottom:0;"><iframe width="100%" height="635" style="border:1px solid #000000;" src="https://cdn.knightlab.com/libs/timeline3/latest/embed/index.html?source=1AQiHJEzkhEi71uIi7wTWWgSFRwR6wRbRyfhbASrw3Ig&font=Default&lang=en&initial_zoom=2&height=650" title="Timeline of Special Pathogens"></iframe></p>
<h2 style="background-color:#c7e5f8;"><span style="font-size:70%;">*Click for <a href="/timeline2access"><button>a screen reader accessible table of this timeline</button></a>. </span></h2>
</div>
Publication
A peer reviewed publication.
URL
https://www.ncbi.nlm.nih.gov/pubmed/26010276
Citation
Citation information for the publication itself.
Lenaghan, P. A. and M. Schwedhelm (2015). "Nebraska biocontainment unit design and operations." J Nurs Adm 45(6): 298-301.
Abstract
Planning and design of a unique biocontainment unit specifically for care of patients with rare and highly infectious diseases presented an opportunity for nurse leaders to engage staff in crucial groundbreaking decisions. The Magnet(R) philosophy and framework were used to structure committees with key stakeholders and staff to ensure best and safe practices. Members of the biocontainment unit are engaged in active research and outreach training.
Accessibility
Information on accessibility of the document(s), such as university log-in necessary, request form, open access, etc.
pay online - or through ovid subscription
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Nebraska biocontainment unit design and operations
Creator
An entity primarily responsible for making the resource
Lenaghan, P. A. and M. Schwedhelm
Subject
The topic of the resource
Physical Infrastructure
Description
An account of the resource
Planning and design of a unique biocontainment unit specifically for care of patients with rare and highly infectious diseases presented an opportunity for nurse leaders to engage staff in crucial groundbreaking decisions.
Date
A point or period of time associated with an event in the lifecycle of the resource
2015-06-01
Type
The nature or genre of the resource
Publication
Contributor
An entity responsible for making contributions to the resource
2022-12-07 general asset review - IPC
2024-03-28 by J. Mundy – IPC review 2023 (Q2) skipped – bumping to 2024 (Q4)
Coverage
The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant
2024-06-10
Relation
A related resource
Y - D0.1PI/D0.2PI Qualtrics # 103, original # 2a
Identifier
An unambiguous reference to the resource within a given context
Infection Prevention and Control
Equipment and Supplies
Infection Prevention and Control
Isolation/Biocontainment
Physical Infrastructure
R-PhIn
R-Res&Pub
-
https://repository.netecweb.org/files/original/7ccbf980d30dcc68daf6e663d1c458b9.pdf
a19270db8917466a627a5876d3dc676d
PDF Text
Text
HHS Public Access
Author manuscript
Author Manuscript
AJR Am J Roentgenol. Author manuscript; available in PMC 2016 June 01.
Published in final edited form as:
AJR Am J Roentgenol. 2015 June ; 204(6): 1157–1159. doi:10.2214/AJR.15.14344.
Performance of Bedside Diagnostic Ultrasound in an Ebola
Isolation Unit: The Emory University Hospital Experience
Courtney C. Moreno1, Colleen S. Kraft2,3, Sharon Vanairsdale4, Prem Kandiah5, Matthew A.
Klopman6, Bruce S. Ribner3, and Srini Tridandapani1,7
1Department
of Radiology and Imaging Sciences, Emory University School of Medicine, 1364
Clifton Rd NE, Atlanta, GA 30322.
Author Manuscript
2Department
of Pathology and Laboratory Medicine, Emory University Hospital, Atlanta, GA.
3Department
of Medicine, Division of Infectious Diseases, Emory University Hospital, Atlanta, GA.
4Emergency
Services, Emory University Hospital, Atlanta, GA.
5Department
of Neurosurgery, Emory University Hospital, Atlanta, GA.
6Department
of Anesthesiology, Emory University Hospital, Atlanta, GA.
7School
of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA.
