The COVID-19 pandemic has been a stressful time for healthcare workers everywhere. But at MelroseWakefield Hospital, creative and proactive thinking by experienced and highly skilled staff throughout the organization has led to new levels of innovation to respond to the challenges.
The anticipated low supplies of personal protective equipment such as masks, hand sanitizer, and bed capacity has brought about some incredible employee-led innovations to help fulfill the needs of patients and staff and keep everyone safe and well-protected.
Keeping Hands Clean
During the first few weeks of the pandemic, it became clear that handwashing and the use of hand sanitizer would be crucial in stopping the spread of COVID-19. Our pharmacy, anticipating the shortages of sanitizer and unreliable supplies and shipments throughout the country, began compounding supplies of hand sanitizer in-house, based on guidelines from The Massachusetts Board of Pharmacy, The Food and Drug Administration, and the United States Pharmacopeia.
“Our pharmacy technicians, with supervision from the pharmacists, have been compounding hand sanitizer to supplement the supply we have on hand,” said director of pharmacy Nicole Clark, PharmD, MHA, BCPS, who is also a Fellow of the American Society of Healthcare-System Pharmacists. “Everyone throughout the organization is looking at ways to step out of our typical roles and find new ways to help each other get through this time, and the pharmacy is happy to do what we can.”
The resourcefulness of the hospital pharmacy staff has resulted in a consistent supply of critical hand sanitizer.
Reprocessing Masks Safely and Effectively
The low supply of coveted N95 masks, the kind best used to help prevent the spread of droplet–borne viruses like COVID-19, has been an ongoing problem during this pandemic. The MelroseWakefield Hospital central sterile processing team took a standard, well-established vaporized hydrogen peroxide (VHP) sterilization process and effectively applied it to the sterilization of N95 masks in-house. Since the beginning of April, they have been able to safely and effectively sterilize N95 masks for staff, who are able to safely reuse their individual masks. At the end of each shift, masks are safely collected, sterilized, and returned to the same caregiver for protected reuse at their next shift. The process, which uses low-heat and an approved combination of sterilizing agents, kills germs and viruses. It can be done repeatedly without degrading the material.
“We are applying established, accepted sterilization science to address new needs and to serve a new purpose,” said Richard Olans, MD, medical director of infection control. According to central sterile processing supervisor Dianne Koch, ST, CRCST, CHL, CIS, who was instrumental in leading the development of the in-house reprocessing effort, the team can reprocess hundreds of masks each day, enabling staff to receive their sterile mask for their next shift.
Maximizing Bed Capacity
COVID-19 patients are treated on isolation units in negative-pressure rooms, which means that the air in the room is ventilated out through special ducts so that it does not disperse out of a patient’s room into the rest of the unit or the hospital.
On an average pre-pandemic day, the hospital operates six negative-pressure rooms. The hospital now has entire negative-pressure units. The engineering department at MelroseWakefield Hospital has been modifying current clinical areas and also building new clinical space to address the anticipated surge in patients. The engineers devised a way to effectively provide negative-pressure air flow to entire units, rather than one room at a time. In addition, the engineers have increased the total bed capacity in the hospital by approximately 50 percent, by enabling beds and critical equipment with access to electrical power in parts of the hospital never typically used to treat patients.
“This has truly been a feat in engineering, and we are very proud of these efforts,” said Steven Sbardella, MD, emergency medicine physician and chief medical officer of MelroseWakefield Healthcare. “New clinical space has been created in the hallways, in waiting areas and in other traditionally non-clinical areas of the hospital. We certainly hope that we don’t need to rely on using these beds, but if it comes to that with the predicted surge, we can do so confidently knowing that we are treating patients safely and to the best of our ability.”
“The ingenuity from employees to meet the challenges of this pandemic has come from every level throughout this organization in ways big and small to ensure the safety and well-being of patients and staff,” said Sue Sandberg, MBA, RN, chief executive officer.
Physicians and Staff Helping Out
Throughout the pandemic, the questions “how can I help,” or “what do you need,” are commonly being asked by employees and physicians. With the need for more hands available in certain areas of the hospital, staff members are being cross-trained to work in areas they do not commonly work.
With elective and non-urgent surgeries on hold during the pandemic, our physicians are also looking for ways to help. Several have volunteered to be cross-trained in critical care medicine to be available to work in intensive care units. According to surgeon Adam Blau, MD, if there is a surge and the ICU needs to increase capacity, there will need to be more physicians available to treat those patients. “As a surgeon, I want to use my skills and training where they can help the most. There are many similarities between treating surgical ICU patients and treating non-surgical ICU patients. If I can help by treating COVID-19 patients while also supporting my colleagues, then I want to be part of that.”
We have remarkable teams, supported by remarkable families,” added Sandberg. “We have no choice but to get through this; and I am confident we will do so…together.”