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Modifying ICU Rooms to Protect Health Care Workers During the COVID 19 Crisis: Brief Report

Background: With the growing crisis of the pandemic COVID-19, healthcare providers have been put 
under tremendous emotional stress and physical strain attempting to protect themselves from contracting 
the infection while caring for critically ill patients. This task is further challenged by the global shortage of 
the protective equipment recommended for their safety. 
Methods: In two different ICUs in different hospitals in Hawaii, we were able to modify our rooms, both 
those equipped and not equipped with negative pressure capabilities. We were able to remove the 
intravenous pumps, feeding tubes, and even the ventilator monitors out of the patient room without affecting 
the negative pressure inside the room. The purposes of such measures were to reduce the exposure risk for 
nurses, respiratory therapists, radiology technicians, and physicians from entering the room for routine 
medication changes, blood draws, or ventilator checks. Those measures are by no means to neglect the 
patients from physical examination, communicating with the patient if alert enough, or emergency 
situations. 
Conclusion: The modifications implied are feasible, practical and conceptually safe to implement. We 
hypothesize that those measures will reduce the number of times entering the rooms for routine measures, 
thus reducing personnel exposure, infection rate, and reducing the growing need for the now precious PPE. 
Additionally, it will enhance response time to medications needs or ventilator adjustments.