Lessons Learned From Hospital Ebola Preparation

2015 ◽  
Vol 36 (6) ◽  
pp. 627-631 ◽  
Author(s):  
Daniel J. Morgan ◽  
Barbara Braun ◽  
Aaron M. Milstone ◽  
Deverick Anderson ◽  
Ebbing Lautenbach ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Ebola Virus ◽  
Virus Disease ◽  
The United States ◽  
Routine Care ◽  
Lessons Learned ◽  
Convenience Sample ◽  
Control And Prevention ◽  
Prevention Activities ◽  
Healthcare Epidemiology

BACKGROUNDHospital Ebola preparation is underway in the United States and other countries; however, the best approach and resources involved are unknown.OBJECTIVETo examine costs and challenges associated with hospital Ebola preparation by means of a survey of Society for Healthcare Epidemiology of America (SHEA) members.DESIGNElectronic survey of infection prevention experts.RESULTSA total of 257 members completed the survey (221 US, 36 international) representing institutions in 41 US states, the District of Columbia, and 18 countries. The 221 US respondents represented 158 (43.1%) of 367 major medical centers that have SHEA members and included 21 (60%) of 35 institutions recently defined by the US Centers for Disease Control and Prevention as Ebola virus disease treatment centers. From October 13 through October 19, 2014, Ebola consumed 80% of hospital epidemiology time and only 30% of routine infection prevention activities were completed. Routine care was delayed in 27% of hospitals evaluating patients for Ebola.LIMITATIONSConvenience sample of SHEA members with a moderate response rate.CONCLUSIONSHospital Ebola preparations required extraordinary resources, which were diverted from routine infection prevention activities. Patients being evaluated for Ebola faced delays and potential limitations in management of other diseases that are more common in travelers returning from West Africa.Infect Control Hosp Epidemiol 2015;00(0): 1–5

Healthcare Epidemiology is the Paradigm for Patient Safety

2002 ◽  
Vol 23 (1) ◽  
pp. 47-51 ◽  
Author(s):  
William E. Scheckler
Keyword(s):  
Patient Safety ◽  
The United States ◽  
Lessons Learned ◽  
Institute Of Medicine ◽  
Hospital Epidemiology ◽  
Making A Difference ◽  
Control And Prevention ◽  
Quality Of Medical Care ◽  
Healthcare Epidemiology

I was honored to receive the 2001 Lectureship Award from the Society for Healthcare Epidemiology of America (SHEA). It was my intent during the talk to review our field and implications that some of the new initiatives called “patient safety” have for our expertise. This article is based on the SHEA Lectureship that was given April 1, 2001, at the SHEA Annual Meeting in Toronto, Ontario, Canada.This article consists of four sections. First, I review lessons learned from colleagues during the 33 years that I have been associated with the field of hospital epidemiology and infection control, since my first days at the Centers for Disease Control and Prevention (CDC). Second, I explore issues raised by the Institute of Medicine (IOM) report on patient safety, adverse events, and medical errors, evaluating research that went into the extrapolation of the numbers of preventable deaths that this report highlighted. Those deaths gained everyone's attention. Third, I review the field of healthcare epidemiology, highlighting the three decades of success in our field in enhancing the safety of patients, improving their outcomes, and making a difference in the quality of medical care received in the United States. Finally, I discuss the challenges that hospital epidemiology currently faces and the opportunities that come with the expertise we have developed during more than 30 years.

Current Capabilities and Capacity of Ebola Treatment Centers in the United States

2015 ◽  
Vol 37 (3) ◽  
pp. 313-318 ◽  
Author(s):  
Jocelyn J. Herstein ◽  
Paul D. Biddinger ◽  
Colleen S. Kraft ◽  
Lisa Saiman ◽  
Shawn G. Gibbs ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Virus Disease ◽  
The United States ◽  
Ebola Virus Disease ◽  
Treatment Center ◽  
Disease Treatment ◽  
Control And Prevention ◽  
Infectious Waste ◽  
Electronic Spreadsheet ◽  
Us Census

OBJECTIVETo describe current Ebola treatment center (ETC) locations, their capacity to care for Ebola virus disease patients, and infection control infrastructure features.DESIGNA 19-question survey was distributed electronically in April 2015. Responses were collected via email by June 2015 and analyzed in an electronic spreadsheet.SETTINGThe survey was sent to and completed by site representatives of each ETC.PARTICIPANTSThe survey was sent to all 55 ETCs; 47 (85%) responded.RESULTSOf the 47 responding ETCs, there are 84 isolation beds available for adults and 91 for children; of these pediatric beds, 35 (38%) are in children’s hospitals. In total, the simultaneous capacity of the 47 reporting ETCs is 121 beds. On the basis of the current US census, there are 0.38 beds per million population. Most ETCs have negative pressure isolation rooms, anterooms, and a process for category A waste sterilization, although only 11 facilities (23%) have the capability to sterilize infectious waste on site.CONCLUSIONSFacilities developed ETCs on the basis of Centers for Disease Control and Prevention guidance, but specific capabilities are not mandated at this present time. Owing to the complex and costly nature of Ebola virus disease treatment and variability in capabilities from facility to facility, in conjunction with the lack of regulations, nationwide capacity in specialized facilities is limited. Further assessments should determine whether ETCs can adapt to safely manage other highly infectious disease threats.Infect. Control Hosp. Epidemiol. 2016;37(3):313–318

scholarly journals Ebola or Not? Evaluating the Ill Traveler From Ebola-Affected Countries in West Africa

