COVID-19 Procedure: Isolation Area Management:

COVID-19 Procedure: Isolation Area Management

This process template is part of our COVID-19 Procedures pack. 

It is built as a reproduction of the procedures outlined in the Handbook of COVID-19 Prevention and Treatment (2020) produced by The First Affiliated Hospital, Zhejiang University School of Medicine (FAHZU). 

FAHZU had great success in combatting the novel Coronavirus COVID-19 and this handbook outlines best-practices, procedures, and useful charts for hospitals and medical centers to practically employ. 

The items contained within the handbook were compiled according to clinical experience. 

You can edit this process template to adapt it to the specific needs of your institution. When you come to follow the procedure, you can run this template as a checklist. You can add form fields throughout the checklist to gather information. You can connect your Process Street account with other platforms via automation to automatically store or utilize any data entered into your checklists. 

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You can find the full handbook embedded below.

Process Street is not a medical institution and the items contained in this process template are illustrative and not intended to be understood as medical advice. Please refer to the attached PDF document for any and all medical or operational recommendations. 

Enter checklist details

Fever Clinic:

Layout

  • 1
    Healthcare facilities shall set up a relatively independent fever clinic including an exclusive one-way passage at the entrance of the hospital with a visible sign;
  • 2
    The movement of people shall follow the principle of "three zones and two passages": a contaminated zone, a potentially contaminated zone and a clean zone provided and clearly demarcated, and two buffer zones between the contaminated zone and the potentially contaminated zone;
  • 3
    An independent passage shall be equipped for contaminated items; set up a visual region for one-way delivery of items from an office area (potentially contaminated zone) to an isolation ward (contaminated zone);
  • 4
    Appropriate procedures shall be standardized for medical personnel to put on and take off their protective equipment. Make flowcharts of different zones, provide full-length mirrors and observe the walking routes strictly;
  • 5
    Infection prevention and control technicians shall be assigned to supervise the medical personnel on putting on and removing protective equipment so as to prevent contamination;
  • 6
    All items in the contaminated zone that have not been disinfected shall not be removed.

Zone arrangement

  • 1
    Set up an independent examination room, a laboratory, an observation room, and a resuscitation room;
  • 2
    Set up a pre-examination and triage area to perform preliminary screening of patients;
  • 3
    Separate diagnosis and treatment zones: those patients with an epidemiological history and fever and/or respiratory symptoms shall be guided into a suspected COVID-19 patient zone; those patients with regular fever but no clear epidemiological history shall be guided into a regular fever patient zone.

Patient management

  • 1
    Patients with fevers must wear medical surgical masks;
  • 2
    Only patients are allowed to enter the waiting area in order to avoid overcrowding;
  • 3
    The duration of the patient's visit shall be minimized so as to avoid cross infections;
  • 4
    Educate patients and their families about early identification of symptoms and essential preventative actions.

Screening, admission, and exclusion

  • 1
    All healthcare workers shall fully understand the epidemiological and clinical features of COVID-19 and screen patients in accordance with the screening criteria below (see Table 1 );
  • 2
    Nucleic acid testing (NAT) shall be conducted on those patients who meet the screening criteria for suspected patients;
  • 3
    Patients who do not meet the screening criteria above, if they do not have a confirmed epidemiological history, but cannot be ruled out from having COVID-19 based on their symptoms, especially through imaging, are recommended for further evaluation and to obtain a comprehensive diagnosis;
  • 4
    Any patient who tests negative shall be re-tested 24 hours later. If a patient has two negative NAT results and negative clinical manifestations, then he or she can be ruled out from having COVID-19 and discharged from the hospital. If those patients cannot be ruled out from having COVID-19 infections based on their clinical manifestations, they shall be subjected to additional NAT tests every 24 hours until they are excluded or confirmed;
  • 5
    Those confirmed cases with a positive NAT result shall be admitted and treated collectively based on the severity of their conditions (the general isolation ward or isolated ICU).

Isolation Ward Area:

Scope of application

The isolation ward area includes an observation ward area, isolation wards, and an isolation ICU area. The building layout and workflow shall meet the relevant requirements of the hospital isolation technical regulations. Medical providers with negative pressure rooms shall implement standardized management in accordance with relevant requirements. Strictly limit access to isolation wards.

Layout

  • 1
    Healthcare facilities shall set up an isolation ward area including an exclusive one-way passage at the entrance of the hospital with a visible sign;
  • 2
    The movement of people shall follow the principle of "three zones and two passages": a contaminated zone, a potentially contaminated zone and a clean zone provided and clearly demarcated, and two buffer zones between the contaminated zone and the potentially contaminated zone;
  • 3
    An independent passage shall be equipped for contaminated items; set up a visual region for one-way delivery of items from an office area (potentially contaminated zone) to an isolation ward (contaminated zone);
  • 4
    Appropriate procedures shall be standardized for medical personnel to put on and take off their protective equipment. Make flowcharts of different zones, provide full-length mirrors and observe the walking routes strictly;
  • 5
    Infection prevention and control technicians shall be assigned to supervise the medical personnel on putting on and removing protective equipment so as to prevent contamination;
  • 6
    All items in the contaminated zone that have not been disinfected shall not be removed.

Ward requirements

  • 1
    Suspected and confirmed patients shall be separated in different ward areas;
  • 2
    Suspected patients shall be isolated in separated single rooms. Each room shall be equipped with facilities such as a private bathroom and the patient's activity should be confined to the isolation ward;
  • 3
    Confirmed patients can be arranged in the same room with bed spacing of not less than 1.2 meters (appx 4 feet). The room shall be equipped with facilities such as a bathroom and the patient's activity must be confined to the isolation ward.

Patient management

  • 1
    Family visits and nursing shall be declined. Patients should be allowed to have their electronic communication devices to facilitate interactions with loved ones;
  • 2
    Educate patients to help them prevent further spread of C0VID-19, and provide instructions on how to wear surgical masks, proper handwashing, cough etiquette, medical observation and home quarantine.

Post-Review Steps:

Review notes

Fever Clinic Layout

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Fever Clinic Zone Arrangement

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Fever Clinic Patient Management

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Fever Clinic Screening, Admission, Exclusion

{{form.Fever_clinic_screening,_admission,_and_exclusion_notes}}

Isolation Ward Area Layout

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Isolation Ward Area Ward Requirements

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Isolation Ward Area Patient Management

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Record action items

Sources:

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