A survey on infection control in emergency departments in Japan

Abstract

AimInfection control in the emergency department is important for hospital risk management; however, few clinical guidelines have been established. This study aimed to determine whether hospitals in Japan have infection control manuals, and investigate the contents of manuals, consulting systems, and isolation facilities for emergency departments.MethodsA total of 517 hospitals certified as educational institutions for board‐certified acute care physicians in Japan were requested between March and May 2015 to provide a written evaluation of the infection control in the emergency department.ResultsA total of 51 of 303 (16.8%) hospitals had no manuals regarding infection control in the emergency department. Among 250 hospitals having emergency department manuals, 115 (46.0%) did not include contents regarding disinfection and sterilization for imaging examination rooms, and only 44 (17.6%) had criteria for contacting the emergency medical service when patients are suspected of, or diagnosed with, communicable diseases. Of the 303 hospitals, 277 (91.4%) prepared specific manuals for the 2009 pandemic influenza. Of the 303 hospitals, 80 (26.4%) did not prepare manuals for the Ebola virus disease outbreak in West Africa in 2014. Furthermore, 92 (30.4%) of the 303 hospitals did not have any negative‐pressure isolation rooms.ConclusionsPractices and guidelines necessary for infection control in the emergency department were not sufficiently covered in the hospitals studied. Education, information sharing, and a checklist for preparing manuals are needed to establish better infection control systems in emergency departments.

N95 filtering facepiece respirators do not reliably afford respiratory protection during chest compression: A simulation study

“…Emergency departments (EDs), the principal portals of entry into healthcare systems, are increasingly required to screen and treat patients with communicable infections [1,2]. In 2015, a large outbreak of Middle East respiratory syndrome (MERS) coronavirus infection occurred after exposure to a single patient in an overcrowded ED of a hospital in South Korea; several individuals, including healthcare workers (HCWs), were infected [3,4].…”

Checklist for infection control in the emergency department

“…In this Joint Working Group, from the standpoint of a professional academic organization, a comprehensive and multifaceted examination of infection control and related matters in the emergency department was carried out. As the first step, we undertook three surveys on the current situations using a questionnaire: infection control measures in emergency departments at facilities certified as educational institutions for board‐certified acute care physician by JAAM, 1 infection control measures in prehospital care for national fire departments, 2 and microbiological testing system in emergency departments for clinical microbiological technician‐registered facilities certified by the Japanese Society for Clinical Microbiology 3 . The second step was to disseminate the infection control measures, taking into account the peculiarities of the emergency department based on these findings, to the world as academic societies.…”

“…It is desirable to have an infection control manual that takes into account the special characteristics of emergency departments 7 . According to a survey of specialized medical institutions by the Japanese Society for Emergency Medicine, undertaken in 2015, 51 facilities (16.8%) did not have an infection control manual for emergency departments 1 . An emergency department item could be included in the hospital infection manual, instead of an infection control manual dedicated to emergency departments.…”

Airflow dynamics in an emergency department: A CFD simulation study to analyse COVID-19 dispersion

“…Additionally, it is critical to design the ventilation system such that turbulence is eliminated [10] . Studies investigated the location of air inlet and outlet through experimental tests and simulation using advanced programs [11] , [12] , [13] , [14] , [15] , [16] . Such experiments culminated in a series of design codes and standards to legislate a set of minimum requirements for ventilation systems in healthcare environments.…”

“…Air quality and ventilation research centered on individual areas such as isolation quarters [12] , [13] , hospital corridors [16] , nursing stations [2] , and operating rooms [11] to provide suitable air suppression locations and to ensure that airborne transmissions do not reach users of care areas. Studies that examined the emergency room are few or minimal [15] .…”