Biomedical Engineering Reference
In-Depth Information
Table 23.1
Standard provision of protective gear against SARS
Level
Description
Surgical
mask
N95
mask
Latex
gloves
Protective
gown
Protective eye
shield
Disposable
caps
Shoe
cover
√
√
√
√
√
√
1
SARS
wards/areas
±
(indirect
patient care)
(direct
patient care)
√
√
√
√
2
Acute patient
admission
Upon staff
special
request
√
√
√
3
Others
Gown/apron
for splashing
like procedure
(direct
patient care)
(splashing like
procedure)
1. Staff should remove all protective gear when leaving the ward.
2. SARS patient should change surgical mask and pajama when leaving the ward.
23.5.1.3 Disinfection and environmental
cleanliness
All equipments were cleaned with diluted sodium
hypochlorite solution after use in SARS patients.
Use of nebulized treatment in all patients was
prohibited in light of a report of nosocomial trans-
mission of SARS in another Hong Kong hospital
[8]. As many SARS patients had presented with
diarrhea, there was a high possibility of oro-fecal
spread through contaminated fomites [13]. Addi-
tional housekeeping personnel were employed for
environmental disinfection with special attention to
shared toilet facilities in the wards. In full protec-
tive gear, they performed immediate disinfection of
the toilet with sodium hypochlorite after its every
use by SARS patients. Since SARS could survive
for prolonged periods in the environment [14], we
submit that this measure had contributed signifi-
cantly to reduction of nosocomial spread of SARS.
reduce unnecessary entry of non-HCW into cohort
wards, buffer areas were delineated near the
entrances for the delivery of food and other items.
Ventilation of staff changing rooms and toilets
were upgraded, with the addition of simple show-
ering facilities in every cohort ward in case gross
contamination occurred. Nursing care was stream-
lined to minimize patient contact. CXR were
taken with portable machines stationed in the
cohort wards. X-ray film cassettes were disinfected
between cases. Medical records were prohib-
ited in patient areas, and documentation could
only be made after removal of potentially infec-
tious PPE and donning of new and clean PPE.
Documents from cohort wards were sent by email
and fascimile, and hard copies were avoided.
Hospital wards and operation rooms (OR) in
PYNEH had been designed to operate at posi-
tive pressure with respect to the surrounding to
prevent the ingress of contaminants. Temperature
and humidity were closely controlled via a standard
heating, ventilation and air-conditioning (HVAC)
system. Apart from the OR, a significant propor-
tion of well-mixed room air was re-circulated
after filtering and conditioning. As the predomi-
nant mode of SARS spread was assumed to be
through infectious droplets, the existing HVAC
design could not meet infection control require-
ments. With no clear guidelines for HVAC design
for SARS wards and OR, input from ICT and
the clinicians were critical toward the modification
23.5.1.4 Work place re-design and
ventilation upgrade
The facilities management team (FMT) worked
closely with PCCT and ICT to re-design ward
facilities in accordance with infection control
requirements. Ward areas were segregated into
“clean” or non-infectious from “dirty” or infec-
tious/potentially infectious areas. Separate routings
were designed for entry and exit, with dedicated
gowning and de-gowning areas, respectively. To
