Authors (including presenting author) :
Yung WM(1), Wong LF(1), Lo TK(1), Wong SY(1),
Chung SHC(1), Lee YM(1),Li CM(1)
Affiliation :
(1)Department of Medicine and Geriatrics, Kwong Wah Hospital
Introduction :
As of December 2021, there were already over two billion confirmed cases of COVID-19 globally since its outbreak in 2019.1 In Hong Kong, the situation became alarming and marked as the third wave of the epidemic in July 2020. More than 100 confirmed cases were recorded daily on that moment.2 In response to this impending public health crisis, a general medical ward (E10) in KWH was transformed into a medical surveillance ward.
Objectives :
- To enhance surveillance and screening of COVID-19 and prevent nosocomial transmissions.
- To relieve the burden of isolation facilities and prevent the healthcare system from collapsing.
Methodology :
To enhance infection control and early identification of hidden COVID cases, E10 ward was assigned as a medical surveillance ward. With the tremendous support of M&G, Infection Control Team, OSH team, Central Nursing Department, Facilities Management Department and Central Domestic & Portering team, E10 was successfully transformed into a medical surveillance ward in a week.
In regard to patients spacing and ventilation considerations such as ensuring 1-metre spacing between patients, adding exhaust fan and portable HEPA filter(s) to achieve minimum 12 ACH. 3 Designated equipment was used for each patient to prevent cross infection. Environmental hygiene and equipment disinfection was enhanced. Posters were hoisted at each cubicle to alert all HCW on necessary isolation precaution before entering. PPE cupboard were set at each entrance for easy accessibility. Designated room with 12 ACH and negative pressure was for CPR and NPS collection to mitigate infection risk. Disposable items were available and discarded as clinical waste. 4
Besides the hardware, staff briefing and refresher training were also very important. Orientation AND drill exercises such as hand hygiene assessment, PPE assessment, resuscitation flow, were conducted. Buddy system was set up to remind each staff on infection control in daily operation, particularly when preforming Aerosol-generating Procedures (AGPs).
Result & Outcome :
During the period from July 2020 to November 2021, over 7692 screening cases that were admitted to E10 surveillance ward. 15 preliminary positive cases were identified and were sent to the airborne isolation ward (E3) promptly. After contact tracing, corresponding healthcare staff underwent COVID-19 test and no outbreak among staffs. This can successfully prevent the outbreak in general ward, enhance the safety of patient and out colleagues. Besides, save resource for contact tracing and interrupting the ward operation.
The success of transformation from a general medical ward into a surveillance ward relied on the participation of many different parties. The setting up of the surveillance ward, as same as other country5, could efficiently perform extensive COVID screening under satisfactory infection control standards to reduce nosocomial transmission as a second-line isolation facility and relieve the burden of the healthcare system effectively.
