COVID-19 Operational Updates-CFMRI

June 5th 2020: Research Ramp-Up Policies (Orange Phase)

UCSD Center for Functional MRI: COVID-19: Research Ramp-Up Policies & Procedures

In an effort to provide a safe imaging environment for the research projects that we support, the following policies and procedures will be implemented at the UCSD Center for Functional MRI (CFMRI) during the initial research ramp-up phases at UC San Diego. Current policies are focused on maintaining compliance in the “Orange” phase of the UCSD research ramp-up guidelines, and are subject to change as the situation evolves.

During the initial phases of the reopening of CFMRI to human imaging studies, only research projects/PI’s who have submitted all of the required documentation (https://ucsd.edu/researchactivityform), and who have received final approval to begin imaging during the “orange” phase of the research ramp-up plan will be permitted to resume MRI sessions at CFMRI. For some studies, the population of interest, procedures, or study requirements may result in a need to postpone your imaging sessions until we enter a less restrictive phase of the ramp-up plan.

CFMRI staff are working to ensure that appropriate policies and safe-guards are in place so that the facility can be available for imaging during the orange phase of the research ramp-up plan.

Please review the updated recommendations and proposed policy changes below. Please send any questions or comments to cfmri@ucsd.edu.

For UCSD-specific requirements and guidelines, please review the UC San Diego Research Ramp-Up Guidelines available at https://blink.ucsd.edu/research/covid-19/research-ramp-up.html

Familiarize your team with the CDC COVID-19 Prevention Guidelines

Recruitment & Appointment Scheduling

MRI Booking Requirements

  • Mandatory 30-minute gap between all MRI bookings
  • Limit study team to 1 operator and 1 assistant (if absolutely necessary)
  • Staff & RV & essential guests (if applicable) must be identified (Staff initials, RV ID, guest relationship to RV) in booking description
_images/booking_example.png

Pre-Scan Reminder, Screening & Instructions (~24 hours prior to appointment)

  • RE-screen RVs and all visitors one day prior to the appointment, and again on the day of the scan
  • Exchange relevant contact information
  • Instruct RVs to wait in their car, notify study team upon arrival, and wait for a study representative to escort them to the testing area
  • Exchange relevant contact information so RV can notify you
  • Inform RVs they are required to wear a facial covering and to use hand sanitizer/wash their hands upon entering the facility. The study group should be prepared to provide RVs with an MRI-safe face-mask. See section “PPE Requirements” below.

Upon Arrival at UCSD

  • The main entrances to the facility will remain locked during the initial ramp up phase
    • Only certified scanner operators will have access added to their proximity cards
  • RVs will alert a member of the study team when they arrive
  • Study team will deliver the CFMRI parking pass and escort RVs to the testing area
  • All staff, RVs, and visitors must use the provided automatic hand sanitizer upon entry to the facility
_images/east_west_entrance.png
  • RVs and study team should proceed directly to the pre-testing or imaging rooms, bypassing the waiting areas
  • The previous 3T waiting area has been cleared of almost all furniture and should not be used as a gathering place for staff, RVs, and guests
_images/3t_waiting_area.png
  • Exam rooms #1 and #2 will no longer be accessible for RV testing sessions
_images/exam_closed_notification.png
  • Projects with a verified & approved need to use exam spaces at CFMRI will have access to temporary exam locations in the large conference and multi-purpose rooms

CFMRI-Exam Room Usage Request Form

_images/conf_exam_combined.png _images/mpr_exam_combined.png
  • Non-essential guests of RVs will not be permitted within the imaging facility
  • Essential, pre-screened guests (e.g., parent or caregiver) may wait in designated areas
  • Additional signage indicating proper distancing and procedures will be present in the area immediately outside the facility and in common areas throughout the building

