On Oct. 6, the Centers for Disease Control and Prevention (CDC) issued a Health Alert Network (HAN) Health Advisory about a recently confirmed outbreak of the Ebola virus in Uganda. The outbreak is attributed to the Sudan virus for which there is no vaccine and a high mortality rate. At the time of the HAN there were no reported cases outside of Uganda.
The New York City area was advised of the outbreak due to its proximity to international airports that service flights from Uganda. The NYC Health Department echoed the warning to all hospitals and other primary care centers.
A subcommittee pulled from the SBH Health System’s emergency management committee immediately convened to discuss and plan for this warning. The committee consisted of emergency department (ED), nursing and nursing education, infection control, supply chain, laboratory and administrative leadership.
The first order of business was to check the ventilation rates on the Ebola treatment room that were set up during the 2014 Ebola outbreak. This room differs from isolation rooms in that it is a three-room suite consisting of donning and doffing stations, and a patient room.
The donning room is for clinicians to apply appropriate personal protective equipment (PPE). This area leads to the patient room and exits to the doffing room where PPE is discarded appropriately.
The next step was the fabrication and installation of signs at all emergency and outpatient arrival points asking about recent travel and particular symptoms as outlined in the advisory. Travel questions were also added to the triage/registration forms in the health system’s electronic medical record software.
The infection control practitioners reviewed and updated policies and procedures, and (ED) staff were trained in proper PPE usage and patient handling. SBH’s supply chain leadership insured appropriate levels of PPE availability and set up a portable cart stocked with supplies to be deployed in the ED.
The environmental services department developed training for the handling of waste generated from a potential exposure. The subcommittee set a schedule to meet weekly to continue to review procedures and update records of training and supplies. A call tree was issued for the notification of leadership positions in the event of an infected persons arrival.
The next step in the plan is to conduct a drill to test the procedures and uncover opportunities for improvement.