AN EBOLA CENTER? 11/14/2014. What does it take to be

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1 What does it take to be AN EBOLA CENTER? Dr. Alexander Tomach DNP, RN, CIC Director, Infection Prevention & Control Amelia Bumsted, BA, BSN, RN, CRRN, CIC DNP student: Population-Based Infection Prevention & Environmental Safety Rush University Medical Center, Chicago Loyola University, Chicago 1

2 Ebola Background Ebola Viral Disease (EVD) is an acute illness that is in the family of viral hemorrhagic fevers Incubation period is 2-21 days Ebola is spread via contact with infected blood/body fluids of a symptomatic individual 3 Ebola Background Early symptoms: fever, intense weakness, muscle pain, headache and a sore throat. Later symptoms: vomiting, diarrhea, rashes, impaired liver and kidney function, and in some cases internal and external bleeding. At this time, an individual with these symptoms who also has traveled to an African country where Ebola is present (Guinea, Liberia, Sierra Leone), or had personal contact with someone who has traveled to that area. 4 2

3 Ebola Planning Special multidisciplinary Ebola Emergency Management Committee convened to develop implement preparedness and care activities Subsequent planning committee began meeting daily Focus on finalizing necessary policy/protocols, screening protocol and PPE selection A policy was developed to guide organization with planning efforts. 5 Ebola Policy The policy guides practice for: Screening for cases Identified critical path of patient flow Including protocols for clinics, university and affiliate hospital Personal Protective Equipment (PPE) training and exercise of donning/doffing Lab procedures Waste handling and disposal 6 3

4 Core Team Development To optimize patient and staff outcomes an voluntary core team was established Team is multidisciplinary and is comprised with representation from: Medicine, Nursing, Infection Prevention, Respiratory Therapy, Dialysis and Religion, Health and Human Values 7 Communication Plan Focus was employee awareness and reassurance Multiple well attended town hall meetings were held with panel of experts Infection Prevention and Control website continually updated with latest information Initial daily communication sent to all staff 8 4

5 The Hospital Rush University Medical Center is located in the heart of Chicago s medical district 9 Special Containment Unit Construction completed in the Medical Intensive Care Unit (MICU) and a new isolation unit was built 10 5

6 Special Containment Unit Consists of 3 patient rooms, negative air pressure, PPE donning room, staff room with shower, and additional storage room 11 Special Containment Unit Room with a relaxing view of the Chicago skyline 12 6

7 Training and Education Use of Simulation Lab Practice Donning & Doffing Training and Education Education and drilling of staff is underway for 3 levels of PPE 14 7

8 Level I PPE Gown, mask with face shield, protective visor and gloves. Training and Education Level II PPE Fluid Impervious gown, foot coverings, head covering, mask with face shield, protective visor and gloves. 15 Training and Education Level III PPE Consists of impermeable synthetic suits with gloves, sleeves, foot coverings, head covering and a powered air purifying respirator (PAPR) 16 8

9 Resource Hospital Designation In October the Chicago Department of Public Health (CDPH) in consultation with the Centers for Disease Control, designated Rush University Medical Center as a resource hospital to care for patients that are identified as highly suspicious or confirmed with EVD The resource hospitals collaborate via CDPH regarding preparedness, PPE procurement, training and resource/information sharing 17 What if you are not equipped to be AN EBOLA CENTER? Amelia Bumsted BA, BSN, RN, CRRN, CIC DNP Student: Population-Based Infection Prevention & Environmental Safety Loyola University, Chicago 9

10 We will never see an Ebola patient Epidemiology of the outbreak can shift quickly with a mobile society Risk depends upon your location, specialty, scope of services Plan is necessary in order to coordinate with higher level providers Infrequency of an event or unfamiliarity with policies & procedures has been identified as a serious gap in our healthcare infrastructure Could lead to potential exposures, unnecessary transfers & healthcare waste Ebola as Litmus Test for Readiness EIS investigations of Ebola outbreaks from outbreaks 1976 Congo--showed spread by contaminated needles & syringes as well as hospital spread. Sudan--Many medical workers infected. Recurrence in Sudan of same virus in Congo-- showed lack of containment due to poor quarantine practice 1996 showed spread among those with close contact & caregivers. Ill healthcare worker travelled from Gabon To Johannesburg, South Africa after treating Ebola-infected patients. He was hospitalized, and nurse who took care of him became infected and died. 10

11 Infrastructure What contingencies must be planned for? How will you get your PPE? What type of PPE do you need? How will you dispose of your waste? Who will repair a leaking pipe in the room? Who do you call first? How long will I have to isolate the patient until they are transferred? What does your health department want you to know? Know: HOW to screen WHAT countries are included & what are considered risk factors WHO to call WHEN to call HOW to stay safe HAVE A PLAN! 11

12 What about the PATIENT EXPERIENCE? How do you provide true humanitarian care while remaining safe? 12

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