Addressing infection prevention and control in the first U.S. community hospital to care for patients with Ebola virus disease: context for national recommendations and future strategies

Details

• Personal Author:
  Choi MJ ; Chung WM ; Cummings, Kristin J. ; De Perio, Marie A. ; Esswein, Eric J. ; Harney, Joshua M. ; Lakey DL ; Liddell AM ; Rollin PE
• Description:
  Health care personnel (HCP) caring for patients with Ebola virus disease (EVD) are at increased risk for infection with the virus. In 2014, a Texas hospital became the first U.S. community hospital to care for a patient with EVD; 2 nurses were infected while providing care. This article describes infection control measures developed to strengthen the hospital's capacity to safely diagnose and treat patients with EVD. After admission of the first patient with EVD, a multidisciplinary team from the Centers for Disease Control and Prevention (CDC) joined the hospital's infection preventionists to implement a system of occupational safety and health controls for direct patient care, handling of clinical specimens, and managing regulated medical waste. Existing engineering and administrative controls were strengthened. The personal protective equipment (PPE) ensemble was standardized, HCP were trained on donning and doffing PPE, and a system of trained observers supervising PPE donning and doffing was implemented. Caring for patients with EVD placed substantial demands on a community hospital. The experiences of the authors and others informed national policies for the care of patients with EVD and protection of HCP, including new guidance for PPE, a rapid system for deploying CDC staff to assist hospitals ("Ebola Response Team"), and a framework for a tiered approach to hospital preparedness. The designation of regional Ebola treatment centers and the establishment of the National Ebola Training and Education Center address the need for HCP to be prepared to safely care for patients with EVD and other high-consequence emerging infectious diseases. [Description provided by NIOSH]
• Subjects:
  Communicable Diseases Engineering Health Personnel Occupational Health Personal Protective Equipment Safety
• Keywords:
  Administrative Controls Ebola Virus Disease Engineering Controls Health Care Personnel Health Care Workers Infection Control Infection Prevention Infectious Agents Infectious Diseases Infectious Waste Medical Personnel Medical Waste Personal Protection Personal Protective Equipment

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• ISSN:
  0003-4819
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Colorado ; Georgia ; Ohio ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 5 ; OSHA Region 6 ; OSHA Region 8 ; Texas ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division ; WSD - Western States Division ; DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  41-49
• Volume:
  165
• Issue:
  1
• NIOSHTIC Number:
  nn:20048329
• Citation:
  Ann Intern Med 2016 Jul; 165(1):41-49
• Contact Point Address:
  Kristin J. Cummings, MD, MPH, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1095 Willowdale Road, MS 2800, Morgantown, WV 26505
• Federal Fiscal Year:
  2016
• NORA Priority Area:
  Services
• Peer Reviewed:
  True
• Source Full Name:
  Annals of Internal Medicine
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:3e8f8264152ac384df62135e012eaa4147a428f016876d8c4bb1a61421f21e07e6dcd01c909992a5995421735b3e0102510ac136039a29f0d433abc70f153748
• Download URL:
  https://stacks.cdc.gov/view/cdc/203103/cdc_203103_DS1.pdf
• File Type:
  [PDF - 731.61 KB ]