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Flinn JB, Arguinchona CL, Vasa A, Carrasco SV, Agreiter I, Boxnick S, Stadtmann B, Tennill PA. Frontline Leadership: Nurses in Special Pathogens Preparedness and Response. Health Secur 2024. [PMID: 38829221 DOI: 10.1089/hs.2023.0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Affiliation(s)
- Jade B Flinn
- Jade B. Flinn, MSN, RN, CCRN, CNRN, is Director of Operations, Johns Hopkins Special Pathogens Center, The Johns Hopkins Hospital, Baltimore, MD
| | - Christa L Arguinchona
- Christa L. Arguinchona, MSN, RN, CCRN, is Manager, Special Pathogens, Special Pathogens Program, Providence Health and Services, Spokane, WA
| | - Angela Vasa
- Angela Vasa, MSN, RN, is Director, Biopreparedness and Special Pathogens Programs, Nebraska Medicine, Omaha, NE
| | - Sharon Vanairsdale Carrasco
- Sharon Vanairsdale Carrasco, DNP, APRN, ACNS-BC, NP-C, CEN, FAEN, FAAN, FNAP, is an Associate Clinical Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA
| | - Iris Agreiter
- Iris Agreiter, MSN, RN, is a Clinical Nurse Manager 2, National Isolation Unit, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Stefan Boxnick
- Stefan Boxnick, MSN, RN, CCRN, is Senior HLIU Coordinator, High-Level Isolation Unit, Düsseldorf, Department of Gastroenterology, Hepatology, and Infectious Diseases, University Hospital, Düsseldorf, Germany
| | - Benjamin Stadtmann
- Benjamin Stadtmann, BSN, RN, is Senior HLIU Coordinator, High-Level Isolation Unit Berlin, Medical Department for Infectious Diseases and Pneumology, Campus Virchow-Clinic, University Hospital Charité, Berlin, Germany
| | - Patricia Ann Tennill
- Patricia Ann Tennill, RN, BSN, is Director of Nursing, Nurse Lead, Special Pathogens Program, NYC Health + Hospitals/Bellevue, New York, NY
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Grosman-Rimon L, Li DHY, Collins BE, Wegier P. Can we improve healthcare with centralized management systems, supported by information technology, predictive analytics, and real-time data?: A review. Medicine (Baltimore) 2023; 102:e35769. [PMID: 37960822 PMCID: PMC10637563 DOI: 10.1097/md.0000000000035769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/03/2023] [Indexed: 11/15/2023] Open
Abstract
This narrative review discusses the effects of implementing command centers, centralized management systems, supported by information technology, predictive analytics, and real-time data, as well as small-scale centralized operating systems, on patient outcomes, operation, care delivery, and resource utilization. Implementations of command centers and small-scale centralized operating systems have led to improvement in 3 areas: integration of both multiple services into the day-to-day operation, communication and coordination, and employment of prediction and early warning system. Additional studies are required to understand the full impact of command centers on the healthcare system.
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Affiliation(s)
| | - Donny H Y Li
- Research Institute, Humber River Health, Toronto, Ontario, Canada
- McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada
| | | | - Pete Wegier
- Research Institute, Humber River Health, Toronto, Ontario, Canada
- University of Toronto, Institute of Health Policy, Management and Evaluation, Ontario, Canada
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Lukowski J, Vasa A, Arguinchona C, ElRayes W, Frank MG, Galdys AL, Garcia MC, Garland JA, Kline S, Persson C, Ruby D, Sauer LM, Vasistha S, Carrasco S, Herstein JJ. A narrative review of high-level isolation unit operational and infrastructure features. BMJ Glob Health 2023; 8:e012037. [PMID: 37423621 DOI: 10.1136/bmjgh-2023-012037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/29/2023] [Indexed: 07/11/2023] Open
Abstract
High-level isolation units (HLIUs) are specially designed facilities for care and management of patients with suspected or confirmed high-consequence infectious diseases (HCIDs), equipped with unique infrastructure and operational features. While individual HLIUs have published on their experiences caring for patients with HCIDs and two previous HLIU consensus efforts have outlined key components of HLIUs, we aimed to summarise the existing literature that describes best practices, challenges and core features of these specialised facilities. A narrative review of the literature was conducted using keywords associated with HLIUs and HCIDs. A total of 100 articles were used throughout the manuscript from the literature search or from alternate methods like reference checks or snowballing. Articles were sorted into categories (eg, physical infrastructure, laboratory, internal transport); for each category, a synthesis of the relevant literature was conducted to describe best practices, experiences and operational features. The review and summary of HLIU experiences, best practices, challenges and components can serve as a resource for units continuing to improve readiness, or for hospitals in early stages of developing their HLIU teams and planning or constructing their units. The COVID-19 pandemic, a global outbreak of mpox, sporadic cases of viral haemorrhagic fevers in Europe and the USA, and recent outbreaks of Lassa fever, Sudan Ebolavirus, and Marburg emphasise the need for an extensive summary of HLIU practices to inform readiness and response.
