Preparing for patients with high-consequence infectious diseases: Example of a high-level isolation unit.

<h4>Introduction</h4>Patients with high-consequence infectious diseases (HCID) are rare in Western Europe. However, high-level isolation units (HLIU) must always be prepared for patient admission. Case fatality rates of HCID can be reduced by providing optimal intensive care management....

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Main Authors: Frieder Pfäfflin, Miriam Songa Stegemann, Katrin Moira Heim, Stephan Achterberg, Ursula Pfitzner, Louise Götze, Lars Oesterhelweg, Norbert Suttorp, Christian Herzog, Benjamin Stadtmann, Alexander Uhrig
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0264644&type=printable
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author Frieder Pfäfflin
Miriam Songa Stegemann
Katrin Moira Heim
Stephan Achterberg
Ursula Pfitzner
Louise Götze
Lars Oesterhelweg
Norbert Suttorp
Christian Herzog
Benjamin Stadtmann
Alexander Uhrig
author_facet Frieder Pfäfflin
Miriam Songa Stegemann
Katrin Moira Heim
Stephan Achterberg
Ursula Pfitzner
Louise Götze
Lars Oesterhelweg
Norbert Suttorp
Christian Herzog
Benjamin Stadtmann
Alexander Uhrig
author_sort Frieder Pfäfflin
collection DOAJ
description <h4>Introduction</h4>Patients with high-consequence infectious diseases (HCID) are rare in Western Europe. However, high-level isolation units (HLIU) must always be prepared for patient admission. Case fatality rates of HCID can be reduced by providing optimal intensive care management. We here describe a single centre's preparation, its embedding in the national context and the challenges we faced during the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic.<h4>Methods</h4>Ten team leaders organize monthly whole day trainings for a team of doctors and nurses from the HLIU focusing on intensive care medicine. Impact and relevance of training are assessed by a questionnaire and a perception survey, respectively. Furthermore, yearly exercises with several partner institutions are performed to cover different real-life scenarios. Exercises are evaluated by internal and external observers. Both training sessions and exercises are accompanied by intense feedback.<h4>Results</h4>From May 2017 monthly training sessions were held with a two-month and a seven-month break due to the first and second wave of the SARS-CoV-2 pandemic, respectively. Agreement with the statements of the questionnaire was higher after training compared to before training indicating a positive effect of training sessions on competence. Participants rated joint trainings for nurses and doctors at regular intervals as important. Numerous issues with potential for improvement were identified during post processing of exercises. Action plans for their improvement were drafted and as of now mostly implemented. The network of the permanent working group of competence and treatment centres for HCID (Ständiger Arbeitskreis der Kompetenz- und Behandlungszentren für Krankheiten durch hochpathogene Erreger (STAKOB)) at the Robert Koch-Institute (RKI) was strengthened throughout the SARS-CoV-2 pandemic.<h4>Discussion</h4>Adequate preparation for the admission of patients with HCID is challenging. We show that joint regular trainings of doctors and nurses are appreciated and that training sessions may improve perceived skills. We also show that real-life scenario exercises may reveal additional deficits, which cannot be easily disclosed in training sessions. Although the SARS-CoV-2 pandemic interfered with our activities the enhanced cooperation among German HLIU during the pandemic ensured constant readiness for the admission of HCID patients to our or to collaborating HLIU. This is a single centre's experience, which may not be generalized to other centres. However, we believe that our work may address aspects that should be considered when preparing a unit for the admission of patients with HCID. These may then be adapted to the local situations.
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spelling doaj.art-f5e7d3822b8a4e9897807cced9fa97602024-01-20T05:33:50ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01173e026464410.1371/journal.pone.0264644Preparing for patients with high-consequence infectious diseases: Example of a high-level isolation unit.Frieder PfäfflinMiriam Songa StegemannKatrin Moira HeimStephan AchterbergUrsula PfitznerLouise GötzeLars OesterhelwegNorbert SuttorpChristian HerzogBenjamin StadtmannAlexander Uhrig<h4>Introduction</h4>Patients with high-consequence infectious diseases (HCID) are rare in Western Europe. However, high-level isolation units (HLIU) must always be prepared for patient admission. Case fatality rates of HCID can be reduced by providing optimal intensive care management. We here describe a single centre's preparation, its embedding in the national context and the challenges we faced during the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic.<h4>Methods</h4>Ten team leaders organize monthly whole day trainings for a team of doctors and nurses from the HLIU focusing on intensive care medicine. Impact and relevance of training are assessed by a questionnaire and a perception survey, respectively. Furthermore, yearly exercises with several partner institutions are performed to cover different real-life scenarios. Exercises are evaluated by internal and external observers. Both training sessions and exercises are accompanied by intense feedback.<h4>Results</h4>From May 2017 monthly training sessions were held with a two-month and a seven-month break due to the first and second wave of the SARS-CoV-2 pandemic, respectively. Agreement with the statements of the questionnaire was higher after training compared to before training indicating a positive effect of training sessions on competence. Participants rated joint trainings for nurses and doctors at regular intervals as important. Numerous issues with potential for improvement were identified during post processing of exercises. Action plans for their improvement were drafted and as of now mostly implemented. The network of the permanent working group of competence and treatment centres for HCID (Ständiger Arbeitskreis der Kompetenz- und Behandlungszentren für Krankheiten durch hochpathogene Erreger (STAKOB)) at the Robert Koch-Institute (RKI) was strengthened throughout the SARS-CoV-2 pandemic.<h4>Discussion</h4>Adequate preparation for the admission of patients with HCID is challenging. We show that joint regular trainings of doctors and nurses are appreciated and that training sessions may improve perceived skills. We also show that real-life scenario exercises may reveal additional deficits, which cannot be easily disclosed in training sessions. Although the SARS-CoV-2 pandemic interfered with our activities the enhanced cooperation among German HLIU during the pandemic ensured constant readiness for the admission of HCID patients to our or to collaborating HLIU. This is a single centre's experience, which may not be generalized to other centres. However, we believe that our work may address aspects that should be considered when preparing a unit for the admission of patients with HCID. These may then be adapted to the local situations.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0264644&type=printable
spellingShingle Frieder Pfäfflin
Miriam Songa Stegemann
Katrin Moira Heim
Stephan Achterberg
Ursula Pfitzner
Louise Götze
Lars Oesterhelweg
Norbert Suttorp
Christian Herzog
Benjamin Stadtmann
Alexander Uhrig
Preparing for patients with high-consequence infectious diseases: Example of a high-level isolation unit.
PLoS ONE
title Preparing for patients with high-consequence infectious diseases: Example of a high-level isolation unit.
title_full Preparing for patients with high-consequence infectious diseases: Example of a high-level isolation unit.
title_fullStr Preparing for patients with high-consequence infectious diseases: Example of a high-level isolation unit.
title_full_unstemmed Preparing for patients with high-consequence infectious diseases: Example of a high-level isolation unit.
title_short Preparing for patients with high-consequence infectious diseases: Example of a high-level isolation unit.
title_sort preparing for patients with high consequence infectious diseases example of a high level isolation unit
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0264644&type=printable
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