High-isolation hospital cluster project
The creation of a network of reference hospitals for the early assessment of cases of suspected infection requires that some regional hospitals are equipped with hospital clusters capable of supporting all the diagnosis and treatment procedures, over a 78-96 hours period, such as to lead the patient to discharge or to activate the emergency procedures to transfer the patient to the two national reference hospitals (Spallanzani in Rome and Sacco in Milan).
The project of a high-isolation hospital unit involves the articulation in three functional areas: external areas, low-risk areas and high-risk areas.
Entering the treatment cluster through the low-risk area, the patient is placed in the room where he will remain in high-isolation conditions until the end of the assessment cycle. For the proper functioning of the cluster all the flows (staff, patient and supplies) are unidirectionally oriented.
The project of the high isolation cluster under construction at Sant’Orsola Policlinico Hospital of Bologna represents a new concept able to join this high level of requirements in emergency with the needs of a normal infective desease ward.
The cluster, in high isolation mode, provides for the possibility of direct patient access from the outside, carried in a bio-containment stretcher, to a room that is isolated from the rest of the department and which will act as a filter area and dressing / staff room. From this, through a further dedicated filter, the patient is introduced into the real high-risk area: the patient room, where he comes out of the isolated stretcher and lies in the bed.
The hospital bed, equipped for intensive care, is placed under direct control of the work room, placed next to a glass window from which it is also possible to work from the outside through two pairs of gloves, fairleads and a pass-box to allow the entry of materials without contact with the interior of the room.
Leaving che room, the staff enters the DPI decontamination / undressing shower room, than in the clean area where it completes the dressing. The dirty / decontaminated ROT deposit is accessible from the same room, where the waste materials, suitably wrapped, are introduced into the deposit through a drawer dunk tank in chlorine solution.
The flow then goes again towards the low-risk area represented by the staff work room and, from this, directly to the outside or to the ordinary ward.
Through the pressures management in each room, the high isolation cluster can be used for the stay of patients infected with contact diseases or aero-transmissible diseases and it can also host immunosuppressed patients.
The realization of a network of high-intensity isolation facilities can be a valuable support for containing the risk of the onset of epidemic diseases. The creation of these units must necessarily be accompanied by the definition of emergency health protocols.