Editor’s note: A nurse at Texas Health Presbyterian Dallas has contracted Ebola. She is the first known transmission of the disease within the U.S., according to reports. Monitor Nurse.com for more information in coming days.
What is the best way for nurses to make sure they are prepared to deal with a possible case of Ebola virus in their healthcare organizations? Stay informed and ask lots of questions, said nurses who work in infectious disease control. The more questions we get and the more people look at the protocols and policies and ask for training, I think the more prepared we can be, said Linda Greene, RN, MPS, CIC, an infection prevention manager at Highland Hospital in Rochester, N.Y., and a former board member of the Association for Professionals in Infection Control and Epidemiology.
Healthcare organizations around the country have increased training and education for healthcare workers to prepare them for the possibility of caring for more patients with the often deadly hemorrhagic virus, according to nursing organizations.
Nurses are taking their responsibilities seriously, said Emergency Nurses Association president Deena Brecher, MSN, RN, APN, ACNS-BC, CEN, CPEN. When she asked 500 ED nurses at a recent ENA conference if they felt comfortable about their ability to screen and isolate potential Ebola patients, and if they knew where to go for resources on the disease, their response was a unanimous yes, she said. We know were the front line, Brecher said. We know we have the responsibility of helping prevent an epidemic in this country.
The Dallas case, in which Thomas Eric Duncan, who passed away Oct. 8, was treated for fever and released two days before he was re-admitted and diagnosed with Ebola, holds serious lessons for healthcare providers, said Laura Buford, BSN, RN, CIC, an infection prevention coordinator at St. Davids South Austin Medical Center in Texas and a member of the communications committee for APIC. Those include keeping the staff informed; making sure people who have the first contact with a patient know to ask the right questions, including travel history and possible contact with someone suspected of having the disease; and flagging any unusual information and bringing it to the healthcare teams attention, she said.
What happened in Texas really underscores what the CDC has been saying that hospitals need to have a plan in place in the eventuality that someone arrives with a travel history and symptoms consistent with Ebola virus, said Nancye Feistritzer, DNP, RN, CNO and vice president of patient care services at Emory University Hospital in Atlanta, which cared for three healthcare workers who contracted Ebola in West Africa and were evacuated to the U.S.
Patients admitted to U.S. hospitals should be suspected of having Ebola and put into immediate isolation if they meet two conditions, according to the CDC: They must have a fever of at least 101.5 degrees, or other Ebola symptoms including headache, muscle pain or vomiting. And they must have traveled from a virus-infected area or made contact with someone with a suspected or confirmed case of Ebola in the last three weeks. Hospitals around the country have reported more than 100 possible cases, according to CDC officials, but only one, Duncan, turned out to have Ebola.
Though APIC has not done a survey of its members, anecdotally, infection control specialists say they are doing much more teaching and training about the disease since the Dallas case, said Liz Garman, a spokeswoman for the organization. Its occupying 100% of their time, she said.
CDC Director Tom Frieden, MD, MPH, and other public health officials have said repeatedly that although the country will probably see more isolated cases of the illness, an Ebola outbreak in the U.S. is extremely unlikely. The disease has killed hundreds of healthcare workers in West Africa, and recently a Spanish nursing assistant contracted the disease in Madrid.
ED nurses had concerns about having enough isolation gear and space to handle an onslaught of Ebola cases, especially in smaller hospitals, which Brecher said is an unlikely situation. During flu season, she said, EDs probably will isolate a fair number of patients who end up not having Ebola, erring on the side of caution. We are going to overcall and we should overcall.
But nurses hope the greatest effect Ebola has on the flu season will be to extend its spotlight to basic infection control practices hand-washing, removing protective equipment appropriately, not touching the face, isolating possibly contagious patients in all settings. ED nurses, herself included, Buford said, tend to think they dont need to (take certain precautions) because theyve been exposed to everything, she said. Its my hope this makes people think, Maybe I do need to be aware, and protect myself and others.