North Texas hospitals and neighborhood clinics are stepping up training efforts to ensure that workers are ready to deal with Ebola patients.
“We did a drill last week. We, like everybody else, have a heightened awareness of this,” said Carrie Hecht, a registered nurse and director of emergency management at John Peter Smith Hospital in Fort Worth. Employees of Tarrant County’s publicly funded hospital system conducted drills last week to make sure they are prepared to respond if patients come in with Ebola-like symptoms.
The U.S. Centers for Disease Control and Prevention is calling for increased training not only in Dallas-Fort Worth, but nationwide, after Sunday’s revelation that a healthcare worker at Texas Health Presbyterian Hospital Dallas contracted Ebola while caring for Thomas Eric Duncan, who died there of the virus Wednesday.
The unidentified worker was exposed to the lethal virus even though she wore protective gear while performing the duties. She is the first person known to have contracted the disease in the United States.
The drills at JPS include wearing protective gear such as face masks, gloves and foot coverings, and simulating moving a patient to an isolation room, Hecht said. Employees used a “buddy system” to help each other put on and take off their gear, she said. Removal of gear was identified Sunday by the CDC director, Dr. Tom Frieden, as a “major area for risk.”
The exercises were conducted not only at John Peter Smith’s main campus south of downtown Fort Worth, but also at all 15 community health centers, spokeswoman J.R. Labbe said.
National nurses’ group concerned
While local healthcare professionals sought to assure the public that they’re properly equipped and trained to deal with Ebola patients and prevent the disease from becoming an epidemic in the U.S., one nurse advocacy group says weaknesses in hospitals’ ability to respond to an outbreak are being exposed.
National Nurses United, with headquarters in the Washington, D.C., area, is receiving “steady reports from nurses at multiple hospitals who are alarmed at the inadequate preparation they see at their hospitals,” Executive Director Ann DeMoro said in a statement.
“The time to act is long overdue,” she said.
The group is calling for hospitals nationwide to immediately put an emergency preparedness plan for Ebola into place. Of more than 1,900 nurses who responded to a nationwide survey, 76 percent said their hospital hasn’t communicated to them a policy regarding potential admission of Ebola-infected patients, DeMoro said.
Also, 37 percent of respondents said their hospital doesn’t have enough eye protection, and 36 percent say their employer lacks fluid-resistant gowns.
A lack of equipment hasn’t surfaced as an issue in North Texas, officials said.
JPS has enough protective equipment and is familiar with isolating patients for numerous illnesses far more common than Ebola, including influenza, Labbe said.
JPS is aware of the CDC guidelines for isolating patients with Ebola-like symptoms but conducted the training on its own, using its own guidelines, Hecht said.
The federal agency has guidelines for hospitals and 911 emergency drills, quarantine rules, even details like checking to make sure that plastic body bags meet the minimum thickness of 150 micrometers.
The need for better training is quickly becoming a national issue.
Cities work on responses
In cities with large West African populations like Philadelphia, Boston and New York, health department decision-makers are scrambling to come up with specific recommendations for how to deal with Ebola, Reuters reported. Previous emergency management plans for handling Ebola were largely based on generic recommendations for everything from hurricanes to terrorist attacks.
“It takes a certain amount of reverse engineering to get the plan to where it can respond to new, emerging threats,” said political scientist Chris Nelson, an expert on public health systems at Rand Corp.
The CDC stepped up its training at Texas Health Presbyterian Hospital Dallas several days ago, Frieden said Sunday during a news briefing. The agency is still investigating precisely what led to the worker contracting Ebola. The investigation is focusing on performance of kidney dialysis and respiratory intubation, procedures that are considered high-risk because they can spread contaminated body fluids, he said.
“The care of Ebola can be done safely, but it is hard to do it safely,” he said.
While the Ebola outbreak that has killed more than 4,000 people in West Africa is a global story, the health scare has included multiple Texas aspects.
Dr. Kent Brantly, who contracted Ebola in the summer while doing missionary work in Liberia, lived in Fort Worth for five years while doing his residency at JPS.
On Wednesday, Duncan died at Texas Health Presbyterian Hospital Dallas after traveling to the Metroplex from Liberia, where he was believed to have contracted the Ebola virus while trying to help a pregnant woman who was ill.
Then on Sunday, officials said the worker who had cared for Duncan had tested positive for the virus.