APIC s ongoing Ebola response

Transcription

1 APIC s ongoing Ebola response BY JANIENE BOHANNON, ms assisting infection preventionists in ebola training and education Ebola Task Force To expedite the development of additional training materials and resources to support you in this heightened time of need, the APIC Board of Directors has authorized the creation of an APIC Task Force on Ebola. The members of the task force are: Carla Alvarado, PhD Research Scientist Emerita University of Wisconsin Madison, Wisconsin Terri Rebmann, PhD, RN, CIC Associate Professor Institute for Biosecurity Saint Louis University, School of Public Health St. Louis, Missouri Judith F. English, PhD, RN, CIC Infection Prevention Consultant Navy Bureau of Medicine and Surgery Falls Church, Virginia Barbara DeBaun, MSN, RN, CIC Cynosure Health San Francisco, California Pamela Falk, MPH, F-SHEA, CIC Infection Prevention Consultant Sandy Springs, Georgia D. Kirk Huslage, RN, BSN, MSPH, CIC Associate Director North Carolina Statewide Program for Infection Control and Epidemiology Durham, North Carolina Training modules for safe PPE use APIC and the Johns Hopkins Armstrong Institute for Patient Safety and Quality have collaborated to create an interactive webbased educational training program focusing on proper personal protective equipment (PPE) use for healthcare personnel caring for patients with Ebola. The program includes educational modules on crucial areas related to healthcare worker safety when caring for patients with Ebola. The modules are designed to help institutions develop in-person training to promote adherence to the recent Centers for Disease Control and Prevention (CDC) guidance on PPE for Ebola. They include a focus on the proper donning of PPE, safe removal of PPE, and the important role of teamwork For the latest Ebola resources and updates from APIC, visit 50 WINTER 2014 Prevention

2 APIC members Simone Almeida, Sibley Memorial Hospital, and Pamela Falk, APIC Ebola Task Force member, are shown during the filming of the Ebola personal protective equipment training for healthcare personnel in October Photo courtesy of the Johns Hopkins Armstrong Institute for Patient Safety and Quality. and the trained observer in keeping healthcare workers safe during these steps. The modules utilize concepts of human factors engineering to address potential safety failures such as limited space in healthcare facilities, exhausted healthcare personnel, and more. At the request of the CDC, APIC and the Johns Hopkins Armstrong Institute for Patient Safety and Quality brought together a 40-member multidisciplinary team of experts from CDC, academic institutions, and professional associations that developed the training program. Pamela Falk, MPH, FSHEA, CIC, an infection preventionist (IP) consultant, acted as APIC s representative. Falk was involved in CDC s Train-the- Trainers courses for healthcare personnel deployed to West Africa and has extensive experience in the proper donning and doffing of PPE. The modules are available on CDC s website at Additional collaboration with CDC APIC recruited experienced infection preventionists (IPs) for Rapid Ebola Preparedness (REP) Assessment Teams to help assess the readiness and provide technical assistance for select Ebola Treatment Centers, developed through the CDC. Several of these have been deployed; the IPs involved have contributed significantly to the teams and have found the experience to be valuable. In addition, APIC was asked to help recruit experienced IPs for CDC teams that will provide immediate assistance for hospitals with confirmed Ebola patients. Interactive education APIC launched a new Ebola Q&A series of live webinars to help address inquiries regarding Ebola prevention and control. The first Q&A session was held on October 31 and focused on donning and doffing PPE while managing patients with Ebola virus disease. APIC Communications Committee Member Barbara Smith, RN, BSN, MPA, CIC, facilitated this 45-minute presentation and discussion. The next Q&A session on November 7 focused on Ebola preparation for outpatient settings; Marcia Patrick, RN, MSN, CIC, presented. The November 14 presentation focused on Developing an Ebola Center What does it take? And what if you are not equipped to be an Ebola center? and was presented by Alexander Tomich, DNP, RN, CIC, director of Infection Prevention and Control, Rush University Medical Center and Amelia Bumsted, BA, BSN, RN, CRRN, CIC, DNP student: Population-Based Infection Prevention & Environmental Safety, Loyola University. On December 5, Kim Delahanty, BSN, PHN, MBA/HCM/CIC, administrative director Infection Prevention Clinical Epidemiology, UC San Diego Health System presented a webinar on Ebola Waste Management. On December 12, Kathy Aureden, MS, MT(ASCP), SI, CIC, presented on Ebola laboratory considerations for patient diagnosis and management. Additionally, during International Infection Prevention Week on October 21, APIC hosted an Ebola guidance webinar presented by Joseph Perz, DrPH, MA, of CDC. To access archived Ebola webinars, visit APIC Consulting activities Almost immediately, APIC Consulting received requests for Ebola-related PPE training and readiness planning. To respond to this need, APIC Consulting designed an in-person training course that can be tailored for state health departments, state hospital associations, hospital systems and individual facilities, and began delivering the live course in early November. Its team of consultants, some of whom have been trained by the CDC on Ebola-specific PPE guidance, are board certified IPs located across the country. In addition to the training course, webinars were made available for Ebola-readiness in ambulatory, ASC, and urgent care settings, as well as in physician offices. Readiness checklists were also made available to participants. For more information, visit continued on page