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Jessica K. Fairley ◽  
Phyllis E. Kozarsky ◽  
Colleen S. Kraft ◽  
Jeannette Guarner ◽  
James P. Steinberg ◽  
...  
Keyword(s):  
West Africa ◽  
Infection Control ◽  
Ebola Virus ◽  
Virus Disease ◽  
Plasmodium Falciparum Malaria ◽  
The United States ◽  
Case Definition ◽  
Lessons Learned ◽  
Treatment Unit ◽  
Life Threatening

Abstract Background.  The 2014–2015 Ebola epidemic in West Africa had global impact beyond the primarily affected countries of Guinea, Liberia, and Sierra Leone. Other countries, including the United States, encountered numerous patients who arrived from highly affected countries with fever or other signs or symptoms consistent with Ebola virus disease (EVD). Methods.  We describe our experience evaluating 25 travelers who met the US Centers for Disease Control and Prevention case definition for a person under investigation (PUI) for EVD from July 20, 2014 to January 28, 2015. All patients were triaged and evaluated under the guidance of institutional protocols to the emergency department, outpatient tropical medicine clinic, or Emory's Ebola treatment unit. Strict attention to infection control and early involvement of public health authorities guided the safe evaluation of these patients. Results.  None were diagnosed with EVD. Respiratory illnesses were common, and 8 (32%) PUI were confirmed to have influenza. Four patients (16%) were diagnosed with potentially life-threatening infections or conditions, including 3 with Plasmodium falciparum malaria and 1 with diabetic ketoacidosis. Conclusions.  In addition to preparing for potential patients with EVD, Ebola assessment centers should consider other life-threatening conditions requiring urgent treatment, and travelers to affected countries should be strongly advised to seek pretravel counseling. Furthermore, attention to infection control in all aspects of PUI evaluation is paramount and has presented unique challenges. Lessons learned from our evaluation of potential patients with EVD can help inform preparations for future outbreaks of highly pathogenic communicable diseases.

scholarly journals Ebola virus disease: Case management in the Institute of Infectious Diseases, University Hospital of Sassari, Sardinia, Italy

2016 ◽  
Vol 10 (05) ◽  
pp. 537-543 ◽  
Author(s):  
Giulia Bertoli ◽  
Marco Mannazzu ◽  
Giordano Madeddu ◽  
Riccardo Are ◽  
Alberto Muredda ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Ebola Virus ◽  
Virus Disease ◽  
Developed Countries ◽  
The United States ◽  
Ebola Virus Disease ◽  
University Hospital ◽  
Governmental Organization ◽  
Medical Division ◽  
Disease Case

Since the onset of the worst epidemic of Ebola virus disease in December 2013, 28,637 cases were reported as confirmed, probable, or suspected. Since the week of 3 January 2016, no more cases have been reported. The total number of deaths have amounted to 11,315 (39.5%). In developed countries, seven cases have been diagnosed: four in the United States, one in Spain, one in the United Kingdom, and one in Italy. On 20 July 2015, Italy was declared Ebola-free. On 9 May 2015, an Italian health worker came back to Italy after a long stay in Sierra Leone working for a non-governmental organization. Forty-eight hours after his arrival, he noticed headache, weakness, muscle pains, and slight fever. The following day, he was safely transported to the Infectious Diseases Unit of University Hospital of Sassari. The patient was hospitalized for 19 hours until an Italian Air Force medical division transferred him to Rome, to the Lazzaro Spallanzani Institute. Nineteen people who had contacts with the patient were monitored daily for 21 days by the Public Health Office of Sassari and none presented any symptoms. So far, neither vaccine nor treatment is available to be proposed on an international scale. Ebola is considered a re-emerging infectious disease which, unlike in the past, has been a worldwide emergency. This case study aimed to establish a discussion about the operative and logistic difficulties to be faced and about the discrepancy arising when protocols clash with the reality of facts.

scholarly journals Implementation of a study to examine the persistence of Ebola virus in the body fluids of Ebola virus disease survivors in Sierra Leone: Methodology and lessons learned

2017 ◽  
Vol 11 (9) ◽  
pp. e0005723 ◽  
Author(s):  
Gibrilla Fadlu Deen ◽  
Suzanna L. R. McDonald ◽  
Jaclyn E. Marrinan ◽  
Foday R. Sesay ◽  
Elizabeth Ervin ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Ebola Virus ◽  
Virus Disease ◽  
Body Fluids ◽  
Lessons Learned ◽  
The Body ◽  
Ebola Virus Disease
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