Abstract
Author Manuscript
OBJECTIVE—Individuals with Ebola virus disease, a contagious and potentially lethal infection,
are now being treated in specialized units in the United States. We describe Emory University's
initial experience, current operating procedures, and ongoing planning with diagnostic ultrasound
in the isolation unit.
CONCLUSION—Ultrasound use has been limited to date. Future planning considerations include
deciding what types of ultrasound studies will be performed, which personnel will acquire the
images, and which ultrasound machine will be used.
Keywords
Ebola; infectious diseases; isolation; ultrasound
Author Manuscript
The current outbreak of Ebola virus disease (EVD) began in West Africa in December 2013
and is the most widespread and deadliest to date [1, 2]. As of December 2014, more than
20,000 cases have been documented in West Africa and more than 7000 individuals have
died as a result of EVD [3]. Additionally, two American health care workers infected with
the Ebola virus in West Africa were successfully treated at Emory University Hospital
(Atlanta, GA) and were the first known patients with EVD treated in the United States [4].
The Emory University Hospital isolation unit was designed to support the research
laboratories and field epidemiologists at the Centers for Disease Control and Prevention
(CDC) [5]. Two similar facilities are located at the National Institutes of Health (Bethesda,
Address correspondence to S. Tridandapani (stridan@emory.edu)..
�Moreno et al.
Page 2
Author Manuscript
MD) and the Nebraska Medical Center (Omaha, NE). Since the current Ebola outbreak
began, the CDC has designated an additional 32 hospitals as Ebola Treatment Centers [6].
Ebola Treatment Centers are defined as institutions prepared to treat individuals with EVD
for the duration of their illness [6].
Because patients being treated for known EVD are confined to isolation units, imaging is
generally limited to portable methods, including portable radiography and ultrasound. Our
institution's experience with portable radiography has been described previously [7, 8]. The
purpose of this article is to describe our institution's initial experience, current standard
operating procedures, and ongoing planning with diagnostic ultrasound in the isolation unit.
The article begins with a general overview of the pathophysiology of EVD and concludes
with some considerations for radiology departments preparing for the potential ultrasound
imaging of individuals with EVD.
Author Manuscript
Ebola Virus Disease
The Ebola virus was first identified in Africa in 1976 and first reported in 1977 [9]. The
disease that results from Ebola virus infection was initially termed “Ebola hemorrhagic
fever” but has since been changed to “Ebola virus disease” because most individuals
infected with the Ebola virus do not develop bleeding complications.
High fever, body aches, and malaise are often the first symptoms of EVD [10]. By days 3–5,
patients typically develop nausea, vomiting, and diarrhea [10]. The resultant large-volume
fluid losses and electrolyte imbalances, if untreated, result in multiorgan failure, cardiac
arrhythmia, and death [10]. In resource-limited environments, the disease can progress
rapidly, with most deaths occurring between days 7 and 12 in the current outbreak [10].
Author Manuscript
Presently, the mainstays of treatment are supportive care, including fluid and electrolyte
replacement [10]. In resource-poor environments, such as parts of West Africa, supportive
care may be limited to oral rehydration. IV fluids and close electrolyte monitoring and
replacement are necessary for many patients. In the United States, patients with EVD have
been supported with mechanical ventilation and renal replacement therapy [11]. The role of
diagnostic imaging in the evaluation and treatment of individuals with EVD is yet to be
defined.
Author Manuscript
In addition to supporting individuals with EVD, preventing disease spread to healthy
individuals is also critical. Ebola transmission occurs when healthy individuals come in
contact with the bodily fluids of individuals with EVD [10]. To prevent the spread of
disease, EVD patients are treated by health care providers wearing personal protective
equipment [12].
Ultrasound Use in the Isolation Unit
To date, the clinical applications of ultrasound have been limited in our institution's isolation
unit. This limited use is due in part to the known pathophysiology of EVD and positive
patient outcomes with current supportive care measures. For example, acute renal failure is a
known complication of EVD and results from fluid losses due to vomiting and diarrhea.
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Because renal failure is a known complication of EVD, it does not prompt an ultrasound
examination to rule out hydronephrosis.
