High-Level Isolation Unit Infection Control Procedures

Jocelyn J. Herstein, Paul D. Biddinger, Shawn G. Gibbs, Aurora B. Le, Katelyn C. Jelden, Angela L Hewlett, John-Martin J Lowe

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The 2014-2016 Ebola outbreak in West Africa prompted a select group of US hospitals to establish high-level isolation units equipped with advanced engineering controls, trained staff, and stringent protocols to safely treat highly infectious disease patients. This survey details the comprehensive infection control protocols developed by these units, including for decontamination of units, post-mortem management, liquid waste disposal, and personal protective equipment (PPE) use. In spring 2016, a survey was electronically distributed to the 56 original Centers for Disease Control and Prevention (CDC)-designated high-level isolation units. Responses were collected via a fillable PDF and analyzed using descriptive statistics. Thirty-six (64%) high-level isolation units responded; 33 completed the survey, and 3 reported they no longer maintained high-level isolation unit capabilities. Nearly all responding units had written procedures for decontamination, liquid waste disposal, and PPE use; however, infection control protocols varied between units. High-level isolation units implemented multiple strategies in promoting hand hygiene among staff and in monitoring correct PPE use. Maximum time allowed in full PPE was restricted in all but 2 units (average of 3.45 hours per shift). Almost all (94%) had written procedures for the management of human remains, although only 2 units had written protocols for an autopsy of a patient with a highly infectious disease. While the vast majority of high-level isolation units reported having written protocols for infection control practices, staff compliance and procedural application are the true indicators of the state of preparedness. Therefore, rigorous training and staff adherence to infection control practices is critical to minimizing exposure risks.

Original languageEnglish (US)
Pages (from-to)519-526
Number of pages8
JournalHealth Security
Volume15
Issue number5
DOIs
StatePublished - Sep 1 2017

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Infection Control
social isolation
Decontamination
staff
Communicable Diseases
infectious disease
waste disposal
Waste disposal
Hand Hygiene
Waste Management
Western Africa
contagious disease
Disease control
Centers for Disease Control and Prevention (U.S.)
disease control
Disease Outbreaks
hygiene
Liquids
Autopsy
West Africa

Keywords

  • High-level isolation unit
  • Hospital preparedness/response
  • Infectious diseases
  • Personal protective equipment
  • Public health preparedness/response

ASJC Scopus subject areas

  • Health(social science)
  • Emergency Medicine
  • Safety Research
  • Public Health, Environmental and Occupational Health
  • Management, Monitoring, Policy and Law
  • Health, Toxicology and Mutagenesis

Cite this

Herstein, J. J., Biddinger, P. D., Gibbs, S. G., Le, A. B., Jelden, K. C., Hewlett, A. L., & Lowe, J-M. J. (2017). High-Level Isolation Unit Infection Control Procedures. Health Security, 15(5), 519-526. https://doi.org/10.1089/hs.2017.0026

High-Level Isolation Unit Infection Control Procedures. / Herstein, Jocelyn J.; Biddinger, Paul D.; Gibbs, Shawn G.; Le, Aurora B.; Jelden, Katelyn C.; Hewlett, Angela L; Lowe, John-Martin J.

In: Health Security, Vol. 15, No. 5, 01.09.2017, p. 519-526.

Research output: Contribution to journalArticle

Herstein, JJ, Biddinger, PD, Gibbs, SG, Le, AB, Jelden, KC, Hewlett, AL & Lowe, J-MJ 2017, 'High-Level Isolation Unit Infection Control Procedures', Health Security, vol. 15, no. 5, pp. 519-526. https://doi.org/10.1089/hs.2017.0026
Herstein JJ, Biddinger PD, Gibbs SG, Le AB, Jelden KC, Hewlett AL et al. High-Level Isolation Unit Infection Control Procedures. Health Security. 2017 Sep 1;15(5):519-526. https://doi.org/10.1089/hs.2017.0026
Herstein, Jocelyn J. ; Biddinger, Paul D. ; Gibbs, Shawn G. ; Le, Aurora B. ; Jelden, Katelyn C. ; Hewlett, Angela L ; Lowe, John-Martin J. / High-Level Isolation Unit Infection Control Procedures. In: Health Security. 2017 ; Vol. 15, No. 5. pp. 519-526.
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