Infection control in the intensive care unit: expert consensus statements for SARS-CoV-2 using a Delphi method

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Public Health

Background:

• Healthcare workers and patients in intensive care units (ICUs) face SARS-CoV-2 infection risks.
• Variable infection control practices in ICUs due to limited evidence on SARS-CoV-2 transmission.
• Urgent need for standardized infection control guidelines in critical care settings.

Purpose of the Study:

• To establish consensus-based clinical practice statements for SARS-CoV-2 infection control in ICUs.
• To provide evidence-informed guidance for healthcare professionals managing COVID-19 patients in critical care.
• To address uncertainties and improve patient and healthcare worker safety in ICUs.

Main Methods:

• A Delphi process involving international experts in intensive care, infectious diseases, and infection control.
• Development and voting on 33 statements related to SARS-CoV-2 infection control in ICUs.
• Consensus building to achieve agreement on clinical practice recommendations.

Main Results:

• Consensus reached on 31 out of 33 statements (94% agreement).
• 25 clinical practice statements were issued, covering ICU design, healthcare worker safety, PPE, patient management, and disinfection.
• Disagreement persisted on return-to-work criteria for infected healthcare workers and disinfection of heat-sensitive instruments.

Conclusions:

• Consensus statements provide crucial guidance for SARS-CoV-2 infection control in ICUs.
• Further research is needed to address areas of non-consensus and evaluate the impact of implemented practices.
• Standardized infection control measures are vital to mitigate transmission risks in critical care environments.