Additionally, the relatively limited treatment options available to EVD patients compared
with patients not confined to isolation wards may curtail the imaging workup of individuals
with EVD. Our infectious disease colleagues only acquire ultrasound images if the
information obtained will alter management. For example, to our knowledge, no operating
rooms currently exist in the United States that are designed or designated to treat individuals
with EVD. Therefore, an imaging workup to establish a surgical indication would be futile if
no operating room exists that is capable of caring for a patient with EVD.
Author Manuscript
To limit the potential spread of EVD, ultrasound images have been acquired by physicians
who are highly trained in the appropriate use of personal protective equipment. The images
are acquired using a dedicated ultrasound machine that is permanently housed in the
isolation unit. To date, the anesthesiology physicians have imaged two patients to guide
placement of intravascular catheters. Obtaining a chest radiograph was a multistep, timeconsuming process that was performed when necessary and safe [7]. Clinicians comfortable
with the use of point-of-care ultrasound were able to evaluate for pneumothorax or
hemothorax after central line placement or if there was acute hemodynamic or respiratory
decompensation. Evaluating for popliteal and femoral vein thrombosis was also performed
when evaluating for causes of shock and hypoxemia.
Author Manuscript
The floor plan of the Emory isolation unit has been described previously [7]. The unit
consists of the patient room that was designed to be capable of functioning as an ICU room,
an anteroom where sanitization procedures can take place, and the area outside of the
anteroom. The protocol used for cleaning medical equipment that enters the patient room in
the isolation unit is as follows [13]:
Author Manuscript
1.
In the patient's room, the nurse should cleanse the contaminated equipment with
disinfectant designated by the hospital.
2.
Both the patient room nurse and the anteroom nurse are to create disinfectant mats
with disposable pads and the disinfectant (200 mL of the solution to 400 mL of
water) from the patient's doorway to the storage destination.
3.
The room nurse will then roll or hand off the unofficial cleaned equipment to the
anteroom nurse, where the nurse will clean the equipment again with disinfectant
while wearing full personal protective equipment, similar to that used by waste
management.
4.
The nurse will cover the equipment with plastic bags and label it as dirty so that it
will be further decontaminated with vaporized hydrogen peroxide after the patient
is discharged.
5.
The nurse will roll or hand off the equipment to the resource nurse outside the
anteroom and store it in the designated dirty storage area. The resource nurse
outside the room should wear a gown, gloves, booties, and mask with a face shield.
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6.
Author Manuscript
The resource nurse outside the room removes the personal protective equipment in
accordance with standard operating procedures. The anteroom nurse removes the
powered air purifying respirator hood and sets it aside.
Issues for Consideration
When preparing for the possible ultrasound evaluation of an individual with EVD, issues to
consider include what ultrasound studies will be performed, who will acquire the images,
and which ultrasound machine will be used.
What Ultrasound Imaging Studies Will Be Performed?
Author Manuscript
As noted, ultrasound images are only acquired if the information gained will alter medical
management. Both the natural history of EVD (rapid course typically managed with
supportive care) and the relatively limited invasive treatment options available to individuals
confined to an isolation ward will result in the performance of a relatively small number of
ultrasound examinations in the isolation unit.
Which Personnel Will Acquire Ultrasound Images?
At our institution, to minimize the risk of disease transmission, ultrasound images are
acquired by physicians with training and experience using personal protective equipment.
Health care professionals also perform other jobs in the isolation unit that are more typically
performed by technologists in other settings. For example, the physicians centrifuge urine
specimens and analyze them under a microscope as well as perform ECGs and
venipunctures.
Author Manuscript
Informally, at least two infectious disease specialists at our institution have volunteered to
obtain just-in-time focused ultrasound training as needed by the patients being treated. They
would then use this focused training for imaging patients with real-time feedback from
radiologists or ultrasound technologists from the anteroom or the room outside the
anteroom. Such limited just-in-time training seems appropriate for relatively simple
applications, such as evaluating for pleural effusions or ascites, and perhaps for slightly
more complex applications, such as evaluating the gallbladder for cholecystitis or the
kidneys for hydronephrosis. Just-intime training seems appropriate rather than acquiring
skills in advance because the latter may atrophy with lack of practice and any imaging tests
performed are expected to be rare.
