Alternate Care Site Infection Prevention and Control Practices: A Rapid Systematic Review

Alternate care sites (ACSs) are temporary medical locations established in response to events that disrupt or limit the ability of established medical facilities to provide adequate care. As with established medical facilities, ACSs require careful consideration of infection prevention and control (IPC) practices to mitigate risk of nosocomial transmission and occupational exposure. We conducted a rapid systematic review of published literature from the date of inception of each database until the date the search was run (September 2021) on the IPC practices in ACSs. The practices described were categorized using the National Institute of Occupational Safety and Health hierarchy of controls framework, including elimination, substitution, engineering controls, administrative controls, and personal protective equipment. Of 313 articles identified, 55 were included. The majority (n=45, 81.8%) were case reports and described ACSs established in the context of infectious disease outbreaks (n=48, 87.3%), natural disasters (n=5, 9%), and military deployments (n=2, 3.6%). Implementation of engineering and/or administrative control practices predominated, with personal protective equipment emphasized in articles related to infectious disease outbreaks. These findings emphasize both a need for more high-quality research into the best practices for IPC in ACSs and how to incorporate the most effective strategies in these settings in response to future events.