PPE Requirements

  • All faculty, staff, study team members, RVs, and essential visitors will be required to wear a facial covering while within the facility (UCSD policy)
    • In some circumstances, RVs may remove their mask briefly if it is a requirement for a study procedure and if the project received approval in the “alternative risk mitigation” plan documents (submitted during the orange phase approval process)
  • MRI safety and compatibility of face-masks must be assessed
    • The study group should be prepared to provide RVs with an MRI-safe face-mask
    • In many cases, the small metal nose bridge can be easily removed from a mask
    • Face-masks without a metal nose bridge are available for purchase from some online vendors
    • The “Welcome Kit” supplied by UCSD to all approved projects contains a small supply of cloth masks that are MR safe and should not generate noise in MR images
  • Disposable gloves may be used but can give a false sense of protection and allow cross- contamination
    • Frequent and habitual hand-washing (without gloves) is likely better than wearing one set of disposable gloves for an extended period of time without washing them
  • RVs should NOT wear their own gloves into the facility
  • In cases where gloves are used, proper glove usage should be reviewed by the study team and explained to participants
  • Due to the high demand and limited supply of gloves at this time, each group should plan to supply gloves to the RV and study team at times when gloves are required/recommended
  • CFMRI will attempt to maintain a supply of gloves, but cannot guarantee availability at every scan session

Pre-Scan MR Safety Screening & Testing

  • Whenever possible, all pre-MRI safety screening (pre-procedure screening checklist, operator checklist, metal detector screening) should be completed in the MRI suite console room
  • In rare cases, the pre-procedure screening checklist can be completed in available exam spaces
    • Temporary Exam Room #1 (Conference Room) & the Multi-Purpose Room (MPR)
      • See images above
    • Exam rooms must be reserved in Calpendo
    • Exam room usage is subject to CFMRI approval
    • Furniture will be positioned in a manner that promotes social distancing
    • Markers on the floor will indicate a safe distance between RVs and study staff
    • Plexiglass barriers will be available wherever appropriate
  • Additional testing (neuropsychological batteries, etc.) should be completed at an alternate location whenever possible
    • Active imaging studies are required to request approval from CFMRI to use exam spaces for activities not directly related to the MRI scan

MR Suite & Facility Disinfection Protocol

  • CFMRI staff will disinfect equipment and common areas on a regular schedule
  • Operators and (safety trained) study staff will be required to disinfect equipment and surfaces at the beginning/end of their scan session
    • A short cleaning checklist will be included with the standard MRI safety screening forms in the scanner console room and available exam locations
    • All relevant items disinfected at the beginning/end of their scan session must be initialed in the checklist
  • The checklist will be filed with safety screening forms at the end of each session
  • CFMRI MRI Suite Cleaning Checklist
  • A modified checklist will be available for the 7T scanner/prep-rooms & mock scanner

Procedural Updates to MRI Scanner Operator Training

  • Additional training will be provided to certified operators working on active imaging projects on CFMRI-managed scanners
  • Please contact Aaron Jacobson (ajacobson@health.ucsd.edu) and Conan Chen (coc004@health.ucsd.edu) for details and scheduling
  • Supplementary training will cover the following updated procedures:
    • RV positioning on MRI bed from a safe social distance
    • Patient bed movement options available from the console room
    • Safe usage of peripheral equipment
    • Pre/Post-scan cleaning requirements & procedures

During the Imaging Session

  • Staff and RVs must use the hand sanitizer available in the MRI console room immediately upon entry to the MR suite
_images/sanitizer_console_room.png
  • Hand washing/sanitizing should be completed multiple times during your session (e.g., scanner setup, RV prep and positioning, removal of RV from the scanner, before/after scanner suite sanitization procedures)
  • If gloves are used during these procedures, proper usage and removal should be reviewed by the study team and explained to participants
  • Pre/post scan disinfection procedures are outlined above (“MR Suite & Facility Disinfection Protocol”)

CFMRI MRI Suite Cleaning Checklist

Policy Summary and Compliance

  • A short compliance checklist will be used at each imaging session as a reminder of each of the key points listed above. Scanner operators will be required to initial each of the 12 items on the form and return the document to CFMRI, along with the standard MRI safety screening forms, and the new pre/post scan cleaning checklist.