Author Manuscript
If it is necessary for ultrasonographers or radiologists to acquire ultrasound images in the
isolation unit, it is suggested that volunteers be sought. Some individuals in the radiology
department may decide to participate in working in a high-containment isolation unit. For
example, the isolation unit at Emory is staffed by nurses who volunteer to work in the unit.
Informally, at least one radiologist has volunteered to perform ultrasound-guided procedures
if the need arises. Such individuals will require just-in-time training in isolation procedures
and work under the supervision of infectious disease specialists to ensure that appropriate
procedures are followed. Thus, close collaboration between radiology and infectious disease
divisions is envisioned.
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Page 5
What Ultrasound Machine Will Be Used?
Author Manuscript
In our institution, a designated ultrasound machine is permanently housed in the isolation
unit. Space may be limited in the isolation unit, so machines with a small footprint may be
preferable. Additionally, the cleaning regimens recommended to eradicate the Ebola virus
may be detrimental to the longevity of an ultrasound machine. To date, an older ultrasound
machine has been adequate for vascular access applications in the isolation unit.
Increasingly, more clinicians are being trained to use of point-of-care focused ultrasound.
The addition of a lower frequency cardiac probe (typically 2–4 MHz) with a small footprint
for intercostal views would offer the benefit of being able to evaluate for volume status,
right ventricular function, left ventricular function, pericardial effusion, or cardiac
tamponade in a critically ill patient with EVD.
Author Manuscript
Future Directions
We are in the early stages of Ebola treatment in the United States. Most of the patients being
treated are otherwise healthy volunteers who have returned from areas such as Guinea,
Liberia, and Sierra Leone. In the future, if individuals are supported longer and if invasive
treatment options expand, it may be necessary to perform additional imaging evaluations
that would require either scanning by experienced sonographers or radiologists or focused
training of the bedside physicians. In addition, if other individuals who are not otherwise
healthy volunteers traveling to the more affected countries become infected, it is possible
that additional imaging may be required for their other potential comorbidities.
Author Manuscript
Investment in wireless transmission technology for ultrasound and radiography equipment
may be useful so that images can be viewed and interpreted in near real time by individuals
distant from the isolation unit. Already, a number of palm-top ultrasound machines have
become available and are being used in various clinical settings [14–16]. With dropping
prices, it is conceivable that each patient's room in the isolation unit may have a dedicated
scanner that never leaves the room, thus minimizing the need for repeated cleaning. Work is
under way evaluating protective bubbles that may enable isolation patients to be imaged in
CT and MRI machines without contaminating the machines.
Author Manuscript
In summary, ultrasound use has been limited to date in the isolation unit at Emory
University Hospital. Images are acquired by physicians with training and experience with
personal protective equipment and using a machine permanently housed in the isolation unit.
Because the pathophysiology of the disease is well understood and most patients respond to
supportive treatment, the indications for ultrasound in the isolation unit have so far been
limited. However, this may change in the future, and it is incumbent on radiologists to
collaborate with infectious disease specialists to be prepared to provide advanced ultrasound
and other advanced types of imaging to patients with EVD.
Acknowledgments
Supported by the National Center for Advancing Translational Sciences (award number UL1TR000454). The
content is solely the responsibility of the authors and does not necessarily represent the official views of the
National Institutes of Health.
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Author Manuscript
References
Author Manuscript
Author Manuscript
1. World Health Organization website. [December 14, 2014] Ebola virus disease. www.who.int/
mediacentre/factsheets/fs103/en. Updated September 2014.
2. Baize S, Pannetier D, Oestereich L, et al. Emergence of Zaire Ebola virus disease in Guinea. N Engl
J Med. 2014; 371:1418–1425. [PubMed: 24738640]
3. Centers for Disease Control and Prevention web-site. [January 1, 2015] Ebola outbreak in West
Africa: case counts. 2014. www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/case-counts.html.
Updated December 31, 2014.
