Taiwan's traffic control bundle and the elimination of nosocomial severe acute respiratory syndrome among healthcare workers

Abstract

The traffic control bundle consists of procedures designed to help prevent epidemic nosocomial infection. We retrospectively studied the serial infection control measures to determine factors most effective in preventing nosocomial infections of healthcare workers (HCWs) during the 2003 Taiwanese severe acute respiratory syndrome (SARS) epidemic. Fever screening stations, triage of fever patients, separating SARS patients from other patients, separation of entrances and passageways between patients and HCWs, and increasing hand-washing facilities all demonstrated a protective effect for HCWs (univariate analysis; P<0.05). By multiple logistic regression: (i) checkpoint alcohol dispensers for glove-on hand rubbing between zones of risk, and (ii) fever screening at the fever screen station outside the emergency department, were the significant methods effectively minimising nosocomial SARS infection of HCWs (P<0.05). The traffic control bundle should be implemented in future epidemics as a tool to achieve strict infection control measures.

Figure 1

Traffic control bundle procedures. Following triage outside the hospital entrance, patients who are possibly infected are directed (red arrow) into the contamination zone. Healthcare workers (HCWs) and patients are separated by zones of risk with decontamination and glove-on alcohol or hand-washing, or both, between zones of risk. PPE, personal protective equipment.