Calling the Shots: Nursing News and Notes

Is Your Hospital Prepared for an Ebola Patient?

Is Your Hospital Prepared for an Ebola Patient?

Thursday, October 2, 2014
Is Your Hospital Prepared for an Ebola Patient?

The World Trade Center attack of September 2001 revealed a need to assess hospitals’ readiness for various disasters.  Since then, outbreaks such as the H5N1 avian flu, which was responsible for 248 human deaths in Asia and Africa, and natural disasters such as Hurricane Katrina, created more concern about whether hospitals were prepared to act as frontline facilities, assessment and/or treatment centers in the event of a crisis.

Now, the Centers for Disease Control and Prevention (CDC) is offering guidance to assist state and local health departments, acute care hospitals, and other emergency care settings (including urgent care clinics) in the development of preparedness plans for patients with possible Ebola Virus Disease (EVD). Acute healthcare facilities can serve one or more of three roles:

  • Frontline healthcare facilities
  • Ebola assessment hospitals
  • Ebola treatment centers

Certain healthcare facilities across the state may be designated to serve in one of three suggested roles outlined in the CDC guidance document. Not every state is obligated to adopt a three-tiered approach; however, all states are strongly encouraged to identify Ebola assessment hospitals that can successfully manage a suspected or confirmed case of Ebola while awaiting transfer to an Ebola treatment center, or until an EVD diagnosis is ruled out. Some hospitals may need to be prepared to serve in more than one role (e.g., as an Ebola assessment hospital and also as an Ebola treatment center).

Most U.S. hospitals with emergency departments fall into the “frontline healthcare facilities” tier. As such, the CDC guidelines say that these facilities should work with state and local healthcare agencies to be able to:

  • Rapidly identify and triage patients with relevant exposure history AND signs or symptoms of EVD
  • Immediately isolate any patient with relevant exposure history and signs or symptoms compatible with EVD, and take appropriate steps to adequately protect staff caring for the patient, including appropriate use of personal protective equipment (PPE)
  • Immediately notify the hospital/facility infection control program, other appropriate facility staff, and the state and local public health agencies that a patient has been identified who has relevant exposure AND signs or symptoms compatible with EVD
  • For patients who have a higher probability of EVD or who are more severely ill, frontline healthcare facilities should consider immediately transferring the patient in accordance with the state’s plan to either an Ebola assessment hospital or an Ebola treatment center that can provide Ebola testing and care for the higher risk patients until an Ebola diagnosis is either confirmed or ruled out. Such plans should ensure that transport providers are aware of the patient’s status and have appropriate training and PPE to safely transport a patient to a treatment center.
  • Ensure there is no delay in the care for these patients by being prepared to test, manage, and treat alternative etiologies of febrile illness (e.g., malaria in travelers) as clinically indicated.

Nurses will play a critical role in each facility’s preparedness for Ebola patients, and should be deeply involved in developing plans and procedures. Has your healthcare facility developed a networked approach to the evaluation, care, and testing of persons under investigation for EVD, including specific plans for the transfer and treatment of patients with confirmed EVD? If your facility should need to care for a suspected Ebola patient, is there an internal and external communications in place to share appropriate information in a coordinated way?

Tell us in the comments below if you think your facility is a frontline EVD center for assessment, treatment, or both, and if you think it is adequately prepared for its role.

 

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