EBOLA VIRUS DISEASE PREPAREDNESS

Screening, Detection & Planning

Assumptions

• P/SL will only have 1 potential Ebola patient at a time– With more than 1 patient the plan would be altered

• Ebola is transmitted through contact with infectious droplets and contact with body fluids

• Donning and doffing of PPE presents the highest risk of exposure to healthcare workers

• Limit staff and physicians in the room to essential personnel only

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EBOLA BACKGROUND

Predominantly in West AfricaHIGH RISK Countries = Liberia, Sierra Leone, Guinea Medium Risk Countries = Democratic Republic of Congo (DRC), Republic of Congo (ROC), Uganda, Senegal, Gabon, Ivory Coast, South Sudan, NigeriaLow Risk= Other African countries

Understanding the GeographyPatients are screened for recent travel outside of the US. It’s important to know which areas of the world currently present the highest risk

Ebola Symptoms

Symptoms may appear from 2 to 21 days after exposure, average is 8 to 10 days.Initial Signs

– Fever (at least 100.4°F)– Weakness & exhaustion – Pain

• Severe headache• Muscles & joints• Abdominal pain

– Sore throat– Nausea– Dizziness

Ebola Transmission

Should I be concerned?

• HCA/HealthONE & PSL Leadership and Physicians are implementing best practices across the system.

• Our priority is the health and safety of our patients, employees, physicians, and the community.

• Anticipate additional communication, education and training as we continue to prepare

• The initial step of SCREENING & DETECTION is essential and your role is very important

First Point of Contact Infectious Disease Screening

• Patient registration staff all have infectious disease and Ebola risk screening questions on Meditech.

• Will immediately notify Infection Prevention and appropriate staff if patient screens positive for Ebola risk.

• Screening questions also in Meditech for nursing staff during assessment.

First Point of Contact Infectious Disease Screening

• Emergency Department Screening 100% of patients and visitors – Security completes screening form • If positive, Security contacts ED staff– Patient is masked– Asked to wait in wheelchair for ED staff

• If negative, form is given to patient or visitor

Levels of Isolation• Level 1 ( Possible Ebola):

– Airborne and Contact Isolation– Gown, gloves, N95

• Level 2* (Probable Ebola):– Impermeable gown– 3 layers of gloves– N95 or PAPR hood– Face shield– Surgical hood– Boot covers

*For patients with advanced disease including uncontrollable vomiting and diarrhea that cannot be contained use Tyvek suits with impervious apron and option of PAPR hood

If, at any time, a patient is deemed high risk for Ebola Virus, initiate Level II Isolation immediately.

Patient’s Infectious Disease Screen positive for travel history, exposure, and/or

symptoms

Put Patient in Level I isolation (contact &

airborne)

Page Infection Prevention through PBX

Travel history, exposures, onset date, symptoms,

and any pertinent clinical information

Infection Prevention to Call CDPHE

CDPHE to determine index of suspicion and

initiate testing

Infection Prevention to notify ED

Infection Prevention to initiate Level II

Isolation

R/O Ebola Not Ebola

House Supervisor AOC Physician Leadership

Notify:Receiving Unit

LabRadiology

EVSFANSRT

Other Related Departments

Evaluate need to activate Incident

Command

Notify Dr. Quach and Dr Terra

Provide

To Notify

If physician has high clinical

suspicion, initiate Level II Isolation

Location of Care

• All patients will be cared for in ICU setting– Ideal location equipped with:• Negative pressure room • Sink outside door to patient room• Anterooms no longer required or needed for negative

air pressure rooms due to more efficient design.

– Location isolated from other patients if possible– Locations may vary within hospitals.• All PSL patients will be in room 15 in the ICU with

dedicated equipment stored in room 14

Established Protocols for:

• Personal Protective Equipment ( PPE) donning and doffing

• Environmental cleaning• Waste management• Laboratory• Specimen Transport• Patient transport