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Affiliation(s)
- Joseph Lukowski
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | | | - Christa Arguinchona
- Special Pathogens Program, Providence Sacred Heart Medical Center, Spokane, Washington, USA
| | - Wael ElRayes
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Maria G Frank
- School of Medicine, University of Colorado, Denver, Colorado, USA
- Biocontainment Unit, Denver Health and Hospital Authority, Denver, Colorado, USA
| | - Alison L Galdys
- Division of Infectious Disease and International Medicine - Department of Medicine, University of Minnesota Medical School Twin Cities Campus, Minneapolis, Minnesota, USA
| | - Mary C Garcia
- Department of Laboratory Services, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Jennifer A Garland
- Department of Hospital Epidemiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Susan Kline
- Division of Infectious Disease and International Medicine - Department of Medicine, University of Minnesota Medical School Twin Cities Campus, Minneapolis, Minnesota, USA
| | - Caroline Persson
- Biocontainment Unit, Denver Health and Hospital Authority, Denver, Colorado, USA
| | - Darrell Ruby
- Special Pathogens Program, Providence Sacred Heart Medical Center, Spokane, Washington, USA
| | - Lauren M Sauer
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Sami Vasistha
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Sharon Carrasco
- Serious Communicable Disease Program, Emory University, Atlanta, Georgia, USA
| | - Jocelyn J Herstein
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Global Center for Health Security, University of Nebraska Medical Center, Omaha, Nebraska, USA
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The role of dedicated biocontainment patient care units in preparing for COVID-19 and other infectious disease outbreaks. Infect Control Hosp Epidemiol 2020; 42:208-211. [PMID: 32883382 PMCID: PMC7503040 DOI: 10.1017/ice.2020.451] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In response to the Ebola outbreak of 2014-2016, the US Office of the Assistant Secretary for Preparedness and Response (ASPR) established 10 regional treatment centers, called biocontainment units (BCUs), to prepare and provide care for patients infected with high-consequence pathogens. Many of these BCUs were among the first units to activate for coronavirus disease 2019 (COVID-19) patient care. The activities of the Johns Hopkins BCU helped prepare the Johns Hopkins Health System for COVID-19 in the 3 domains of containment care: (1) preparedness planning, education and training, (2) patient care and unit operations, and (3) research and innovation. Here, we describe the role of the JH BCU in the Hopkins COVID-19 response to illustrate the value of BCUs in the current pandemic and their potential role in preparing healthcare facilities and health systems for future infectious disease threats.
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Modi AR, Miranda CC, Procop GW, Foster CB, Harrington S, Evans D, Johnson LT, Gordon SM. Addressing the threat from within: Investigation of respiratory symptoms in a health care worker with untreated latent tuberculosis infection. Am J Infect Control 2020; 48:82-85. [PMID: 31444095 DOI: 10.1016/j.ajic.2019.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/12/2019] [Accepted: 07/13/2019] [Indexed: 10/26/2022]
Abstract
Tuberculosis (TB) in the health care worker demands orchestrated efforts from health care institutions to promptly identify cases and address community risk. We describe a pediatric intensive care unit nurse with latent TB infection who developed hemoptysis and a lung infiltrate concerning for active TB. Her evaluation and contact investigation were facilitated by our institution's command center. Although TB was ultimately ruled out, this case tested our team-based care in response to a suspected high-consequence pathogen.
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