COVID-19
BRIËTTE DU TOIT – TRAINING COORDINATOR, INFECTION CONTROL AFRICA NETWORK; KEVIN POGGENPOEL – RETIRED TECHNICAL OPERATIONS GENERAL MANAGER OF MEDICLINIC SOUTHERN AFRICA; DR JUAN DU TOIT – EMERGENCY MEDICINE DOCTOR, MEDICLINIC WORCESTER, SOUTH AFRICA
Triage and screening to effect infection control
This article examines the novel interventions in hospitals necessitated by COVID-19 and the lessons that can be learned from the pandemic for the design of future healthcare facilities, and how IPC (infection prevention and control) teams and hospital engineers can work closely together.
The COVID-19 pandemic had a significant impact on healthcare facilities worldwide and highlighted the strength and weaknesses in healthcare delivery and infrastructure. Triage is important during healthcare delivery to improve patient outcomes and effectively prioritise patients according to the seriousness of their condition and the resources available.1
During infectious diseases outbreaks, triage and screening are paramount to separate patients likely to be infected with a disease from others to minimise transmission and to ensure that facilities cope with the influx of patients. Triage and screening assist with case management and directing of resources to effectively support the critically ill while protecting
the safety of other patients and healthcare workers.
It is unprecedented times and many
healthcare facilities were not designed or equipped for the demands and challenges brought upon them by the global COVID- 19 pandemic. During these challenging times appropriate triage and screening are imperative to ensure the prioritisation of patients while adhering to crucial infection prevention and control (IPC) principles.2
Briëtte du Toit Kevin Poggenpoel Dr Juan du Toit
•Briëtte du Toit is currently working for ICAN (Infection Control Africa Network) as the training coordinator for the International Post Graduate Diploma in Infection Prevention and Control (IPC). She has vast experience in the development and implementation of IPC strategy, training, clinical risk management, clinical audits, quality improvement, surveillance, implementation of electronic systems, project management, hospital design, antimicrobial stewardship and policy and guideline development. Briëtte was part of the IPC subcommittee for the COVID-19 Ministerial Advisory Committee and assisted with the COVID-19 National Guideline development as well as the National IPC Strategic Framework and Implementation Guide. Briëtte is a registered nurse with a post- graduate diploma and Master’s degree in IPC and has completed a certificate course at Harvard University in airborne infection control. •Kevin Poggenpoel is the former general manager for technical operations of Mediclinic Southern Africa in South Africa. He joined the Mediclinic group in 1990, later being promoted to regional positions overseeing multiple hospitals, including maintenance of ten hospitals in the northern Gauteng region. His responsibilities included the maintenance of the complete facility between the foundation and the roof. During this period he was responsible for the upgrading of numerous facilities as the group took over smaller hospital group to manage 55 private hospital facilities. Kevin retired from his position as general manager for technical operations in March 2021. •Dr Juan du Toit is a medical doctor at Worcester Emergency Centre near Cape Town, South Africa. Dr du Toit obtained his medical degree at Stellenbosch University in 2015. He then completed two years of internship at Livingston Hospital in Gqeberha (formerly Port Elizabeth). In 2018, he completed one year of community service at Worcester Community Day centre, a primary healthcare centre with a focus on HIV and TB. Since 2019, he has been part of the Emergency Centre team at Mediclinic Worcester. In 2020, Dr du Toit did a six-month contract at Carnival Cruise line as a ship physician after which he returned to the Emergency Department at Mediclinic Worcester. Dr du Toit has a special interest in emergency care and IPC relating to the emergency centre and critical care setting.
IFHE DIGEST 2022
Background Normally, large numbers of patients are not screened and tested for an infectious disease upon admission and healthcare facilities are not designed to accommodate these patients that require isolation. Triage and screening assist with the prioritisation of patients. Triage refers to the sorting of patients into priority groups according to their needs and the resources available, whereas screening is a systematic process used to identify individuals at risk of a disease or disorder and possible further investigation and/or intervention. In the context of COVID-19, it refers to the identification of patients who might have COVID-19, the so-called suspected patients and those with COVID-19, confirmed by a positive laboratory result and the subsequent separation of these patient from others. Suspected patients refer to those who had been in close contact with a positive COVID-19 patient or has symptoms of COVID-19, with absent or inconclusive laboratory results.3 Never in modern life had we been challenged with an infectious disease of such epidemic proportions where healthcare facilities had to provide urgent medical care to excessive numbers of patients. Emergency centres (EC) in particular have not been designed to triage, screen and accommodate such large numbers of infectious patients, neither to manage different streams of patients - namely, those with medical emergencies, those with suspected or
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