9 things to consider with US Ebola prevention in hospitals

With the recent Ebola outbreak in the Congo, many U.S. hospitals are evaluating their ability to diagnose, treat, contain and craft a disease plan.  

Jennifer Rainer, RN, PhD candiate, was the senior director of quality, patient safety and infection prevention at Texas Health Dallas during the diagnosis and treatment of three U.S.diagnosed Ebola patients in 2014 and led the hospital's comprehensive performance improvement plan for future emerging diseases.

Here are nine things she wants you to consider:

1. The process of notifying and communicating with important hospital staff, such as lab leadership, is crucial to preventing further outbreak. "That gray time of initial decision-making has the greatest potential for delays in patient treatment while clinical staff and leaders decide how to protect staff from exposure," she writes.

2. Proper training of hospital staff is critical to patient treatment and limiting the outbreak.

3. Have critical care physicians treat the patients with the emerging disease from the start, even if the patient is not yet critically ill. Also consider that those physicians treating the ED patient should not see other patients. Extra staffing maybe required, which can be a financial burden.

4. It is possible that staff on duty in the hospital with the quarantined patient should not return to their families, at least right away, due to exposure.

5. Waste management is another means of protecting hospital staff and everyone outside of the quarantine. Ebola waste is considered class A and requires a department of transportation permit to carry to another state, Rainer writes. Until the hospital is able to obtain permits to properly dispose of the waste, leaders must decide where to store it.

6. Due to the emergent nature of the disease, a hospital will more than likely host local or governmental authorities, both of which will ask who is in charge. Make sure to include who will be in charge of the necessary duties outlined in a protection plan.

7. It is important to ensure the EHR is up to date with screening questions and will make doing the right thing easy for staff.

8. Assess what resources are available and ensure the facilities can accommodate an Ebola patient. A one-directional ante room, patient room, dirty room and shower, as well as a telemetry monitor so staff can monitor the patient in question while limiting time in the room, are all crucial to treating Ebola patients.

9. Plan for care of hospital staff after the quarantine is lifted. Provide employee assistance and critical incident debriefing sessions.

More articles on clinical leadership and infection control: 

Confirmed Ebola cases in Congo spikes to 39
Ebola workshop for health leaders set for August in Atlanta
WHO chief hesitant to call preemptive victory against Ebola outbreak

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