Hospital care in Departments defined as COVID-free: A proposal for a safe hospitalization protecting healthcare professionals and patients not affected by COVID-19

  • Rosario Leonardi | leonardi.r@tiscali.it Musumeci GECAS Clinic, Gravina di Catania, Catania, Italy.
  • Piera Bellinzoni Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
  • Luigi Broglia Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
  • Renzo Colombo Department of Urology, San Raffaele Hospital, Milan, Italy.
  • Davide De Marchi Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
  • Lorenzo Falcone Musumeci GECAS Clinic, Gravina di Catania, Catania, Italy.
  • Guido Giusti Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
  • Vincenzo Grasso Musumeci GECAS Clinic, Gravina di Catania, Catania, Italy.
  • Guglielmo Mantica Department of Urology, IRCCS Policlinico San Martino Hospital, University of Genova, Genova, Italy.
  • Giovanni Passaretti Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
  • Silvia Proietti Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
  • Antonio Russo Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
  • Giuseppe Saitta Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
  • Salvatore Smelzo Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
  • Nazareno Suardi Department of Urology, IRCCS Policlinico San Martino Hospital, University of Genova, Genova, Italy.
  • Franco Gaboardi Department of Urology, San Raffaele Turro Hospital, Milan, Italy.

Abstract

The COVID-19 pandemic influenced the normal course of clinical practice leading to significant delays in the delivery of healthcare services for patients non affected by COVID-19. In the near future, it will be crucial to identify facilities capable of providing health care in compliance with the safety of healthcare professionals, administrative staff and patients. All the staff involved in the project of a Covid-free hospital should be subjected to a diagnostic swab for COVID-19 before the beginning of healthcare activity and then periodically in order to avoid the risk of contamination of patients during the process of care. The modifications of various activities involved in the process of care are described: outpatient care, reception of inpatients, inpatient ward and operating room. For outpatient care, modality of appointment procedure, characteristics of waiting room and personal protective equipment (PPE) for healthcare professionals and administrative staff are presented. Reception of inpatients shall be conditional on a negative swab for COVID-19 obtained with a drive-in procedure. The management of the operating room represents the most crucial step of the patient's care process. The surgical team should be restricted and monitored with periodic swabs; surgical procedures should be performed by experienced surgeons according to standard procedures; surgical training experimental treatments and research protocols should be suspended. Adequate personal protective equipment and measures to reduce aerosolization in the operating room (closed circuits, continuous cycle insufflators, fume extraction) should be adopted. Prevention of possible transmission of the virus during procedures in open, laparoscopic and endoscopic surgery is to use a multi-tactic approach, which includes correct filtration and ventilation of the operating room, the use of appropriate PPE (FFP3 plus surgical mask and protective visor for all the staff working in the operating room) and smoke evacuation devices with a suction and filter system.

 

on behalf of the UrOP Executive Committee
Giuseppe Ludovico, Angelo Cafarelli, Ottavio De Cobelli, Ferdinando De Marco, Giovanni Ferrari, Stefano Pecoraro, Angelo Porreca, Domenico Tuzzolo

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Published
2020-04-24
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Issue
Section
COVID-19
Keywords:
Covid 19; Pandemy; Surgery; Endoscopy; Filtration
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How to Cite
Leonardi, R., Bellinzoni, P., Broglia, L., Colombo, R., De Marchi, D., Falcone, L., Giusti, G., Grasso, V., Mantica, G., Passaretti, G., Proietti, S., Russo, A., Saitta, G., Smelzo, S., Suardi, N., & Gaboardi, F. (2020). Hospital care in Departments defined as COVID-free: A proposal for a safe hospitalization protecting healthcare professionals and patients not affected by COVID-19. Archivio Italiano Di Urologia E Andrologia, 92(2). https://doi.org/10.4081/aiua.2020.2.67