Dataset Information

Implementing a negative-pressure isolation ward for a surge in airborne infectious patients.

ABSTRACT:

Background

During a large-scale airborne infectious disease outbreak, the number of patients needing hospital-based health care services may exceed available negative-pressure isolation room capacity.

Methods

To test one method of increasing hospital surge capacity, a temporary negative-pressure isolation ward was established at a fully functioning hospital. Negative pressure was achieved in a 30-bed hospital ward by adjusting the ventilation system. Differential pressure was continuously measured at 22 locations, and ventilation airflow was characterized throughout the ward.

Results

The pressure on the test ward relative to the main hospital hallway was -29 Pa on average, approximately 10 times higher than the Centers for Disease Control and Prevention guidance for airborne infection control. No occurrences of pressure reversal occurred at the entrances to the ward, even when staff entered the ward. Pressures within the ward changed, with some rooms becoming neutrally or slightly positively pressurized.

Conclusions

This study showed that establishing a temporary negative-pressure isolation ward is an effective method to increase surge capacity in a hospital.

SUBMITTER: Miller SL

PROVIDER: S-EPMC7115276 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Publications

Implementing a negative-pressure isolation ward for a surge in airborne infectious patients.

Miller Shelly L SL Clements Nicholas N Elliott Steven A SA Subhash Shobha S SS Eagan Aaron A Radonovich Lewis J LJ

American journal of infection control 20170320 6

<h4>Background</h4>During a large-scale airborne infectious disease outbreak, the number of patients needing hospital-based health care services may exceed available negative-pressure isolation room capacity.<h4>Methods</h4>To test one method of increasing hospital surge capacity, a temporary negative-pressure isolation ward was established at a fully functioning hospital. Negative pressure was achieved in a 30-bed hospital ward by adjusting the ventilation system. Differential pressure was cont ...[more]

PMID: 28330710

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Project description:Project description: In Germany there is great interest in better preparing learners in the health care professions for interprofessional (IP) collaboration on IP training wards. On the MIA, Mannheim's interprofessional training ward, medical students, nursing apprentices and physiotherapy (PT) trainees learn and practise real patient care in a team under supervision. The concept of the MIA, its implementation and the first evaluation results are reported. During the 2017/18 academic year, 201 medical students, 72 nursing apprentices and 33 PT trainees completed their mandatory placements on the MIA, which they evaluated online at the end of the placement (questions on the organisation of the MIA placement, learning gains, supervision, participant satisfaction, personal insights). The data was analysed according to frequency for each health care profession separately using the Kruskal-Wallis test for comparing the evaluation data between the three participant groups. Results: The response rate was 45% (104 medical students, 16 nursing apprentices, 19 PT trainees). 64% of the medical students considered the placement too short. For 70% of the nursing apprentices, the number of patients to be treated was too high. The supervision by the facilitators was adequate. There were often IP contacts. Professional and IP learning gains were rated high. IP learning took place mainly in personal conversations and on IP ward rounds. IP communication/collaboration was mentioned most often as an important insight gained from the placement. Discussion: The implementation of the MIA concept is considered successful. The learning objectives were achieved. The structured daily routine on the ward with its IP elements promotes IP collaboration and helps to minimise difficulties in the clinical placement, which - often for the first time - demands that the participants manage patient care in an accountable manner. Conclusion: Placements on IP training wards in the education of health care professionals can be a good preparation for practising optimal patient care in the future.

Project description:BackgroundThe morning blood pressure surge (MBPS) is related to an exaggerated risk of cardiovascular diseases and mortality. With increasing attention on circadian change in blood pressure and extensive use of ambulatory blood pressure monitoring (ABPM), chronotherapy that administration of medication according to biological rhythm, is reported to improve cardiovascular outcomes. The aim of this study is to evaluate the influence of chronotherapy of antihypertensive drugs upon MBPS in hypertensive patients.MethodsA search strategy was applied in Ovid MEDLINE, EMBASE, Cochrane (Wiley) CENTRAL Register of Controlled Trials, Cochrane Database of Systematic Reviews, and the Chinese Biomedical literature database. No language and date restrictions. Randomized controlled trials (RCT) assessing the efficacy of evening and morning administration of the same medications in adult patients with primary hypertension were included.ResultsA total of ten trials, comprising 1724 participants with a mean age of 61 and 51% female, were included in this study. Combined analysis observed significant reduction of MBPS (- 5.30 mmHg, 95% CI - 8.80 to - 1.80), night-time SBP (- 2.29 mmHg, 95% CI - 4.43 to - 0.15), night-time DBP (- 1.63 mmHg, 95 %CI - 3.23 to - 0.04) and increase in night blood pressure dipping (3.23%, 95% CI 5.37 to 1.10) in evening dosage compared with traditional morning dosage of blood pressure-lowering drugs. No significant difference was found in the incidence of overall adverse effects (RR 0.65, 95% CI 0.30 to 1.41) and withdrawal due to adverse effects (RR 0.95, 95% CI 0.53 to 1.71).ConclusionsOur study suggested that evening administration of antihypertensive medications exerted better blood pressure-lowering effect on MBPS compared with conventional morning dosage. Safety assessment also indicated that the evening regimen did not increase the risk of adverse events. However, endpoint studies need to be carried out to confirm the significance and feasibility of this treatment regimen in clinical practice.

Dataset Information

Implementing a negative-pressure isolation ward for a surge in airborne infectious patients.

Background

Methods

Results

Conclusions

Publications

Implementing a negative-pressure isolation ward for a surge in airborne infectious patients.

Similar Datasets

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