DrMatthew O'Sullivan

The NSW Biocontainment Centre (NBC) at Westmead has developed guidelines to ensure preparedness to receive patients with HCID. A 24-hour simulation of patient care, based on these guidelines, will be conducted, to investigate the robustness of the systems, identify potential problems and modify guidelines, if necessary, before any HCID patients present. Ethics approval has been obtained to recruit an inpatient from the infectious disease ward to be cared for in an NBC quarantine room for 24-hours, by staff wearing HCID personal protective equipment. Potential patients will be identified and recruited by the head consultant for infectious diseases. Processes and procedures during the 24-hr simulation will be video-recorded. The clinicians involved, will then collaboratively review and analyse the recordings for latent hazards, equipment or procedural flaws, or communication issues, and design solutions as required. Patient feedback will also be sought and used to improve patient-centred care.

I lead this research, which is continually being undertaken at the NSW Biocontainment Centre (NBC). I collaborate with NBC staff and other stakeholders to adapt current local health district HCID procedures, for the care of patients with HCID. HCID exercises are designed on paper, drawing on local policy as well as international biocontainment centre procedures. Exercises focus on procedures within quarantine rooms including: mobile x-rays; preparation of blood samples for transfer to the PC4 laboratory; removal of a deceased person; and healthcare worker collapse. Simulations of these exercises are video-recorded. After each exercise, the clinicians involved, and colleagues, collaboratively review and analyse the recordings, in researcher-facilitated reflexive discussions. The aim is to identify how optimal infection prevention and biocontainment can be maintained while performing complex procedures. Suggestions for practice optimisation are then tested in subsequent video-recorded simulations and repeated until consensus on optimal practice is achieved.