December 15, 2017
Is your hospital or clinic ready for an Ebola outbreak?

Is your hospital or clinic ready for an Ebola outbreak? Nurses must be at the forefront of developing a workplace strategy to combat an Ebola outbreak.  This strategy should cover from the minute a patient enters your healthcare work area to when they are discharged.  OPEIU Nurses Council encourages each of our nurse/union leaders to be at the forefront of developing these policies and strategies.   Health and safety issues are a mandatory bargaining issue.  The union must insist that employers sit down with the union and discuss how to limit Ebola exposure.

At a minimum the union should insist on:

  •  Full-body hazmat suits that meet the American Society for Testing and Materials F1670 standard for blood penetration and the ASTM F1671 standard for viral penetration.  No skin should be exposed or unprotected

  • Air Purifying respirators with a protection factor of at 50 or greater

  • A dedicated team of nurses who are trained in the intricacies of taking care of a patient who has been diagnosed or is suspected to have contracted Ebola.

  • Continuous and interactive training for all nurses RNs who are on the dedicated Ebola team. 

  • Continuous and interactive training for all nurses in donning and doffing hazmat suit.

  • Compensation for any nurse who is infected or exposed to Ebola, if it results in the loss of wages.

  •  The employer will pay for any medical testing or any medical cost that are result from Ebola exposure.

  • The employer must development of a door to discharge plan for the patient, their family members and healthcare staff.

Your employer may not want to include the union in the development of their Ebola plan.  All nurses must insist on having a voice in the care of the patient and staff during the admission of an Ebola patient.  You must insist that your workplace is ready and that there are protections for those you represent in place.

CDC Guidelines for Ebola patient care

GUIDELINES FOR THE FRONT LINE STAFF

ASSESS:

If patient has fever, ask:

  1. If patient has traveled to Guinea, Sierra Leone, Nigeria, Liberia (West Africa) in the past 21 days, OR
  2. Taken care of anyone else who is ill who has traveled to the above locations within the past 21 days,
  3. In addition to fever, patients may have:
  • Severe headache
  • Diarrhea
  • Vomiting
  • Stomach pain
  • Rash
  • Chest pain
  • Difficulty breathing
  • Difficult swallowing
  • Bleeding inside and outside of the body

NOTIFY:

Notify physician-in-charge immediately (ID and Infection Control will be notified)
DO NOT COLLECT SPECIMEN PRIOR TO SPEAKING WITH ID Physician and Laboratory Director

ISOLATE:

  1. Place patient in private room with private bathroom or own commode, and keep the door closed. (Place in a negative pressure room if anticipating aerosol-generating procedures).
  2. Place patient on Contact and Droplet Isolation.

PROTECT STAFF AND OTHER PATIENTS

  1. Use fluid-impermeable PPE – gowns, gloves, mask, face shields, eye protectors, and shoe covers – when in the patient’s room.
  2. Remove and dispose of contaminated PPE before leaving the room.
  3. Perform hand hygiene per policy
  4. Use dedicated equipment or disposable if any
  5. Restrict staff to essential personnel only
  6. Restrict and screen visitors
  7. Maintain a log of persons entering the patient’s room
  8. Restrict patient's movement from the room

CLEAN PAITENT'S ROOM PER POLICY

About Ebola

Ebola is a highly contagious viral illness, spread by direct contact with body fluid(s)—such as urine, saliva, blood, breast milk, semen, etc.—from an infected individual, which is characterized by the sudden onset of fever and malaise, along with other symptoms such as myalgia, headache, vomiting and diarrhea. In severe and fatal forms, multiorgan dysfunction develops, including liver and kidney damage and central nervous system involvement, leading to shock and death. Experimental research is underway to determine the effectiveness of ZMapp—an experimental treatment was given to seven infected healthcare workers; five of them have survived the deadly illness. To date, no human trials with ZMapp have taken place to assess its efficacy in treating EVD. Until this is determined, no cure for the illness exists.
 
The Ebola virus incubates from two to 21 days before the disease becomes evident, making it very difficult to screen effectively for symptoms as individuals move about in their travels.

The Centers for Disease Control and Preparedness has developed guidelines for hospital readiness and an algorithm that guides the triage nurse or physician in knowing when to immediately isolate suspect cases, and which steps to take once suspicion is aroused.

CDC Resources: