Partial Opening Update

This is a brief update on our post of June 6 (Reopening the CNI – partial opening (part 3)).  Please review that blog post in conjunction with the material here.

The CNI COVID-19 Mitigation SOP  has been revised (June 16, 2020) to make it very clear that the human subjects research (HSR) stages that we define in our SOP are entirely independent of the general University research recovery (URR) stages.  The University may be going to Stage 2 as of June 22nd — but human subjects research will remain at HSR-stage 1 — or same-group research subjects only until the University says otherwise.  The University may also adopt a more granular approach of reintroducing human subjects research such as: same-group subjects, same-department subjects, and so on.

We have also added a CNI SOP Slideshow to our Getting Started page that presents a pictorial view of the main processes in our SOP for scanning.

We have received a number of questions regarding the SOP and generally how to restart research on campus.  Many of these questions will be clarified as individual departments publish more information on the departmental & building SOPs, but we attempt to answer some of these below to the best of our ability.

FAQ

1. Q: What do I need to do besides the CNI training described on the CNI Wiki Getting Started page in order to start scanning?  A: Anyone coming to campus needs to be listed in the new On-site Role Management (OSRM) system.  Your departmental manager should have access to the system. If you were previously in the Essential Roles Smartsheet, you will have been automatically included in the list on the OSRM.  Your PI also needs to have an SOP approved by their appropriate department or school.  This should refer to the CNI SOP, and should also describe the process for recruiting same-group research subjects without any coercion.  If there are any additional interactions with the human subject (behavioral tests, training, etc.), then the process for executing these in a safe manner should also be described.
2. Q: What are the hours that CNI will be open for scanning?   A: We will be initially open on normal business workdays from 9AM – 6PM.  This is so that CNI staff can be onsite to answer questions about implementation of the CNI SOP, as well as to answer questions on the use of the new UHP scanner.  As demand ramps up, we will open up the schedule as needed.  Please feel free to email us if you would like an exception to the current hours.
3. Q: Can we use Protocol Development time? What are the rules for scheduling this time?   A: Yes.  We encourage groups to use Protocol Development time to familiarize themselves with the new scanner, and how to put the new COVID-19 Mitigation SOP into practice.  The more experience all our groups acquire with this SOP, the more positive feedback we can provide to the Human Subjects Research Recovery Subcommittee on CNI users’ preparation to restart research with a broader subject base.  Until further notice, it is acceptable to book Prototype Development time up to 1 week in advance (note this is all on the honor system).  Please exercise reasonable judgment on how much time you book — if the schedule is starting to look full please be considerate of others’ needs.
4. Q: How do I book a slot on the CNI scanner?   A: Use the regular scheduler, but make sure there are 1/2-hour blocks of “COVID19-Mitigation” before and after your booking. Note that only a single 1/2-hour “COVID19-Mitigation” block needs to be between scans.  In this case, researchers from the previous and following scan will each have 15 minutes of the 1/2-hour block for their disinfection protocol.  Only one group of researchers should be in CNI at a time.
5. Q: Can we use the Mock Scanner room or another room while another group is scanning?   A: Sorry – no.  In order to satisfy University requirements on reduced density, we cannot make these rooms available at present.  As the University progresses through the URR-stages, it may be possible to relax this restriction.  We are also investigating whether we can use the neighboring 050 Classroom for extended CNI use.  If this is permitted, we will be able to provide concurrent use of this room while another group is scanning.
6. Q: Do I need to follow Jordan Hall rules for entry and exit?   A: Yes! Jordan Hall will likely have a QR code posted at the primary entrance (Main Psychology entrance facing the Oval) directing you to an entry and exit Google form for tracking personnel.  You are required to complete any such posted requests.  You must also follow all posted social distancing marks and other signage. Note that only the rear elevator has room for 2 people — the front elevator has single occupancy only.  Entry and exit from Jordan Hall is currently also planned to be restricted to only the single main entry — you are required to follow any such restriction and not exit from any other door.
7. Q: Do PIs need to keep track of who is scanning and being scanned?   A: Yes! In the event of a COVID-19 detected infection, County contact tracers will be reaching out to CNI to find out who was in the MRI suite during and after the infected individual was present.  CNI will use it’s calendar to contact PI representatives to find out exactly who was present.
8. Q: What will the process for new user training look like?   A: As described on the CNI Wiki Getting Started page, new users need to register on Canvas for the online training and also register with the provided Zoom link for the CNI orientation session.  At this point they will be Level 2 users, and will need to accompany Level 3 operators to get hands-on training on the MRI system.  Given the University requirements to limit research personnel to a maximum of 2 on campus at any one time, Level 2 users will be limited to scanning phantoms ONLY with the assistance of their Level 3 labmate.  On request, CNI staff can join a Level 2 user to assist in scanning a labmate for instructional purposes and grant Level 3 status. If a lab does not have any Level 3 members, CNI staff can assist a Level 2 user in getting scan experience.
9. Q: What is the process for wearing and changing gloves?   A: New gloves should be put on for any interaction with a scan subject and removed afterwards. Scan subjects themselves do not need to wear gloves but should have either washed or sanitized their hands. We also recommend wearing gloves whenever performing the disinfection protocol. Gloves may be worn in the waiting area and scanner control room, but frequent hand washing or sanitization is also acceptable.
10. Q: I can’t find any Super-Sani wipes.  What do I do?  A: Disinfecting wipes continue to be at extreme shortage.  Please use our available Clorox wipes (4-minute contact time) or paper towels soaked with Sani-Prime spray (3-minute contact time).  Note: it is advisable to spray towels first and use, rather than spray a surface as this can aerosolize any surface virions. Remember, the purpose is to leave the surface noticeably moist with disinfectant.
11. Q: How do I manage to follow posted density requirements and get a subject into the scanner?   A: This is more of an issue when we are allowed to scan non-same-group subjects.  In this case, there will be 3 individuals entering the CNI. We suggest that one researcher remain in the scan room, while the second meets and screens the subject external to Jordan Hall. The second researcher will then escort the subject to CNI, perform the MRI screening and informed consent, have the subject change, and then pass them off to the first researcher in the scan room. This will ensure no posted density limits in CNI are exceeded.  In addition, density requirements will be relaxed as the University progresses to further URR stages.
12. Q: My scan subject feels claustrophobic wearing the mask in the scanner?  Can they remove it?   A: NO! We recognize this is likely to be a significant issue, but approval of our SOP includes the requirement for the scan subject to wear a mask and this is standard procedure for Stanford Radiology.  If the subject cannot tolerate wearing the mask inside the scanner, you need to exit them and cancel your scan.  Remember that scan subjects must wear an MRI-safe mask from which the metal ribbon has been removed.  Researchers that are in the scan room may wear an unmodified mask — CNI staff have tested the masks we have and there is very little attractive force and the ribbon is useful for conforming the mask to the face.

The CNI Team