Logan Reid
Hospitals that treat highly infectious diseases require bio-containment units to prevent the spread of contagion. These units are designed to handle patients with diseases such as cholera, diphtheria, Ebola, smallpox, and COVID-19. They are often separate from the rest of the hospital and employ negative differential pressure, HEPA air filters, video surveillance, and specific SOPs to contain the spread of infection. While some hospitals have their own bio-containment units, others may need to transfer patients to specialized facilities. The development and operation of these units require significant investments and extensive staff training to ensure optimal patient care and safety.
| Characteristics | Values |
|---|---|
| Purpose | To observe, isolate and treat patients with highly infectious diseases |
| Diseases treated | Cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers, SARS, COVID-19, Ebola, etc. |
| Hospitals with biocontainment units | MedStar Washington Hospital Center, Johns Hopkins Hospital, National Institutes of Health, Emory University Hospital, University of Nebraska Medical Center, St. Patrick Hospital |
| Investment | $3 million ASPR grant |
| Patient capacity | 15 beds |
| Use cases | Respiratory isolation, observation, quarantine |
| Features | Negative differential pressure, HEPA air filters, video surveillance system, soft fabric attachment, storage for tools, built-in negative air machines with HEPA filters |
| Benefits | Reduces risk of hospital-associated infections, minimizes patient exposure to dust and infectious agents, cost-saving |
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What You'll Learn
Hospitals with bio-containment units
Several hospitals have bio-containment units to treat patients with highly infectious diseases. For example, the MedStar Washington Hospital Center has a state-of-the-art biocontainment unit (BCU) that can be used for observation, respiratory isolation, and the treatment of patients with highly infectious diseases. These diseases include quarantinable diseases such as cholera, smallpox, and viral hemorrhagic fevers.
The Johns Hopkins Hospital in Baltimore, Maryland, also has a biocontainment unit that serves as one of the U.S.'s regional treatment centers for patients with Ebola or other highly contagious diseases. The unit was opened in 2015 by Nurse Manager Neysa, who has a Bachelor of Science in Food Marketing and has served as President of the Maryland Nurse's Association. Jade Flinn, a neurocritical care nurse and nurse education leader, is the current nurse educator for the Johns Hopkins biocontainment unit.
In addition to these, there are at least two other bio-containment units in the U.S. that have experience in treating patients with Ebola or those suspected of having the disease. These include the National Institutes of Health in Bethesda, Maryland, and Emory University Hospital in Atlanta. The University of Nebraska Medical Center is also mentioned as having experience in treating patients with Ebola, though it is unclear if they have a dedicated bio-containment unit.
Outside of human medicine, veterinary hospitals may also have bio-containment units to treat animals with infectious diseases. For example, the Teaching Hospital of the Faculty of Veterinary Medicine of the University of Lisbon has a Biological Isolation and Containment Unit (BICU) that is located in a separate building from the rest of the hospital. This unit treats dogs and cats with confirmed or suspected infectious diseases.
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Bio-containment units for highly infectious diseases
Biocontainment units (BCUs) are an essential component of the healthcare system, providing critical care to patients with highly infectious diseases. These units are designed to protect the public's health during infectious disease outbreaks and prevent the spread of deadly pathogens. The following sections will explore the critical design considerations, infection control measures, and the evolving landscape of BCUs in hospitals.
Design Considerations for Biocontainment Units
Biocontainment units are purpose-built to handle highly infectious diseases, incorporating specialized features to safeguard staff, patients, and the broader community. These units are designed to account for every particle of air, every surface, and every piece of waste that could potentially harbour infectious agents. Negative-pressure air systems, HEPA filtration, and double-door airlocks are employed to prevent the escape of airborne particles from patient rooms. Ultraviolet light, dunk tanks, autoclaves, and specialized laundry facilities are used to disinfect items and prevent the spread of pathogens.
The size of BCUs is also a critical factor. Larger units, such as the Nebraska Biocontainment Patient Care Unit with five patient rooms, offer flexibility and the ability to adapt to the unique demands of different diseases. For example, during the treatment of Ebola, additional space is required for dirty storage and a point-of-care laboratory. The ample size of the Nebraska unit allows for such adaptations, making it a gold standard in biocontainment patient care.
Infection Control and Sustainability in BCUs
Infection control is paramount in BCUs, and various measures are implemented to prevent the spread of infectious organisms. For example, foot pedal-controlled faucets are preferred over automated faucets as they offer greater control and reduce the likelihood of cross-contamination. Paper towels, despite being wasteful, are chosen over hand dryers to avoid the risk of creating bioaerosols.
While the primary focus of BCUs is infection control, sustainability considerations cannot be overlooked. The environmental impact of BCU operations, including the management of waste and carbon footprint, presents challenges that require careful mediation and balancing with immediate healthcare needs.
The Evolving Landscape of BCUs in Hospitals
The importance of BCUs in hospitals has been underscored by the recent opening of the MedStar Washington Hospital Center's state-of-the-art BCU, capable of caring for patients with highly infectious diseases, including Ebola, smallpox, and severe acute respiratory syndromes. This unit has 15 beds and serves as a referral centre for FEMA Region 3.
The University of Nebraska Medical Center's Biocontainment Patient Care Unit, commissioned in partnership with the CDC, is another notable example. It has 10 beds and is designed to provide the first line of treatment for those affected by bioterrorism or extremely infectious diseases. The unit utilizes "biopods" or "isopods" to safely transport patients to the isolation ward, allowing healthcare workers to provide care without direct contact.
