For long-time health technology management professionals, the COVID-19 outbreak – first detected in late 2019 – likely stirs memories of the SARS outbreak from 2003. Similar to COVID-19, severe acute respiratory syndrome, or SARS, is caused by a coronavirus (CoV) that first infected humans in China. During the 2003 outbreak, SARS affected more than 8,000 people worldwide, contributing to more than 700 deaths. In less than two months, the impact of COVID-19 has far surpassed those totals.
Considerable attention has been given to the risks faced by health care workers treating patients who may have been exposed to the novel coronavirus (2019-nCoV) that causes COVID-19. However, a risk of exposure may also exist for clinical engineering, respiratory therapy and other personnel involved in maintaining equipment that potentially has been exposed to such pathogens.
Protecting Staff during Equipment Maintenance
The following list of protective measures, which ECRI developed in response to the SARS outbreak, should be implemented to protect personnel while they are maintaining and repairing equipment that has been used on – or that has been in the same room as – patients who have been, or may have been, exposed to the coronaviruses causing COVID-19 or SARS or to similar pathogens. For the most part, these measures represent good infection prevention practices that should be followed when servicing any device, independent of concerns associated with the current epidemic.
Furthermore, recognize that “drilling and simulation in situ can be extremely valuable for this type of work,” adds Jim Davis, a senior infection prevention and patient safety analyst at ECRI. “Training and simulation saves lives.”
1. Adhere to isolation precautions. Patients who have confirmed disease or patients of interest will be under isolation precautions – practices designed to minimize disease transmission. Access to such rooms should be restricted to trained personnel to ensure the safety of staff, other patients and visitors. If you are authorized to enter the room, follow all hospital policies and procedures to minimize the exposure risks.
2. Minimize exposure of medical equipment to infected patients. Remove any unessential equipment before the patient is brought into the room, Use breathing-circuit filters to protect exhalation valves and other ventilation components from contamination. Use disposable devices or accessories for these patients whenever possible.
3. Observe proper hand hygiene. Frequent and thorough handwashing with soap and water is essential. Alcohol-based handrubs can be used when hands are not visibly soiled and handwashing facilities are not immediately available. Personnel should not rub their eyes or touch their mouth, nose or other mucous membranes while working on exposed equipment. While wearing gloves, personnel should also avoid touching other surfaces in the room that are not involved in the equipment repair (e.g., doorknobs, phones, test equipment, computer terminals, keyboards, manuals). In addition, personnel should not eat, drink, chew gum, smoke or apply cosmetics until they have removed all protective wear and washed their hands.
4. Use proper decontamination and transport procedures. Equipment should not be transported from the care area until it has been cleaned and disinfected following current guidelines and until disposables have been removed by housekeeping, central processing or other appropriately trained personnel. If equipment must be removed from the room before the exterior can be cleaned and disinfected, follow any hospital policies on transporting contaminated devices.
5. Choose an appropriate work area. Equipment that poses particular infection concerns should be worked on in designated, appropriately equipped areas where servicing can be performed without the risk of infecting patients or other employees. Such areas should have appropriate environmental controls (e.g., negative-pressure processing areas) and signage; and they should not be near any patient care areas, food preparation or storage areas, medication areas or other clean areas.
6. Wear personal protective equipment (PPE). ECRI recommends using the PPE listed below for personnel working on low-risk surfaces, such as the interior of a device that may have been exposed to the CoV from room air drawn into the device by a cooling fan. (The warm air that generally circulates inside a device with a cooling fan promotes drying and dilution of contaminants, which may reduce the viability of some viruses.) Note that compliance with federal and international guidelines with respect to PPE should take precedence, when applicable.
7. Before starting work … If there is any question about whether the exterior surfaces of the equipment were adequately disinfected, including the bottom, back and casters (if applicable), disinfect those surfaces immediately. Also, if disposable components have not already been discarded, do that right away as well.
8. If the interior of the equipment is dusty … Use a vacuum cleaner with a HEPA filter to remove dust as soon as adequate access is gained during disassembly and before working on the interior. Never blow on the equipment or use compressed air to remove dust or other particulates.
9. Clean up when done. Clean and disinfect the work area after servicing is complete.
10. If an exposure occurs … If you believe you have been exposed to a pathogen while unprotected, consult with the hospital’s infection control practitioner, epidemiologist or employee health staff for the procedures to follow.
ECRI Resource Center
In keeping with its mission of effective, evidence-based health care globally, ECRI has developed a free public resource – the COVID-19 (Coronavirus) Outbreak Preparedness Center – to help hospitals protect health care workers as well as patients. Available at www.ecri.org/coronavirus-covid-19-outbreak-preparedness-center, the site includes:
This article is adapted from content that is now freely accessible through the ECRI web page Outbreak Preparedness and Response: The Essentials. The page includes checklists, equipment recommendations, alternate suppliers, and infection control guidelines to help biomedical and clinical engineers, supply chain professionals, and clinicians prepare for contagious outbreaks. To learn more about membership in ECRI programs, visit www.ecri.org/device-evaluations, or contact ECRI by telephone at (610) 825-6000, ext. 5891, or by email at email@example.com.
*By entering your email address, you agree to receive emails regarding TechNation Magazine, Webinars, and Exclusive Promos.
© 2020, TechNation Magazine. Site designed by MD Publishing, Inc.