3 Bryan Christensen, PhD, epidemiologist of the CDC Domestic Infection Control Team for the Ebola Response (left) and Barbara A. Smith, BSN, MPA, CIC, APIC Communications Committee member and nurse epidemiologist of the Division of Infection Control and Epidemiology at Mount Sinai St. Luke s Hospital and Mount Sinai Roosevelt Hospital in New York, New York, demonstrate hand hygiene and the proper donning and doffing of personal protective equipment (PPE) during live Ebola PPE demonstration organized by the Greater New York Hospital Association/1199SEIU on October 21. PHOTO IS USED WITH THE PERMISSION OF 1199SEIU. COPYRIGHT BELINDA GALLEGO. APIC STATEMENTS AND CALLS TO ACTION On October 16, APIC issued a general statement on the Ebola situation, emphasizing the need to strengthen protocols, adherence, and protection for the healthcare personnel working directly in the highest risk areas where exposure to bodily fluids is high. In addition to outlining APIC s role in Ebola response, the statement also pointed out the need for healthcare facilities to have adequately trained, staffed, and resourced infection control departments. Subsequently, APIC collaborated with the Association for the Advancement of Medical Instrumentation and others to develop a joint statement on processing biohazardous medical waste from patients with Ebola. The statement was released on October 23. To assess member needs and better understand how to help, APIC asked its members to take an Ebola readiness survey in October The survey asked members, How prepared is your facility to receive a patient with the Ebola virus? APIC publicly released the results of the survey on October 24 via a media briefing. The survey results indicated that of the 1,039 U.S.-based respondents working in acute care hospitals, about 6 percent reported their facility was well-prepared, while about 5 percent said it was not prepared. The remaining responses reported various levels of preparedness in between the two extremes, with the majority (40 percent) indicating they were somewhat prepared. Survey responses were received from hospitals that ranged in size from less than 100 to more than 400 beds. According to the survey, one in two hospitals (51 percent) had only one or less than one full-time equivalent IP on staff. Among hospitals with zero to one IP on staff, 4 percent felt well-prepared to receive a patient with the Ebola virus, compared to 31 percent of survey respondents with 11 or more IPs on staff. During the media briefing and in its news release, APIC called on healthcare facilities to assess their infection prevention programs by looking at all the care and services provided by the institution and determining the appropriate level of personnel and resources necessary to meet the increased need. APIC urges facilities to focus 52 WINTER 2014 Prevention

