Thank you for the generous contributions from our members providing information on Ebola. A toolkit has been developed to share the tools from their knowledge and expertise. We know this information will be helpful to our employee health professionals. Feel free to provide any different information that is pertinent to managing Ebola. Send your information to AOHP Headquarters at firstname.lastname@example.org.
These are survey findings by National Nurses United – RN Survey: Over 60% of Hospitals Not Ready.
The CDC has provided updated resources and information on its website, including a Checklist for Patients being evaluated for Ebola Virus Disease.
Guidance on Personal Protective Equipment To Be Used by Healthcare Workers During Management of Patients with Ebola Virus Disease in U.S. Hospitals, Including Procedures for Putting On (Donning) and Removing (Doffing) http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html.
Tightened Guidance for U.S. Healthcare Workers on Personal Protective Equipment for Ebola
Health Resources and Services Administration (HRSA) has developed a website http://www.hrsa.gov/ebola/ on Ebola Virus Disease: Information for U.S. Healthcare Workers. This site has lots of great resources on guidelines and procedures that will help you managing Ebola.
Occupational Health is finally listed in one of the CDC guidance documents regarding monitoring movement of persons with potential Ebola exposure!
Joan Kowalczyk, RN, BA/BSN, CIC
Summaries of recent 2014 COCA Ebola Calls can be found on this website: http://emergency.cdc.gov/coca/calls/2014/index.asp
Decision Guide for CDC Consultation and Ebola Virus Disease (EVD) Testing
Detailed Emergency Medical Services (EMS) Checklist for Ebola Preparedness
Ebola Virus Disease (EVD) Consultation Record
Checklist for Patients Being Evaluated for Ebola Virus Disease (EVD) in the United States
CDC's Health Alert Network publishes an advisory to help healthcare professionals evaluate patients for possible Ebola disease
On October 3, the CDC Health Alert Network (HAN) issued a CDC Health Advisory titled Evaluating Patients for Possible Ebola Virus Disease: Recommendations for Healthcare Personnel and Health Officials. The "Summary" section is reprinted below. Other advisory sections that you may wish to consult are titled "Background" and "Recommendations."
The first case of Ebola Virus Disease (Ebola) diagnosed in the United States was reported to CDC by Dallas County Health and Human Services on September 28, 2014, and laboratory-confirmed by CDC and the Texas Laboratory Response Network (LRN) laboratory on September 30. The patient departed Monrovia, Liberia, on September 19, and arrived in Dallas, Texas, on September 20. The patient was asymptomatic during travel and upon his arrival in the United States; he fell ill on September 24 and sought medical care at Texas Health Presbyterian Hospital of Dallas on September 26. He was treated and released. On September 28, he returned to the same hospital, and was admitted for treatment.
The purpose of this HAN Advisory is to remind healthcare personnel and health officials to:
(1) increase their vigilance in inquiring about a history of travel to West Africa in the 21 days before illness onset for any patient presenting with fever or other symptoms consistent with Ebola;
(2) isolate patients who report a travel history to an Ebola-affected country (currently Liberia, Sierra Leone, and Guinea) and who are exhibiting Ebola symptoms in a private room with a private bathroom and implement standard, contact, and droplet precautions (gowns, facemask, eye protection, and gloves); and
(3) immediately notify the local/state health department.
Please disseminate this information to infectious disease specialists, intensive care physicians, primary care physicians, and infection control specialists, as well as to emergency departments, urgent care centers, and microbiology laboratories.
Quick Safety special edition: Assess your organizational readiness for Ebola
According to a recently released special edition of Quick Safety, now is the time to assess the readiness of your organizational response to Ebola Virus Disease. The newsletter provides a signs and symptoms checklist, lists infection prevention and control precautions, and urges organizations to review their infection control mechanisms and emergency operations plan. In addition, links to resources from the Centers for Disease Control and Prevention are provided.
The Greater New York Hospital Association/1199SEIU Healthcare Education Project hosted a live webcast yesterday, which featured a helpful demonstration of donning and doffing PPE with CDC representatives, and interviews with healthcare workers, hospital labor and management, and clinicians.