CFMRI-Research Ramp-Up Policy Summary & Compliance Checklist

_images/CFMRI-Research_Ramp-Up_Compliance_Checklist.png

April 15th 2020

Upcoming Safety Training Offered Through Zoom (4/27: 11am - 12:30pm)

We hope that everyone is healthy and safe during the current health emergency. We look forward to eventually returning to normal operations at the UCSD Center for Functional MRI.

This is a notice to inform the imaging community that the upcoming MRI safety training lecture will be held at the regularly scheduled date and time (Monday 4/27/20: 11am - 12:30pm).

If you are planning to work near the MRI scanners in our facility, and you have not attended our safety training course, please visit https://cfmriweb.ucsd.edu/cfmri-training/ to register for the upcoming session.

The 4/27 training will be offered through Zoom ONLY.

Registered trainees will receive an email containing the Zoom link and password prior to the scheduled session.

If you are unable to attend the 4/27 Zoom session, additional training opportunities will be offered on the following dates:

Thursday, June 11th, 2020 12:00pm - 1:30pm

Wednesday, July 15th, 2020 10:30am - 12:00pm

Please email cfmri@ucsd.edu if you need further assistance.

Thank you!

-CFMRI

March 18th 2020

CRITICAL: Temporary Changes to Scanner & Building Access Policies

This is an update on the current status of the UCSD Center for fMRI. Due to the developing COVID-19 situation, the main entrance to the facility will be locked until further notice, beginning tomorrow (3/19/20). Building access will be limited to individuals with after-hours access privileges and all efforts are being made to limit on-site work to essential duties only.

The majority of the active imaging projects at the Center have indicated that the current plan is to postpone all human subject MRI sessions for at least the next 2-3 weeks.

New research guidance from the Vice Chancellor for Research (Email subject: “UCSD COVID-19 Research Guidance (Reducing On-site Activity)), was announced on 03/17/20. This guidance requires all research programs to develop a safety plan to substantially reduce on-site staff and to minimize exposure to COVID-19.

Our team has completed this process internally and will not be providing in-person support for any ongoing research projects. We will continue to make every effort to assist with operational tasks that can be performed remotely (e.g., establishing new projects in Calpendo, setting up user accounts, managing administrative requests, and addressing any imaging data questions or issues regarding previously acquired data).

In the event that your team is requesting an exception to the new regulations and you believe that your research might qualify for continued limited use of one of our imaging resources (e.g., phantom or animal imaging with limited staff present, etc.) please contact CFMRI staff at cfmri@ucsd.edu to discuss your current needs & plans.

It is the responsibility of each research group to submit project-specific compliance information to their departments and to comply with all safety and ethical guidance announced by the Vice Chancellor for Research.

Thank you for your continued support and patience during this global health emergency. CFMRI staff will be available in a research support role via email during the duration of the COVID-19 situation. Please navigate to https://ucsd-center-for-functional-mri-cfmri-web-rtd.readthedocs-hosted.com/en/latest/coronavirus.html for the latest operational updates.

Specific COVID-19 guidelines from UCSD are available here:

http://adminrecords.ucsd.edu/Notices/2020/2020-3-17-1.html

https://blink.ucsd.edu/research/covid-19-forms.html

We hope everyone remains safe and healthy in the coming weeks.

March 13th 2020

COVID-19 Preparation, Prevention & MRI Suite Cleaning Policy

Faculty and staff at the UCSD Center for Functional MRI have been closely monitoring COVID-19 (Coronavirus) updates from federal, state, and local health officials. The facility is currently operational and our team is making every effort to provide a safe environment for researchers and participants from the imaging community.

In addition to daily UCSD janitorial services and regular staff cleaning of commonly used equipment and surfaces with disinfectant wipes, we have significantly increased our efforts to provide a clean & safe environment for the research projects we support.

Effective immediately, we will be enforcing a more rigorous equipment cleaning procedure requiring all active research groups to use the provided supplies (Clorox wipes, Purell spray disinfectant, gloves, paper towels) to quickly wipe down all surfaces and equipment used during their imaging session.