4 on three aspects of infection prevention in order to effectively protect healthcare workers, patients, and the public. ❶ Personnel: Because Ebola readiness demands intense, in-person training and drilling led by infection prevention experts, adequate infection prevention staffing is critical. ❷ Training: To ensure that guidelines are followed precisely 100 percent of the time, healthcare workers must be trained and drilled on safety protocols so they can demonstrate proficiency in essential infection control practices. ❸ Technology and equipment: To maximize efficiencies and provide real-time data to help IPs detect and control infectious diseases, healthcare facilities must invest in infection tracking and monitoring technology. On October 26, APIC issued a statement in response to the mandatory quarantine of asymptomatic healthcare providers who have treated patients with EVD. APIC s statement noted the following: While APIC understands public concerns, it does not support mandatory quarantine of healthcare providers with no symptoms of Ebola who have treated patients with EVD. The evidence is clear that individuals are not infectious until they show symptoms of the illness. Ebola can only be transmitted by contact with blood and body fluids of an individual who is exhibiting symptoms of the illness and is not transmitted through the air. It is important to be guided by the scientific evidence, and apply the lessons learned so far from other experiences, including the fact that even family members who were in close contact with Mr. Duncan in Dallas have not gotten sick. APIC believes that quarantining healthcare professionals returning from caring for Ebola patients in West Africa will deter potential healthcare volunteers and lead to increased difficulty in assembling care teams in West Africa and the U.S. Forced quarantines of healthcare workers with no symptoms of Ebola who have risked their lives to protect others are unnecessarily harsh and are not aligned with scientific evidence. Quarantines may affect the healthcare worker s ability to make a living and may also have negative emotional and social consequences as a result of being stigmatized for their service. Additionally, APIC, the Society for Healthcare Epidemiology of America (SHEA), the Infectious Disease Society of America (IDSA), the Pediatric Infectious workers returning from Ebola-stricken countries in West Africa. Disease Society (PIDS), the HIV Medicine Association (HIVMA), and the Center for Global Health Policy issued a joint statement on October 31 reinforcing their opposition to mandatory quarantines being imposed on asymptomatic healthcare continued on page 54 Barbara A. Smith, BSN, MPA, CIC, APIC Communications Committee member and nurse epidemiologist of the Division of Infection Control and Epidemiology at Mount Sinai St. Luke s Hospital and Mount Sinai Roosevelt Hospital in New York, New York, demonstrates the proper removal of personal protective equipment (PPE) during live Ebola PPE demonstration organized by the Greater New York Hospital Association/1199SEIU on October 21. PHOTO IS USED WITH THE PERMISSION OF 1199SEIU. COPYRIGHT JIM TYNAN/1199SEIU. 53

5 Left to right: Mike Rosen (Johns Hopkins Armstrong Institute for Patient Safety and Quality), Bill Bridges (APIC), Myles Leslie (Johns Hopkins Armstrong Institute for Patient Safety and Quality), Aaron Dietz (Johns Hopkins Armstrong Institute for Patient Safety and Quality), and Caroline Fuchs (APIC) are shown collaborating on the development of the Ebola personal protective equipment training for healthcare personnel. Photo courtesy of the Johns Hopkins Armstrong Institute for Patient Safety and Quality. COMMUNICATION AND SUPPORT Media relations Since the crisis began, APIC has facilitated more than 30 media interviews with APIC experts, resulting in nearly 200 articles in the news media quoting APIC positions and experts. Linda Greene, Jennie Mayfield, and Katrina Crist served as primary spokespeople around the readiness survey. Members of APIC s Communications and Emergency Preparedness committees including Barbara Smith, Laura Buford, and Jill Holdsworth also fielded media calls. As a result of this, APIC has received coverage in multiple media outlets, including NPR, NBC News, the Washington Post, USA TODAY, TIME, Newsweek, Yahoo! News, HealthDay, Fox News, NY Daily News, Bloomberg Businessweek, National Geographic, Scripps News Service, Modern Healthcare, Medscape, MedPage Today, the American Nurse, Nurse.com, FierceHealthcare, and other outlets. Ebola update s from Katrina Crist, APIC CEO To help keep APIC members informed about the latest updates on the Ebola situation and APIC s response, APIC CEO Katrina Crist, MBA, has provided daily (and subsequent biweekly) s with links to new CDC guidelines, resources from other public health organizations, educational opportunities and trainings through APIC and other organizations, APIC position statements, collaborations with other organizations, and additional APIC Ebola activities. All of Crist s s are posted at Topic-specific-infection-prevention/Ebola. Dedicated Ebola web page Understanding how important it is to ensure APIC members have access to the latest Ebola resources and information, APIC developed an Ebola web page to assist in preparedness. APIC s Ebola resources page features links to publications, webcasts, guidelines, videos, tools, and other resources from both APIC and other credible government and public health organizations at Topic-specific-infection-prevention/Ebola. APIC also worked with the CDC to post a live stream of the latest CDC resources on its site. APIC s Ebola resource page. Care packages To show support for the infection prevention teams at Texas Health Presbyterian Hospital in Dallas, APIC sent care packages with messages of support, goodies, and other comforting items. APIC is dedicated to ensuring its members have appropriate guidance and infection control resources for Ebola. Thank you for your feedback to let us know how we can meet your needs. For the latest Ebola resources and updates from APIC, visit 54 WINTER 2014 Prevention