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Designing Medical Facilities to Care for Patients with Highly Hazardous Communicable Diseases
NEBRASKA UNIV MEDICAL CENTER OMAHA OMAHA United States
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The Ebola virus disease EVD outbreak in West Africa from 2013-2016 necessitated an international response and required countries around the world to reassess their ability to manage highly hazardous contagious pathogens. Care facilities often serve as epicenters for the spread of such pathogens. Experience in a field setting has historically demonstrated the ability to reduce, but not eliminate nosocomial infections among healthcare providers. Despite four decades of experience managing Ebola in a field setting, an estimated 815 confirmed and suspected infections of caregivers occurred. The World Health Organization estimated that care providers were 21 to 32 times more likely to become infected than the general population. Although the establishment of containment care units preceded the EVD outbreak, the outbreak provided impetus for developed countries to make new investments in capabilities to handle patients infected with highly hazardous contagious pathogens. This chapter will focus on the physical features, engineering controls, infection control modalities, and training regimens that hospitals housing containment units have developed and implemented to adapt or design their facilities to minimize the spread of high consequence pathogens to healthcare providers. Other medical facilities need not adapt all such features, but they can utilize some of the principles noted here for improving their own management of the unannounced patient with such an infection. This chapter will not discuss healthcare associated infections, such as ventilator-associated pneumonia or catheter-related infections.
APPROVED FOR PUBLIC RELEASE