A short cleaning checklist will be included with the standard MRI safety screening forms in the scanner console room and waiting area. Operators and (safety trained) study staff will be required to initial all relevant items that they wiped down at the conclusion of their session. The checklist will be filed in the same location as the screening forms at the end of each session. CFMRI staff will continue to perform extensive disinfecting of equipment on a daily basis, but effective cleaning between sessions will significantly improve our ability to maintain a safe facility. Larger trash cans have been added to the scanner console rooms to account for an increase in cleaning-related trash.

Use of the post-scan cleaning checklist is mandatory. Compliance will be assessed on a regular basis.

The checklist can be downloaded using the following link:

CFMRI MRI Suite Cleaning Checklist

Protective Gloves

_images/gloves.png

(https://www.cdc.gov/coronavirus/2019-ncov/infection-control/index.html)

Protective gloves should be used and changed frequently during your MRI session and the cleaning procedure outlined in the checklist (above).

Information on proper glove usage can be found here:

https://blink.ucsd.edu/safety/occupational/PPE/gloves/index.html

In addition to the typical supplies of gloves currently at CFMRI (exam rooms, scanner suite, prep rooms), an adequate supply of nitrile gloves has been added to all common areas including the waiting room, kitchen, conference room, and additional convenient locations throughout the building.

Hand Sanitizer & Hand Washing Locations

_images/handwash.png

(https://www.cdc.gov/handwashing/when-how-handwashing.html)

The CFMRI contains several built-in automatic hand sanitizer dispensers and hand washing locations. Frequent use of these resources is strongly encouraged.

Information on effective hand washing techniques can be found here:

https://myhealth.ucsd.edu/RelatedItems/3,89227

Locations of automatic hand sanitizer dispensers:
  • Exam room 1 & 2
  • 3T console rooms
Locations of hand washing sinks:
  • Main restrooms
  • 3T waiting area (near copy machine)
  • 7T prep rooms

Additional disposable bottles of hand sanitizer will be conveniently located in common areas throughout the facility.

Additional Pre-Scan Phone Screening

All research participants must be pre-screened for COVID-19 symptoms within 24 hours of their scheduled visit to the imaging facility.

Please use the form below as a guide for phone screening procedures.

UCSD COVID-19 Research Participant Phone Screening

Temporary Update to Cancelation Policy

Under our standard policy, it is important to mention that canceled scans are never billed. Canceled scan time that is not re-booked by another project results in the use of pilot hours equal to the length of the cancelled booking. Pilot hours accrue with every paid hour of scan time that a project uses and are bonus hours awarded by the Center to support the functioning of the cancelation policy. One of the primary purposes of our pilot hour system is to help projects effectively address last-minute cancelations. The current policy was developed through several iterations and extensive discussions with the user community and designed to address the specific needs and activities of our community.

In response to the current COVID-19 situation, the CFMRI is implementing a temporary policy to allow cancelations due to illness or public health safety concerns at any time up to 24-hours before your scheduled MRI session without the use of pilot hours to account for the canceled time. This policy modification will remain in effect temporarily during the current health emergency. Any additional changes to the policy will be announced to the user mailing list.

Please remember that in order for our imaging center to have the ability to offer a reasonably available booking schedule, we need the imaging community to be conscientious of other research projects when creating bookings. Our ability to maintain the current policy modification is completely dependent on your ability to book responsibly. If it is evident that projects are booking more time than they need (to generate more availability for their study) and making last-minute cancelations in most of their booked sessions, we will need to reevaluate the temporary policy amendment.

If you have any questions about the policy, please feel free to contact us at cfmri@ucsd.edu

COVID-19: UCSD Center for fMRI Operational Updates

We are committed to providing up to date center-specific safety information and operational updates. The user mailing list and this site will be used to provide regular information regarding the status of the imaging center and any changes in campus policies that might affect our operation.

Additional COVID-19 Information

UCSD Official updates:

https://coronavirus.ucsd.edu