October 2014
Swank Health: Your monthly news from Swank HealthCare


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In This Issue

Did You Know?

Ebola: Lessons Learned?

Top List

Top 10 most important biological preparedness training topics for hospital staff

What's Going On?

ICHAN Conference

Now Trending

Test Your Knowledge: questions from the CDC’s 2007 Guideline for Isolation Precautions

Recommended Readings

Recommended Courses*
  • #32714 Hospital-acquired Infection Control
  • #45914 Understanding Infection Control: Observing Standard Precautions and Protecting Yourself
  • #45814 Understanding Infection Control: Microorganisms
  • #46210 Infection Control: Standard Precautions/Special Contact Precautions

* course numbers may vary by facility


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Did You Know?

Ebola: Lessons Learned?

Even with surveillance and travel screenings in place, the recent Ebola crisis provides yet another example of how quickly a dangerous infectious disease can cross the border of one country and spread exponentially into others. Over the first few weeks of the U.S. Ebola crisis, authorities struggled to provide timely communication and support to healthcare providers and the public. As more information became available, infection control guidelines were updated and redistributed. Healthcare facilities scrambled to implement changing protocols and communicate with staff, in some cases while infected patients were already being treated. The CDC and hospital administrators later admitted to costly mistakes that resulted in exposure and subsequent infections of two nurses.

Healthcare workers across the country, including leaders of a national nurse’s union, called for more education, saying the workforce is unprepared to safely care for patients with this deadly disease. Other experts agreed, saying there were, “deep gaps in training for hospital staff.” Dr. Daniel Varga, Chief Clinical Officer for Texas Health Resources where the two nurses were exposed, said in a testimony to Congress that, “Despite the communications regarding EVD preparedness that occurred, we realized a need for more proactive, intensive, and focused training…” (Varga, 2014)

In 2002, Severe Acute Respiratory Syndrome (SARS) first emerged in a few Chinese citizens, and within weeks had spread to five continents. Exposed healthcare workers, patients, and visitors later became infected and spread the disease to others in healthcare facilities. Nosocomial transmission accounted for 72% of cases in Toronto and 55% of cases in Taiwan. Lapses in infection control measures are thought to be the likely cause of infection in healthcare workers. A retrospective analysis of events during the SARS crisis published by the CDC in 2004, said that unrecognized SARS case- patients was a primary source of transmission and early detection and interventions were important to limit spread. It went on to conclude that preparedness planning should include training on early patient identification and appropriate technique for the use of PPE.

These two pandemic experiences provide very similar opportunities to learn valuable lessons for Ebola and SARS in the future, but perhaps the greater lesson is that healthcare personnel need to be better prepared to face many types of biological threats that could and likely will, arrive in hospitals and clinics with little or no warning. Did we really “learn” from SARS? Experts agreed that better education and preparedness were key to preventing future lapses in early patient detection and infection control, yet, the very same mistakes are to blame for exposure to healthcare workers and others with Ebola. Will we learn from these new experiences by improving education and preparedness measures to prevent the same problems in the future? One thing is for certain, the time to prepare is now, not when a new threat is already here.

References:

McDonald, L., Simor, A., I-J, S., Malone, S., Ofner, M., & Chen K-T, e. a. (2004, May). SARS in Healthcare Facilities, Toronoto and Taiwan. Emerg Infec Dis.

Varga, D. D. (2014). Examining the U.S. Public Health Response to the Ebola Outbreak. House Emergy and Commerce Committee Sub Committee on Oversight and Investigations.