The following archived materials from the webcast are available at http://gnyha.org/ebolatraining
* Personal Protective Equipment (PPE) Training Demonstration (direct link to download: http://vimeo.com/109626204)
* Full Ebola Educational Session
* “Healthcare Personnel Preparedness for Ebola in the U.S.” presentation by CDC’s Dr. Arjun Srinivasan
Also, APIC hosted an Ebola guidance webinar yesterday. CDC’s Dr. Joseph Perz addressed questions on the new CDC Ebola personal protective equipment guidance, environmental services considerations, and more. An archived presentation is available at http://webinars.apic.org/session.php?id=14754
Each state has a Department of Health and Human Services. Check with your state for their guidance. This is an example of one state’s information.
Preparedness for Wisconsin Clinicians Regarding Possible Ebola Virus Infection among Travelers from West Africa from WI Dept. of Health Services
Information provided by Judy Check RN, COHN-S
Article from New England Journal of Medicine
Information provided by Tracy S. Roth, RN, BSN
New England Journal of Medicine publishes a collection of articles and resources on the Ebola outbreak
The New England Journal of Medicine recently posted a collection of articles and other resources on the Ebola outbreak, including clinical reports, management guidelines, and commentary on an Ebola Outbreak web page. You do not need to be a subscriber to the journal to access the articles from this page.
Recommendations for Evaluating Patients for Possible Ebola Virus Disease
Information provided by Elaine B. Dawson, RN, COHN
Infection Prevention and Control Recommendations for Hospitalized Patients with known or Suspected Ebola Hemorrhagic Fever in U.S. Hospitals http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html
Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure http://www.cdc.gov/vhf/ebola/hcp/monitoring-and-movement-of-persons-with-exposure.html
Fever and Symptom Monitoring Form
Information provided by Joan Kowalczyk RN BA/BSN CIC
Evaluating Patients for Possible Ebola Virus Disease: Recommendations for Healthcare Personnel and Health Officials http://emergency.cdc.gov/han/han00371.asp
Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Virus Disease in U.S. Hospitals
Information provided by June M Duck, RN, BSN, COHN-S
Refer to CDC’s webpage: http://www.cdc.gov/vhf/ebola/hcp/index.html
Ebola Outbreak Storyboard
Ebola Storyboard 2014
Information provided by Marguerite L. Knox, COL, AN, SCARNG
Interview questionnaire for employees who think they were exposed or were having symptoms.
Ebola Procedure EHS1
Ebola Risk Algorithm
Information provided by Rob Clark NP-C, COHN-S
In our electronic medical record (EPIC) in ED triage there is now a question, front & center that prompts the nurse AND the physician to ask the patient if they have traveled outside of the country. The CDC map is available for them & the patient as well. From there they write a narrative note with details.
Every ED staff member is going to go through a mandatory PPE & donning/doffing review. There is also going to be documentation that tracks every single person going into & out of the room.
A cleaning protocol is being worked on based on CDC guidelines/mandates.
Donning & Doffing algorithm
Information Provided by Ilene K. Turner, RN, COHN
EH EVD Screening Tool
Information provided by M. Griselda Bourgeois, RN
We will be using much of the information and adapting forms as published on the Florida Department of Health website. http://www.floridahealth.gov/diseases-and-conditions/ebola/guidance/medical-provider1.html
All patients with suspected Ebola will be placed in a negative pressure ICU and attended to by either an adult or pediatric care team. We’ve put a brief protocol in place for our ambulatory care clinics if those sites have a potentially infected patient (isolate patient, PPE, contact infectious disease MD, infection prevention, and occupational health services). Our emergency departments also have a solid plan in place. The organization will be conducting additional drills and training with staff who will care for Ebola patients regarding PPE, use of PAPRs, etc.
Information provided by Trina Girimont, ARNP, COHN-S/CM
Our Infection Prevention dept. has started training. EHS is now screening any healthcare worker returning from Africa as a precaution BEFORE allowing them to return to work.
Ebola Employee Screening Form
Information provided by JoAnn Shea, ARNP, MS, COHN-S
Ebola Virus Disease Protocol
Information provided by Diane Youngblood RN, BSN, MBA