In conclusion, biocontainment units for highly infectious diseases play a crucial role in safeguarding public health during disease outbreaks. These units employ specialized design features, infection control measures, and sustainability practices to balance effective patient care with environmental considerations. As the world continues to face emerging infectious diseases, the expansion and improvement of BCUs in hospitals remain a critical aspect of epidemic preparedness.
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Veterinary hospitals with bio-containment units
Hospitals have bio-containment units to treat patients with highly infectious diseases. These units are designed to contain and prevent the spread of diseases such as Ebola, cholera, diphtheria, smallpox, and other severe acute respiratory syndromes.
Veterinary hospitals also have bio-containment units, known as Biological Isolation and Containment Units (BICU), to treat animals with confirmed infectious diseases or those suspected of having infectious diseases. The BICU is a subunit of the Teaching Hospital of the Faculty of Veterinary Medicine of the University of Lisbon, Portugal. It is located in a separate building from the main teaching hospital and is designed to minimize the risk of transmitting infectious agents. Each isolation room in the BICU has negative differential pressure, HEPA air filters, a video surveillance system, and specific standard operating procedures (SOPs).
The BICU is responsible for the hospitalization of dogs and cats with confirmed or suspected infectious diseases. The unit admits animals with confirmed infections and those awaiting diagnosis, making it a high-risk environment for the transmission of infectious agents. The BICU is subject to disinfection protocols to control bacteriological contamination.
Another veterinary hospital with a bio-containment unit is the Care and Isolation Unit at St. Patrick Hospital in Missoula, Montana. This facility was established in response to a 2005 NIH request for a local patient isolation facility to serve staff and visitors at the nearby Rocky Mountain Laboratories, an NIH facility that handles dangerous pathogens.
These veterinary bio-containment units play a crucial role in treating animals with infectious diseases, contributing to the overall well-being of the veterinary community.
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Mobile dust containment units
The primary advantage of mobile dust containment units is their ability to reduce the risk of hospital-acquired infections (HAIs) associated with facility maintenance and renovation. They seal off above-ceiling work areas, preventing dust and other biohazards from escaping into patient zones. This not only improves patient safety but also enhances infection control measures within the hospital.
There are two main types of mobile dust containment units: soft-sided and hard-sided. Soft-sided units typically feature a fabric attachment at the top for ceiling access, allowing them to fit through doorways easily. These fabric attachments can be in the style of curtains or zippers. Hard-sided units, on the other hand, provide a more rigid structure and may offer both ceiling access and HEPA-filtration in a single unit. An example of a hard-sided unit is the HEPACART™ Mobile Ceiling and Wall Access Unit.
When selecting a mobile dust containment unit, it is important to consider the specific needs of your facility and the project requirements. Some units provide additional features such as built-in negative air machines with HEPA filters, storage space for tools and ladders, and easy wipe-down surfaces. The Aire Guardian line of mobile containment units, for instance, offers ICRA-compliant cubes with overlapped sealed seams, making them easy to clean and ideal for controlling dust during construction, renovation, or maintenance projects in hospitals.
The use of mobile dust containment units can be complemented by other control measures such as temporary barriers, HEPA-filtered negative air machines, and laser air-borne particulate counting to further enhance dust control and infection prevention in hospitals.
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Staff training for bio-containment units
Infection Control Practices:
Staff must be trained in the latest infection control practices to prevent the spread of infectious diseases within the bio-containment unit. This includes proper use of personal protective equipment (PPE), such as masks, gloves, and gowns, as well as hand hygiene and surface disinfection protocols. The BCU team at Johns Hopkins, for example, provided training and expertise to colleagues across the hospital during the COVID-19 pandemic.
Safe Handling of Sharps:
Training on the safe handling of sharp instruments, such as needles and scalpels, is essential to minimize the risk of accidental injuries and the spread of blood-borne pathogens. This includes the use of safe sharps devices and engineering controls to reduce exposure to biohazards. Decontamination and sterilization procedures for reusable sharps are also crucial to prevent cross-contamination.
Biosafety and Laboratory Practices:
For staff working in bio-containment laboratories, training in biosafety practices is vital. This includes understanding the design measures and parameters of Biosafety Level (BSL) laboratories, as well as the risks associated with handling biological materials and biohazards. Additionally, staff should be trained to identify risk factors and maintain good microbiological practices to prevent laboratory-acquired infections.
Disaster Preparedness and Response:
Bio-containment unit staff should be prepared to respond to infectious disease outbreaks and public health emergencies, such as the Ebola and COVID-19 pandemics. Training in disaster preparedness, business continuity planning, and the development of sustainable models of care during crises are important aspects of this. The ability to quickly train and educate additional staff during a pandemic is crucial to mounting an effective response.
Collaboration and Knowledge Sharing:
Participating in national and regional networks, such as the National Emerging Special Pathogen Training and Education Center (NETEC) in the US, allows bio-containment units to collaborate and share best practices. This facilitates the development of standardized protocols and practical, hands-on training for frontline staff. By working together and learning from each other, bio-containment units can continuously improve their level of care and preparedness.
In summary, staff training for bio-containment units covers a wide range of topics to ensure a comprehensive and well-prepared healthcare workforce. By investing in training and education, hospitals can improve patient care, enhance infection control practices, and better respond to emerging infectious diseases and public health challenges.
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Frequently asked questions
Yes, hospitals do have biocontainment units. For example, the MedStar Washington Hospital Center has a Biocontainment Unit (BCU) that is used for the observation, respiratory isolation, and care of patients with highly infectious diseases.
Bio-containment units are used to prevent the spread of highly infectious diseases. They are designed to handle patients with such diseases and provide the necessary care and treatment.
Some examples of hospitals with bio-containment units include the MedStar Washington Hospital Center, Johns Hopkins Hospital, and St. Patrick Hospital in Missoula, Montana.
