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PE RSONAL PROT ECT IVE EQUIPMENT


expand to up to 2,000 beds.


Hospitality suites, corridors and lounges at the Millennium Stadium in Cardiff were converted to wards, while 900 beds were also created in the stadium bowl in five tents. Facilities included rehabilitation space, full radiology and laboratory space, while pharmacies and drug supply chains were put in place for each level, and a CT scanner installed in a lead-lined room.


Morgan described, with immense pride, how staff worked 12-14 hours per day, over a seven-day working pattern – the stadium became ‘home’ for 2-3 months, while they transformed the space into a working hospital. “The operations team would go up to level 6 with a coffee and look out over the pitch, thinking ‘if we can achieve this, we can achieve anything’,” he commented. “It was spectacular and awe inspiring…We pulled together and we were absolutely ready.” A time lapse video of the project can be viewed at: https://youtu.be/bHsJZuAqXD0


Field hospital engineering: managing the risks Jim Tinsdeall, a former head of estates within the NHS for 20 years and an AE (D), went on to share an impressive account of implementing engineering services for two of the Nightingale hospitals – one at Bristol University in a conference facility and one at a former Homebase in Exeter. “Interestingly, we ended up with two very different designs, from the same brief – to build a field hospital. There is no guidance for a field hospital but, where possible, we followed HTMs and risk assessed derogation. This led to the question, who owns the risk and the derogations, when the facility


About the CSC


The Central Sterilising Club was founded in 1960 by a small group of enthusiastic individuals who were either working in the rapidly evolving central sterile supply departments or were attempting to solve the many problems associated with developing rapid, safe methods for sterilising items in bulk. The Club has a multi-disciplinary membership which includes: medical and non-medical microbiologists, infection prevention nurses, authorised persons (sterilisers), and sterile service staff who, together with commercial companies, are involved in all aspects of sterilisation.


The Club normally holds two educational events each year, both being accredited for continuing professional development (CPD), which is currently organised through the Royal College and Pathologist’s scheme. The programme is submitted for review and an


appropriate number of CPD points allocated to the content.


The first of the CSC events is a two- day Annual Scientific Meeting which is normally held in the Spring and comprises a formal programme of lectures, from invited speakers, and a selected number of corporate presentations, which combine to cover a broad range of hot topics. The second education event of the year is the CSC Autumn Study Day. This is usually based around a specific theme covering topical subjects chosen from current challenges faced by members. The CSC are organising a virtual study day on Wednesday February 10th that will focus on “decontamination in dentistry and the impact the pandemic has had on practice.” For further information on events and membership, visit: https://centralsterilisingclub.org


24 l WWW.CLINICALSERVICESJOURNAL.COM


is completed, in terms of engineering? In reality, in a short space of time, it is not possible to meet every part of guidance,” he commented.


He went on to discuss risk evaluation for the various engineering components of the projects – including considerations such as ventilation, oxygen provision, electrical resilience and fire risk. For the first hospital, it was unclear who was going to own the risks, in the early stages of the construction, and the authorising engineers’ input came towards the end of the project. In terms of lessons learnt, Tinsdeall pointed out that authorising engineers for the host organisation need to be involved much earlier in the process. The organisation learned from its previous experience, for the second hospital; challenged the model of care (which was originally to care for ventilated patients) and obtained clarity on who owned the risk – identifying that it was the host


organisation, rather than contractors. UWE Bristol called upon the skills of its own authorising engineers very early on for the second hospital and throughout the project. This was not to ensure compliance but to determine risk mitigation. Tinsdeall argued that the knowledge of authorising engineers on how engineering systems operate, when they are up and running in a hospital setting, exceeds that of engineering design consultants, and they have a better understanding of the potentially serious clinical implications for any interruption in electricity supply or ventilation failure, for example. He went on to describe the outcomes for both Nightingale hospitals, design differences and the lessons learnt. “Ultimately, you need to be prepared to challenge the brief and to understand where the risks will sit. I refer to the ‘newspaper test’: what will the headline read if something goes wrong and where will the blame be apportioned? Use the expertise available to you – internally, hospitals have very competent authorised persons available to offer help and advice on these projects; seek external advice if needed. It is important to design and asses the risk, then design and assess the risk again, so you are absolutely clear what the risks are,” Tinsdeall warned. “When it comes to derogation, understand what the risks are, reject it if they are too great and make sure it is an appropriate person signing off. If it is a medical risk, it should be the medical director signing off,” he concluded.


CSJ


References 1 Elaine Toomey and Yvonne Conway et al. Extended use or reuse of single-use surgical masks and filtering facepiece respirators, Centre for Evidence- Based Medicine, June 2020. Accessed at: https:// www.cebm.net/covid-19/extended-use-or-re- use-of-single-use-surgical-masks-and-filtering- facepiece-respirators-a-rapid-evidence-review/


2 Accessed at: https://www.cdc.gov/ coronavirus/2019-ncov/hcp/ppe-strategy/ decontamination-reuse-respirators.html


JANUARY 2021


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