Revision of Standard Operating Procedures for a Hospital-Based Infectious Disease Response Team

Purpose: The purpose of this project is to determine the need to revise the current standard operating procedures (SOPS) for a hospital based infectious disease response team (IDRT) and involves the review of current standards of procedure, the addition of missing recommendations, and the update of existing standards to improve team preparedness.

Background/ Supporting Literature: The impetus for the project is that several gaps were identified in December 2017 during the IDRT statewide transport disaster drill. One gap is challenges in communication amongst the team members while in full Personal Protective Equipment (PPE). A second gap is the challenges associated with moving patients from the site to the decontamination zone. A third gap is difficulty for the team observer to see in the patient room to monitor the staff for ill effects of prolonged PPE wear and or breaches in PPE. A fourth, is lack of checklists which identify the supply items that are needed in the patient rooms, as well as supplies needed for the ambulance service. Some team members did not have a standard operating procedure, nor an updated procedure for performing the specific role. According to the U.S Department of Health and Human Services, National Guidance for Healthcare System Preparedness, (2012) many of the same identified gaps have been identified by other healthcare organizations and include lack of communication, issues with transportation, and lack of equipment and supplies.

As a result of these gaps, updates and recommendations will be made based on an assessment of the teams response to hospital wide drills during the fourth quarter of 2018 and the first quarter of 2019 . The hospital IDRT team has been in existence since 2014 and this project is the first review of standard operating procedures (SOPS). SOP’s are the guidelines of operation in the event of an infectious disease outbreak for the IDRT. The SOP’s are vital to the provision of safe care for patients with infectious disease, necessary for self-protection of the team, and essential for the safety of the community. According to Schultz, Koenig, Whiteside, & Murray of the National Standardized All Hazard Disaster Core Competencies Task Force (2012), creating disaster curricula and training based on core competencies and performance objectives will confirm that medical personnel are prepared to treat patients and avert catastrophe.

Procedure: The infectious disease response team (IDRT) will be surveyed for performance measures utilizing a nine -question Likert scale survey and an additional open- ended question for comments. The team will be surveyed during the fourth quarter 2018 and first quarter 2019 after hospital IRDT simulations. A comparison will be completed using a t-test for between survey results, and qualitative answers analyzed for common responses for the open ended question. The intervention between the 4th and 1st quarter training is updating the standard operating procedures, focusing primarily on the checklists for donning and doffing of wet/dry Personal Protective Equipment (PPE).

The donning and doffing PPE wet/dry checklists are the most important guidelines for team safety. If something goes wrong in any of these checklist steps, the entire team risks the chance of exposure to a highly infectious disease.

Recommendations/Conclusions: With the comparison of the completed surveys and review of accepted standards it is anticipated the SOP’s will be updated with feedback from the team members and leaders. The updated SOPs will improve quality and safety of care provided to patients in the event of an infectious disease outbreak.