Dr Patricia Ferguson1,2,3, Dr Mary Wyer1,2,3, Ms Catherine Priestley1,2, Ms Alice Polak2,4, Ms Louisa Sasko1, Ms Patricia Walsh1, Dr Nicole Gilroy1,2,3
1Westmead Hospital, Sydney, Australia
2NSW Biocontainment Centre, Westmead, Australia
3Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, Australia
4The Children’s Hospital at Westmead, Westmead, Australia
Background: The newly-built NSW Biocontainment Centre (NBC) at Westmead Hospital is designed to manage patients with high-consequence infectious diseases (HCID). It consists of four Negative-pressure (N-class) rooms routinely used for inpatients, and two Quarantine (Q-class) rooms awaiting commissioning.
Policies and procedures specific to the new Q rooms had been developed over the last year, and incorporated into the existing HCID training program for staff. In May 2022, several patients with confirmed or suspected monkeypox were admitted to the N-class rooms. In this presentation we reflect on challenges and lessons learned through the testing of our planned procedures when managing patients with this infection.
Actions: As the NBC Q-class rooms were not yet commissioned, the Biocontainment team rapidly adapted Q-room HCID processes to the functioning N-class suite, consulting stakeholders as appropriate (Infection Prevention and Control, Security, General Services, Medical Imaging). Just-in-time HCID personal protective equipment (PPE) and procedure training was implemented to ensure competency of staff.
Results: A number of obstacles were encountered and rapid solutions were developed for: workflow; staffing; complex PPE sequences; patient transfers; high volumes of waste; cleaning procedures and other issues. While patients were clinically stable with monkeypox, some patients or close contacts had complex medical issues requiring unexpected investigation and management, which will be discussed.
Conclusions: It is difficult to plan, in advance, complete processes for managing the variety of HCIDs that might present. The NBC experience of managing monkeypox infections provides valuable insights for other facilities preparing for the admission of patients with HCID.
Biography: Trish is an infectious diseases physician with a long interest in infection control, which has lead her to Biocontainment. Her passions include staff and patient safety, strong multidisciplinary teams and continuous improvement. She also loves teaching, camping and static trapeze.