Ebola case highlights lack of planning

'Now, everyone should recognize that Texas is not an island.'
By Government Health IT Staff
10:44 AM

Once the outbreak in West Africa happened and spread to other countries in that region, was it inevitable that Ebola would reach the U.S.? And should hospitals across the nation have been preparing?

“We warned that it was a matter of time in an interconnected world that we would see Ebola in the U.S.,” RoseAnn DeMoro, executive director of National Nurses United told 1,000 nurses at a Las Vegas rally, according to a press statement.

An NNU survey of 700 registered nurses, in fact, shows 80 percent indicating their hospital had not communicated to them any policy regarding potential admission of patients infected by Ebola.

[See also: Web-based tool was first to spot Ebola.]

What’s more, 87 percent said their hospital has not provided education specific to Ebola, 33 percent noted insufficient supplies of personal protective equipment such as face shields, goggles, and fluid resistant gowns, nearly 40 percent do not have plans to equip isolation rooms with necessary plastic covered mattresses and pillows and more than 60 percent responded that their hospital lacks a plan for reducing the overall number of patients to make room a patient that needs to be isolated.

Calling all hospitals
“The failure of the Ebola containment plan was bound to happen eventually, whether in Dallas or somewhere else,” Ron Ashkenas, co-author of a 2013 Harvard Business Review article titled “Why Good Projects Fail Anyway,” told The Dallas Morning News.

The release of the NNU survey came as the first Ebola patient in the U.S., Thomas Eric Duncan, was treated and released with antibiotics by Texas Health Presbyterian Hospital in Dallas although hospital staff were aware he had recently traveled from Liberia — a hotbed of the Ebola outbreak.

[See also: Missed Ebola diagnosis leads to debate.]

THP had screening and procedures in place if the Ebola virus arrived, but those broke down, the hospital said in an examination of the events surrounding Duncan.

Ashkenas said a critical mistake is not making sure key information is repeated enough to sink in such that workers fully understand and follow all procedures.

“Now, everyone should recognize that Texas is not an island,” NNU’s DeMoro said, “and as we’ve heard from nurses across the U.S., hospitals here are not ready to confront this deadly disease.”

National Nurses United said it is calling on U.S. hospitals to immediately upgrade emergency preparations for Ebola or other disease outbreaks.

Such plans should include: full training of hospital personnel along with proper protocols for responding to outbreaks, adequate supplies of Hazmat suits, properly equipped isolation rooms and, of course, sufficient staffing via supplemental nurses and other health workers.

‘A fluid epidemic’
While Health and Human Services Secretary Sylvia Burwell acknowledged during a Thursday press conference that “the nation is frightened,” by Ebola’s near 90 percent fatality rate, Americans will be watching to see whether a second person contracts the virus, or it ends with Duncan, who died Oct. 8 in Dallas. Tests have confirmed that a sheriff’s deputy who exhibited Ebola-like symptoms is not infected.

And major media outlets are reporting that New York airport workers are on strike, five airports are expanding their screening, and some 27 lawmakers are urging President Obama to prohibit flights from West African countries Ebola has impacted from coming into the U.S.

“This is a fluid and heterogeneous epidemic. It is changing quickly and it’s going to be a long fight," CDC director Thomas Frieden, MD said Oct. 9 at a meeting of World Bank donors, according to a Reuters report. "Speed is the most important variable here. This is controllable and this was preventable.

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