Abstract :
ISSUE: In November 2002, 44 hospital labs performing high-complexity microbiology on wound, respiratory, and/or blood culture specimens were enrolled into the Oregon Laboratory Response Network (OLRN) as “sentinels.” Twelve of the 44 OLRN labs (27%) had inadequate or no biological safety cabinets (BSCs). Coordinated by the Oregon State Public Health Laboratories (OSPHL) and complying with the Centers of Disease Control and Preventionʹs 2002 Public Health Preparedness and Response for Bioterrorism (BT) grant, OLRN sentinels can quickly rule out and refer BT agents to the OSPHL for confirmation. When aerosols are generated and high-risk BT agents are suspected, the sentinels use appropriate biosafety practices and move to BSCs to prevent nosocomial transmission of pathogens. By referring out tuberculosis and fungal respiratory specimen requests, these 12 facilities passed state licensing inspections without BSCs. In 2003, the need for certified BSCs in these hospitals increased due to potential emerging laboratory transmissible pathogens and the possibility of BT agent events.
PROJECT: With bed sizes ranging from 12 to 672 licensed beds (median 39), and with 11 of the 12 hospitals in rural locations, the 12 facilities lacked adequate funding and associated remodeling costs for BSCs. To estimate funding costs and space requirements, surveys were sent in September 2003 to each hospital lacking BSCs. BSCs and associated remodeling costs were approved by the Oregon Hospital Preparedness Advisory Committee in October 2003 and funded by the Oregon Health Resources and Services Administration (OHRSA) cooperative agreement. Using BSC specifications developed by the OSPHL microbiology department, a request for purchase was submitted by the OHRSA in November 2003.
RESULTS: A BSC contractor was chosen through the state purchasing department in January 2004. The 12 BSCs are being installed and certified and staff is being trained during the first quarter of 2004.
LESSONS LEARNED: From needs assessment to funding and installation, timelines for facilitating hospital laboratory BSCs (and thus preventing infectious aerosol hazards to laboratorians) may take over 1 year.
