Ebola Thought Leader ThinkTank – Hospital & Clinic Preparedness Takeaways

Our moderated five-day Ebola ThinkTank generated hundreds of pages of actionable insights and recommendations. To capture and summarize the key findings that pertained to hospital and clinic preparedness, we’ve created this infographic. Below are critical excerpts from our Mavens that highlight the key developments in this discussion.

Key Takeaways: Hospital & Clinic Preparedness

Hospital Preparation:

“GNYHA/1199SEIU PQC Ebola Training – October 21, 2014 – Personal Protective Equipment (PPE) Demo: http://gnyha.org/ebolatraining”
– Tony Cappello, PhD

“There is extensive (and recently updated) guidance from the CDC regarding PPE, including step-by-step donning and doffing procedures, training, and information on designated donning and doffing areas: http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html

PPE donning and doffing handouts from UNMC: (only the last handout in each category has updated PPE with hood and face shield): http://app1.unmc.edu/nursing/heroes/ppe_posters_vhf.cfm

Video for donning a Powered Air Purifying Respirator (PAPR): https://www.youtube.com/watch?v=T5knZceQ1xA

Video for doffing PAPR: https://www.youtube.com/watch?v=ls69Tib1PjU

Detailed donning and doffing procedure for PAPR and PPE from the CDC: http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html

Article on PAPR in Anesthesia & Analgesia: Personal_Protective_Equipment_for_Care_of_Pandemic.21 (1).pdf”

– Jeb Kucik

“Infection prevention and control guidance for care of patients in health-care settings, with focus on Ebola from WHO: http://www.who.int/csr/resources/publications/ebola/filovirus_infection_control/en/”
– Jeb Kucik

“Should we think about redesigning PPE to make it easier to don and doff and prevent errors?”
– Stephen S. Morse

“Video for donning a Powered Air Purifying Respirator (PAPR): https://www.youtube.com/watch?v=T5knZceQ1xA”
– Jeb Kucik

“CDC information for Health Care Workers (list of available resources): http://www.cdc.gov/vhf/ebola/hcp/index.html”
– Jeb Kucik

Hospital/Clinic Priorities Today:

“Hospitals and clinics should ensure:

1. They have access to an accredited ambulance service with crews trained in how to handle a suspected case (e.g. use of PPE) and disinfect the vehicle before re-use.
2. Emergency room staff on duty 24/7 trained in receiving suspected cases and if necessary, re-routing the case to a more competent hospital.
3. If re-routing is to far distant hospital, access to an accredited air ambulance (helicopter?) service able to handle highly infectious cases.
4. If Ebola indicated, rapid start of appropriate in-hospital treatment is essential.”

– Jack Woodall
“What I feel must be constantly stressed is attention to detail at the END of patient care – when one is hot, tired, sweaty, and wants to get out of the room. Putting on the (clean) PPE correctly is pretty uncomplicated. Taking off the (infected) PPE without infecting oneself is the real hazard, must always be done with help, and therefore should always have that extra bit of extraordinary vigilance stressed at the conclusion of a patient interaction.”
– Jeb Kucik

“To answer your questions re:  “convincing of the potential threat … head in the sand … ” i would also add that education of the public (and continued education not just flash in pan for current events) is key not only with evidence based specifics regarding the benefits but also helping the populace to know and contribute to their own personal well being and preparedness.  In essence changing the mindset back to self independence as much as possible.”
– Marek Greer

“I would recommend setting up competencies for the medical and nursing personnel specifically for this and any other potentially deadly diseases so that the personnel maintains their skills.”

“There should be principles of decontamination of personnel, patients, and vehicles and recommended safety procedures.”
– David Jaimovich

“Although very basic in principle, for any such response to be effective, much will rely on sound collaboration and communication among a hospital/clinic and their external partners. As there is much that will need to be addressed before, during, and after a case has presented to a hospital, strong communication and collaboration with external partners will be essential (e.g. public health, EMS, Fire, emergency managers, etc). This will better ensure a timely, effective, and safe response.”
– Tony Cappello, PhD

“Triage, staffing, futility of care – all must be discussed effectively (and efficiently) if an administration is going to ask its staff to go in ‘harm’s way.'”
– Jeb Kucik

“The issue here is that, although I agree that we should not be asking first responders to make a diagnosis, they do need to be trained on the signs and symptoms, no different than they evaluate a patient for an MI or for respiratory distress.  What is imperative is that regardless whether it is Ebola, Septic Shock or a Hazmat situation due to possible Anthrax, these staff and all others that come in contact with these patients or situations must be trained to not only treat these patients but protect themselves and those around them. ”
– David Jaimovich