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Top 10 List

Here are the top 10 most important biological preparedness training topics for hospital staff:

  1. Where to go for reliable information on a wide range of potential threats, such as: The CDC including the Health Alert Network, Clinician Outreach and Communication Activity Network, Epidemic Information Exchange Network, The World Health Organization, as well as local and state health departments
  2. When and how to report events to internal external authorities
  3. Potential agents including dangerous emerging infectious disease pathogens and major bioterrorism agents, along with symptoms of disease
  4. How to perform routine and event-specific patient screenings
  5. How to detect outbreaks and bioterrorism events including syndrome-based criteria and epidemiologic features like rapidly increasing disease incidence in an otherwise healthy population or unusual increase in people seeking care with fever, respiratory or gastrointestinal complaints
  6. Infection control practices including standard precautions, transmission-based precautions, donning and doffing of PPE, patient placement, patient transport, cleaning and disinfection of equipment and the environment, waste management, discharge, and post-mortem care
  7. Post exposure management including decontamination of patients and the environment, prophylaxis and post-exposure immunizations, triage and management of large-scale exposures and suspected exposures
  8. Psychological aspects of a biological event such as, minimizing panic and treating anxiety
  9. Laboratory support and confirmation including how to obtain a diagnostic sample and transport requirements
  10. Ethical considerations

References:

APIC Bioterrorism Task Force and the CDC Hospital Infections Program Bioterrorism Working Group. (1999, April 13). Bioterrorism Readiness Plan: A Template for Healthcare Facilities. Retrieved from CDC Emergency Preparedness and Response.

CDC. (n.d.). Detailed Hospital Checklist for Ebola Preparedness. Retrieved from CDC.


Where in the World is Swank HealthCare?

Swank HealthCare exhibited at the National Rural Health Association (NRHA) Critical Access Hospital Conference in Kansas City, MO in October. The conference was attended by more than 500 attendees and 50 exhibitors who all share the same objective; finding solutions to deliver the best patient care in the rural environment.

As a proud Gold Partner of the NRHA, Swank HealthCare strives to be the resource of choice for Critical Access Hospitals faced with educating their staff on a limited budget. A highlight of the conference was revisiting the importance of open communication between customers and solution providers. We learn with and from each other to create stronger bonds and to explore mutually beneficial solutions while focusing on learning management, continuing education, regulatory training and HCAHPS.

For more information on how Swank HealthCare can benefit your Critical Access Hospital please contact us at 1-877-227-0325.


Now Trending

Test your Infection Control knowledge with these questions from the CDC’s 2007 Guideline for Isolation Precautions.

Question 1

The recommended sequence for removal of PPE is:

A. Gloves, face shield or goggles, gown, mask or respirator
B. Gloves, gown, face shield or goggles, mask or respirator
C. Face Shield or goggles, mask or respirator, gloves, gown
D. Mask or respirator, face shield or goggles, gloves, gown

Question 2

Identify the type of type of precautions (standard, contact, droplet, and/or airborne) most appropriate for routine care of patients with these infections.

A. Hantavirus Pulmonary Syndrome
B. Varicella Zoster
C. Measles (rubeola)
D. Meningococcal Disease (pneumonia, meningitis)
E. Rotavirus
F. SARS
G. Leprosy (Hansen’s Disease)

Question 3

Which of the following is NOT a high-priority (CDC Category A) bioterrorism threat?

A. Anthrax
B. Ebola Hemorrhagic Fever
C. Monkeypox
D. Pneumonic Plague

References:

Siegel, J., Rhinehart, E., & Healthcare Infection Cntrl Practices Adivisory Com. (2007). 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Retrieved from CDC.


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Answer

Gloves, face shield or goggles, gown, mask or respirator - Areas considered “contaminated” are the outside front and sleeves of gowns and the outside front of goggles, mask, respirator and face shield. “Clean” parts that will be touched when removing PPE are the inside of gloves, inside and back of the gown including the ties and the ties or ear pieces of the mask, goggles and face shield

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Answer

Hantavirus Pulmonary Syndrome Standard Precautions – not transmitted from person to person
Varicella Zoster Airborne and Contact Precautions
Measles (rubeola) Airborne Precautions
Meningococcal Disease (pneumonia, meningitis) Droplet Precautions until 24 hours after initiation of antimicrobial therapy
Rotavirus Contact Precautions
SARS Airborne, Droplet, and Contact Precautions
Leprosy (Hansen’s Disease) Standard Precautions
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Answer

Monkeypox - Other high-priority bioterrorism threats include: Botulism, Smallpox, and Tularemia.

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