February 27, 2004

Medical Center unveils official SARS plan

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Pete Kegerise, a carpenter with Plant Services, assembles one of the “sneeze stations” which will be located around the Medical Center. Photo by Dana Johnson

Medical Center unveils official SARS plan

Vanderbilt University Medical Center unveiled its official SARS (severe acute respiratory syndrome) plan to employees this week, and will begin requiring training on the plan and its new procedures.

The Tennessee Department of Health, and the U.S. Centers for Disease Control and Prevention (CDC) requested all hospitals adopt plans in the event the quickly spreading SARS is introduced in the United States.

In compiling the plan Vanderbilt officials met with their counterparts in Toronto, and learned that hospitals can quickly become overwhelmed without proper planning, explained Pam Hoffner, MSN, RN, emergency preparedness coordinator for VUMC.

“Hospitals in Canada learned a lot of lessons last year when they had to deal with SARS,” Hoffner said. “We interviewed as many Toronto hospital officials as we could, to prepare our plan.”

The new policy, “respiratory hygiene and cough etiquette,” not only addresses SARS, but also RSV (respiratory syncytial virus), whooping cough, adenovirus and a host of other respiratory agents that can be spread by large droplets.

The most noticeable part of the new plan is the placement of 164 “cough and sneeze” stations in Vanderbilt Medical Center, Vanderbilt Clinics and the Monroe Carell Jr. Children’s Hospital at Vanderbilt.

These stations outline how important it is for visitors to maintain proper respiratory and cough etiquette. The compact stations, designed by Pete Kegerise in the VUMC Carpentry Shop, in conjunction with VUMC Plant Operations, provide a hand sanitizer, along with tissues and a waste can.

VUMC, TVC, and VCH employees will all be required to take training on the new policy, which can be done at the safety fair, or online at www.vandysafe.com. As a component of the SARS training, Vanderbilt has produced a video on how to don and remove personal protective equipment (PPE).

Hoffner said the video has been so well received by Department of Health officials, that it may be used to train other health care workers across the state on the proper use of PPE.

“This is just the type of community-wide sharing of education materials and expertise that is part of VUMC’s role as a regional referral center,” Hoffner said.

The SARS plan has three tiers, each based on the level of severity of reported SARS cases in the world. Tier 1, no human- to-human transmission of SARS in the world; Tier 2, human to human transmission of SARS outside North America; Tier 3 has two levels of response — Tier 3A, 1 to 2 cases of suspected SARS at VUMC; Tier 3B, confirmed cases of SARS at VUMC and activated only by a collaborative decision of the executive leadership team and the SARS response team.

Hoffner said at the most severe level, Tier 3B, VUMC would implement its disaster plan, visitors would not be allowed at the hospital, and a special area (the Round Wing) would be set aside for treatment of SARS patients. Seasoned staff would be assigned to the SARS patients and would be quarantined to that unit.

“In Canada, more than 53 percent of the health care workers who treated SARS patients became infected because they did not don and remove personal protective equipment correctly,” she said. “Because of that, we will strictly adhere to established policies and procedures related to the use of protective equipment. In addition, all identified SARS patients will be considered in a non-teaching patient category.”

The protective equipment includes a properly fitting N-95 mask made by Wilson or 3M. She said those personnel who had masks made by Delta, UVEX, or Racal, will have to be refit tested, as those masks do not properly protect against the SARS virus.

Incentives will be offered to medical personnel treating SARS patients.

Hoffner said a drill will be conducted within the next few months to test the plan, which will include emptying the Round Wing and relocating those patients to other areas.

In the event of the emergency of SARS patients, the Round Wing will become a restricted patient care area for the SARS patients. Other patient options for the Nashville community continue to be explored, including the possibility of an alternate care facility supported by all Nashville area hospitals.