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Ann Am Thorac Soc. 2016 May;13(5):600-8. doi: 10.1513/AnnalsATS.201509-587PS.

The Creation of a Biocontainment Unit at a Tertiary Care Hospital. The Johns Hopkins Medicine Experience.

Author information

1
1 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine.
2
2 Department of Emergency Medicine, Johns Hopkins University School of Medicine.
3
3 Facilities Engineering, Johns Hopkins Health System.
4
4 Department of Nursing, Johns Hopkins Hospital.
5
5 Department of Medicine, Johns Hopkins Hospital.
6
6 Department of Pharmacy, Johns Hopkins Hospital.
7
7 Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine.
8
8 Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital.
9
9 Department of Pathology, Johns Hopkins University School of Medicine.
10
10 Office of Emergency Management, Johns Hopkins Medicine.
11
11 Legal Department, Johns Hopkins Medicine, and.
12
12 Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Abstract

In response to the 2014-2015 Ebola virus disease outbreak in West Africa, Johns Hopkins Medicine created a biocontainment unit to care for patients infected with Ebola virus and other high-consequence pathogens. The unit team examined published literature and guidelines, visited two existing U.S. biocontainment units, and contacted national and international experts to inform the design of the physical structure and patient care activities of the unit. The resulting four-bed unit allows for unidirectional flow of providers and materials and has ample space for donning and doffing personal protective equipment. The air-handling system allows treatment of diseases spread by contact, droplet, or airborne routes of transmission. An onsite laboratory and an autoclave waste management system minimize the transport of infectious materials out of the unit. The unit is staffed by self-selected nurses, providers, and support staff with pediatric and adult capabilities. A telecommunications system allows other providers and family members to interact with patients and staff remotely. A full-time nurse educator is responsible for staff training, including quarterly exercises and competency assessment in the donning and doffing of personal protective equipment. The creation of the Johns Hopkins Biocontainment Unit required the highest level of multidisciplinary collaboration. When not used for clinical care and training, the unit will be a site for research and innovation in highly infectious diseases. The lessons learned from the design process can inform a new research agenda focused on the care of patients in a biocontainment environment.

KEYWORDS:

Ebola virus disease; biocontainment; infectious diseases

PMID:
27057583
DOI:
10.1513/AnnalsATS.201509-587PS
[Indexed for MEDLINE]

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