The University of Nebraska Medical Center, in partnership with Nebraska Medicine, has been awarded a $9.5 million grant from the U.S. Centers for Disease Control and Prevention (CDC) to enhance infection prevention and control (IPC) initiatives in small and rural health care facilities and advance the ability of health care workers to provide safe and effective clinical care.
Three innovations are being proposed for this project:
- The Isolation System for Treatment and Agile Response for high-risk infections (ISTARI) Care Cube 2.0;
- the Mixed Reality for Consultation, Assessment and Education; and
- theNational Infection Control Strengthening (NICS) for Small and Rural HospitalsInnovation Test Bed Network.
ISTARI Care Cube 2.0
The ISTARI Care Cube 2.0 is an advanced, independent, modular and field-adapted version of ISTARI Care Cube.
"It is intended to enable safe infection prevention and control practices and provide highly effective patient care in the field in a manner that is highly scalable," said James Lawler, MD, director, international programs and innovation, Global Center for Health Security. "ISTARI is a negative pressure envelope that is easily portable and can be assembled in minutes. It features an integrated, HEPA-equivalent air filtration and ventilation system; flexible, transparent walls for patient interactions and procedures; airlock pass-through chambers; and compatibility with routine hospital equipment and facilities."
By wrapping personal protective equipment (PPE) around the patient rather than the health care worker, we can drastically conserve PPE, Dr. Lawler said. In turn, there is less risk to the health care worker and less risk of hospital-acquired infection overall. ISTARI 2.0 increases the national capacity for IPC during the COVID-19 pandemic, as well as provides for future public health emergencies.
"Many health care settings endure gaps and challenges to IPC programs, and UNMC/Nebraska Medicine intend to resolve these issues with mixed reality for consultation, assessment, and education," Dr. Lawler said.
Mixed reality is an environment where physical reality and digital content are combined to enable interaction with real-world and virtual objects -- blending real-world and digital settings. It is a fusion of technologies that will be used to assist rural and acute facility infection preventionists with training, assessment, and mentoring.
"By designing a virtual hospital with various infection prevention and control scenarios, the virtual reality environment can be used to train additional staff through engaging technology while maintaining and updating their own skills with more comprehensive hands-on challenges," said Pam Pizzi, Nebraska Regional Disaster Health Response Ecosystem consultant. "IPs can also engage with virtual subject matter experts using an artificial intelligence 'chatline' to find immediate, authoritative answers to pressing issues or, alternatively, complete holistic self-assessments for their facility.
The Global Center for Health Security will establish a NICS testbed network to ensure the generation, transfer, and translation of infection prevention and control innovations for varied clinical environments in frontline and critical access facilities. GCHS's outreach includes more than 32,500 health care workers and 109 facilities of varying size, both domestically and internationally.
"The innovation testbed will allow us to take innovation and put it in places where they will be used for patient care," said David Brett-Major, MD, professor of epidemiology in the UNMC College of Public Health. "The more we are able to bring innovation into the testbeds, the more we can ensure these ideas are developed and are developed in a way they will be useful."
By the end of the project period, the program will have identified gaps as well as opportunities to optimize IPC in small, rural health care facilities; increased the ability of small, rural facilities to implement mitigation strategies; and accelerate the development of novel approaches to advance isolation care.
(Photo by UNMC)