Operational feasibility of an Ebola screening and temporary isolation pathway in a United Nations peacekeeping medical facility: a single in situ simulation study

Introduction Deployed medical facilities may need to recognise and temporarily isolate suspected Ebola cases while maintaining essential care within shared infrastructure. We evaluated a whole-facility pathway for a colocated level 1 clinic and level 2 hospital. Methods This single-site operational evaluation combined facility mapping with one full-scale in situ simulation at a United Nations peacekeeping medical complex in Wau, South Sudan. Existing spaces were reorganised into routine-care, staff transition and high-risk isolation areas, with separate suspected-patient and one-way staff routes. Feasibility required pathway completion, preservation of zone separation and availability of essential services. Ten observers recorded 10 task-specific intervals and assessed completion of a prespecified 20-step workflow, infection prevention and control (IPC) performance, route and zone control and potential exposure events. Results Eight response personnel and one simulated-patient role-player participated. Mapping identified no dedicated suspected-case pathway or designated personal protective equipment (PPE) transition areas; reconfiguration required no major structural modification. All 20 prespecified steps were ultimately completed, and the 10 intervals ranged from 2 to 30 min. One PPE donning-sequence deviation was self-corrected before entry into the high-risk isolation area. No hand hygiene omissions, route deviations, uncontrolled movements between zones, zone-boundary breaches or observer-identified potential exposure events were recorded. Outpatient, inpatient and emergency services remained available throughout the simulation. Conclusions In this single simulation, functional reorganisation translated established IPC principles into an executable whole-facility response while essential services remained available. Multicentre scenario-based evaluation is needed to establish reproducibility, resource requirements and transferability; these findings do not demonstrate clinical effectiveness or sustained readiness.