4. Blinder, A.; Grady, D. [December 14, 2014] American doctor with Ebola arrives in the U.S. for
treatment.. New York Times web-site.. Aug 2. 2014 www.nytimes.com/2014/08/03/us/kent-brantleynancy-writebol-ebola-treatment-atlanta.html?_r=0.
5. Emory Medicine Magazine website.. Lessons from a previous outbreak;
emorymedicinemagazine.emory.edu/issues/2014/fall/features/lessons-from-a-previous-outbreak/
index.html. [January 8, 2015]
6. Centers for Disease Control and Prevention website. [January 18, 2015] Current Ebola treatment
centers. www.cdc.gov/vhf/ebola/hcp/current-treatment-centers.html. Updated December 4, 2014.
7. Auffermann WF, Kraft CS, Vanairsdale S, Lyon GM, Tridandapani S. Radiographic imaging for
patients with contagious infectious diseases: how to acquire chest radiographs of patients infected
with the Ebola virus. AJR. 2015; 204:44–48. [PubMed: 25402496]
8. Bluemke DA, Meltzer CC. Ebola virus disease: radiology preparedness. Radiology. 2015; 274:527–
531. [PubMed: 25405643]
9. Johnson KM, Lange JV, Webb PA, Murphy FA. Isolation and partial characterization of a new virus
causing acute haemorrhagic fever in Zaire. Lancet. 1977; 12:569–571. [PubMed: 65661]
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West Africa: clinical manifestations and management. N Engl J Med. 2014; 371:2054–2057.
[PubMed: 25372854]
11. Grady, D. An Ebola doctor's return from the edge of death. New York Times website; Dec 7. 2014
www.nytimes.com/2014/12/08/health/ebola-doctor-ian-crozier-return-from-the-edge-ofdeath-.html. [December 14, 2014]
12. Emory Healthcare website. [January 8, 2015] Support document 10: standard operating procedures
SCDU training. www.emoryhealthcare.org/ebola-protocol/pdf/support-document-10-standardoperating-procedures-scdu-training.pdf.
13. Emory Healthcare website. [January 8, 2015] Appendix 10: management of contaminated
durable/non disposable equipment. www.emoryhealthcare.org/ebola-protocol/pdf/appendix-10management-of-contaminated-durable-non-disposable-equipment.pdf.
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Circ Cardiovasc Imaging. 2012; 5:676–682. [PubMed: 22991286]
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Author Manuscript
AJR Am J Roentgenol. Author manuscript; available in PMC 2016 June 01.
�
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Performance of bedside diagnostic ultrasound in an Ebola isolation unit: the Emory University Hospital experience
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Moreno, C. C., C. S. Kraft, S. Vanairsdale, P. Kandiah, M. A. Klopman, B. S. Ribner and S. Tridandapani (2015). "Performance of bedside diagnostic ultrasound in an Ebola isolation unit: the Emory University Hospital experience." AJR Am J Roentgenol 204(6): 1157-1159.
Abstract
OBJECTIVE: Individuals with Ebola virus disease, a contagious and potentially lethal infection, are now being treated in specialized units in the United States. We describe Emory University's initial experience, current operating procedures, and ongoing planning with diagnostic ultrasound in the isolation unit. CONCLUSION: Ultrasound use has been limited to date. Future planning considerations include deciding what types of ultrasound studies will be performed, which personnel will acquire the images, and which ultrasound machine will be used.
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free online - Pubmed Central
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Title
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Performance of bedside diagnostic ultrasound in an Ebola isolation unit: the Emory University Hospital experience
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Moreno, C. C., C. S. Kraft, S. Vanairsdale, P. Kandiah, M. A. Klopman, B. S. Ribner and S. Tridandapani
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Treatment & Care
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Individuals with Ebola virus disease, a contagious and potentially lethal infection, are now being treated in specialized units in the United States.
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2015-06-01
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2025-09-27
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2022-09-27 - general asset review - Treatment & Care group
2022-12-07 general asset review - IPC (change to R-T&C)
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Y - D0.1Tx/D0.2Tx Qualtrics # 821, Additional Resource
Diagnosis
Ebola
Equipment and Supplies
Infection Prevention and Control
Patient Care
R-Res&Pub
R-T&C