Containing SARS-CoV-2 in hospitals facing finite PPE, limited testing, and physical space variability: Navigating resource constrained enhanced traffic control bundling

The COVID-19 outbreak has led to a focus by public health practitioners and scholars on ways to limit spread while facing unprecedented challenges and resource constraints. Recent COVID-19-specific enhanced Traffic Control Bundling (eTCB) recommendations provide a cogent framework for managing patie...

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Bibliographic Details
Published in:	Journal of microbiology, immunology and infection Vol. 54; no. 1; pp. 4 - 11
Main Authors:	De Georgeo, Michael R., De Georgeo, Julia M., Egan, Toby M., Klee, Kristi P., Schwemm, Michael S., Bye-Kollbaum, Heather, Kinser, Andrew J.
Format:	Journal Article
Language:	English
Published:	England Elsevier B.V 01-02-2021 Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC Elsevier
Subjects:	COVID-19 COVID-19 - diagnosis COVID-19 - epidemiology COVID-19 - prevention & control COVID-19 - transmission COVID-19 Testing - standards COVID-19 Testing - statistics & numerical data Cross Infection - prevention & control Enhanced traffic control bundling Health care workers Health Personnel - statistics & numerical data Hospitals - statistics & numerical data Hospitals - supply & distribution Humans Infection Control - standards Infection Control - statistics & numerical data Infectious Disease Transmission, Patient-to-Professional - prevention & control Mitigation Nosocomial infection control Pandemic Personal Protective Equipment - standards Personal Protective Equipment - statistics & numerical data Review SARS-CoV-2 - isolation & purification United States - epidemiology United States COVID-19 Mitigation Health care workers Pandemic Nosocomial infection control Enhanced traffic control bundling
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Summary:	The COVID-19 outbreak has led to a focus by public health practitioners and scholars on ways to limit spread while facing unprecedented challenges and resource constraints. Recent COVID-19-specific enhanced Traffic Control Bundling (eTCB) recommendations provide a cogent framework for managing patient care pathways and reducing health care worker (HCW) and patient exposure to SARS-CoV-2. eTCB has been applied broadly and has proven to be effective in limiting fomite and droplet transmissions in hospitals and between hospitals and the surrounding community. At the same time, resource constrained conditions involving limited personal protective equipment (PPE), low testing availability, and variability in physical space can require modifications in the way hospitals implement eTCB. While eTCB has come to be viewed as a standard of practice, COVID-19 related resource constraints often require hospital implementation teams to customize eTCB solutions. We provide and describe a cross-functional, collaborative on-the-ground adaptive application of eTCB initially piloted at two hospitals and subsequently reproduced at 16 additional hospitals and health systems in the US to date. By effectively facilitating eTCB deployment, hospital leaders and practitioners can establish clearer ‘zones of risk’ and related protective practices that prevent transmission to HCWs and patients. We outline key insights and recommendations gained from recent implementation under the aforementioned constraints and a cross-functional team process that can be utilized by hospitals to most effectively adapt eTCB under resource constraints.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	1684-1182 1995-9133
DOI:	10.1016/j.jmii.2020.07.009