A California Hospital's Response to COVID-19: From a Ripple to a Tsunami Warning.

Abstract:

BACKGROUND:The outbreak of coronavirus disease 2019 (COVID-19) rippled across the world from Wuhan, China, to the shores of the United States within a few months. Hospitals and intensive care units were suddenly faced with a "tsunami" warning requiring instantaneous implementation and escalation of disaster plans. EVIDENCE REVIEW:An evidence-based question was developed and an extensive review of the literature was completed, resulting in a structured plan for the intensive care units to manage a surge of patients critically ill with COVID-19 in March 2020. Twenty-five sources of evidence focusing on pandemic intensive care unit and COVID-19 management laid the foundation for the team to navigate the crisis. IMPLEMENTATION:The Critical Care Services task force adopted recommendations from the CHEST consensus statement on surge capacity principles and other sources, which served as the framework for the organized response. The 4 S's became the focus: space, staff, supplies, and systems. Development of algorithms, workflows, and new processes related to treating patients, staffing shortages, and limited supplies. New intensive care unit staffing solutions were adopted. EVALUATION:Using a framework based on the literature reviewed, the Critical Care Services task force controlled the surge of patients with COVID-19 in March through May 2020. Patients received excellent care, and the mortality rate was 0.008%. The intensive care unit team had the needed respiratory and general supplies but had to continually adapt to shortages of personal protective equipment, cleaning products, and some medications. SUSTAINABILITY:The intensive care unit pandemic response plan has been established and the team is prepared for the next wave of COVID-19.

journal_name

Crit Care Nurse

journal_title

Critical care nurse

authors

Bader MK,Braun A,Fox C,Dwinell L,Cord J,Andersen M,Noakes B,Ponticiello D

doi

10.4037/ccn2020799

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

e1-e16

issue

6

eissn

0279-5442

issn

1940-8250

pii

31134

journal_volume

40

pub_type

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