Regardless of whether a hospital or clinic is treating Ebola patients, the recent outbreak offers a chance for healthcare facilities to ensure they are following proper infection control protocols. That was the sentiment among a panel of national healthcare experts who participated in a Dec. 9 webinar hosted by Premier Inc., a Charlotte, N.C.-based healthcare improvement alliance of about 3,400 U.S. hospitals and 110,000 other providers. More than 1,200 healthcare industry representatives and other professionals attended the webinar, titled Ebola Preparation and Response in U.S. Healthcare Settings.
If nothing else, I hope this webinar will remind everybody that the assumption that everybody knows how to do correct infection control is probably misplaced, said Michael Bell, MD, deputy director of the CDCs division of healthcare quality promotion. This is an important and very good opportunity to pause and reassess training needs and make sure that everyone working with patients or near patients understands their role when it comes to preventing the transmission of infection.
Although more than 18,000 cases of Ebola have been reported globally, proper planning, education and staffing at hospitals and other healthcare facilities can increase awareness and safety during the epidemic, the panelists said.
All of our hospitals are actively preparing to assess and treat patients with Ebola, Gina Pugliese, MS, RN, vice president of Premier Safety Institute and moderator of the webinar, said. We have seen a tremendous effort and response from the [Centers for Disease Control and Prevention] to Ebola with detailed and ongoing release of guidance for clinicians, healthcare organizations and the public.
One issue that has arisen for healthcare facilities is having the right amount of staff available to treat exposed or affected patients. David Henderson, MD, deputy director for clinical care and associate director for clinical quality, patient safety and hospital epidemiology at the National Institutes of Health Clinical Center in Bethesda, Md., said the key was volunteers. The NIH clinical center recently began treating an American nurse exposed to Ebola in Sierra Leone.
We went to our staff and said, Were going to be asked by the federal government to provide care for people who are exposed or infected with this virus. If youre willing to participate sign here, Henderson said. One of the advantages is that you end up with people in the room with the patient who really want to be there, who want to learn from this experience, who want to provide care and have an altruistic motivation, and thats terrific. The downside of that is that sometimes you may not get enough of one category of volunteer. You might not get enough critical care nurses. You might not get enough respiratory therapists.
While finding the right volunteers might require a rush to recruit from specific skill sets, Henderson said other facilities simply remind staff that caring for patients is part of the job. No matter what the approach, the important thing is to keep people informed, he said.
Staff that work in hospitals dont like surprises, Henderson said. They dont want to be surprised by having an Ebola patient land in their lap totally unexpectedly when you knew [he] was coming all along.
In New York, where multiple hospitals were designated as Ebola treatment facilities, the New York City Department of Emergency Management, the citys department of health and the states department of health activated emergency protocols to ready the state for Ebola, said Jeffrey Ashkenase, senior vice president of the Greater New York Hospital Association Services.
While there were a number of things that came up that we hadnt really thought through or hadnt been part of the plan, I think that structure and the communication and coordination systems that were in place were really beneficial, he said. When we started to have to deal with issues of waste or tracking healthcare workers who were returning from overseas or had been treating a patient with Ebola, that kind of structure being in place was really beneficial for us.
Panelists also focused on the use of telecommunications to reduce exposure to the virus. Devices such as tablets and applications such as Skype can help patients communicate with physicians and visitors and prevent excessive donning and doffing of personal protective equipment.
The University of Pennsylvania Health System established a policy restricting family members of Ebola patients from visiting, requiring them to instead rely on wireless devices for communication, said Neil Fishman, MD, the health systems associate chief medical officer.
Still, even with the additional precautions hospitals and governmental agencies are taking to prevent the spread of Ebola in the U.S. some people remain fearful. Both Fishman and Henderson said they had staff who discovered their children would not be able to attend daycare if they volunteered to care for Ebola patients.
As we talk about this very interesting disease, there are two separate epidemics going on, Henderson said. One is the epidemic of Ebola and the other is the epidemic of fear in this country which is probably not warranted.