Sunday, October 12, 2014

How to Respond to Ebola? Nurses Have a Plan | The Nation

This piece merits posting.  Hospital un-preparedness is  widespread throughout the U.S. and this is unfortunate because by the time a person infected with Ebola walks through their doors—such as when Thomas Eric Duncan entered Texas Health Presbyterian Hospital on Oct. 2nd—risk to healthcare workers is significant.

Duncan, the first person in the U.S. to die of Ebola, passed away on October 8th.

Glad to see the NNU, the nation's largest nurses union step up to the plate.



How to Respond to Ebola? Nurses Have a Plan | The Nation

How to Respond to Ebola? Nurses Have a Plan

That’s appropriate, as is the growing sense of urgency with regard to
the level of readiness not just for the potential spread of Ebola but
for other disease outbreaks.

This is not a time to panic. It is a time to get things right.

“Ebola is dangerous, and our No. 1 responsibility is to keep our people safe," says Senator Elizabeth Warren, the Massachusetts Democrat who is a member of the Committee on Health, Education, Labor
and Pensions. "But we want to be very careful that we are following the
recommendations of the scientific community. We want to use best
science here. That’s how we’ll keep ourselves safe. So for me, part of
this is the reminder it is powerfully important to make long-term
investments, particularly in medical research."

Warren has not been shy about noting that "with all the spending
cutbacks and all the pressure on the National Institute of Health, much
of that research has been shelved."

Warren is right;  according to The Hill,
"the sequester resulted in a $195 million cut that year to the National
Centers for Emerging and Zoonotic Infectious Diseases, a CDC program
that tries to prevent illness and death from infectious disease."

Research is essential, but so too is basic preparedness.

The best way to determine if our hospitals are ready to respond is by asking a nurse. Or, to be more precise, nurses.

The answer, unfortunately, is that our hospitals are not up to speed.

"We are seeing that hospitals are not prepared,” warns Bonnie Castillo, a RN who directs the Registered Nurse Response Network of National Nurses United.

Describing training and preparations as "woefully insufficient,” Castillo says.
“We have to continue to sound the alarm. There is the potential for
many more Dallases if hospitals are not mandated and do not commit to
more vigorous standards. We see potential gaping holes for this to

Those gaps need to be closed. Resources must be made available to do
the address real concerns, and budgets cannot be nickled-and-dimed by
austerity-obsessed officials.

“The time to act is long overdue,” says RoseAnn DeMoro, the executive director of NNU, the nation's largest nurses union.

NNU leaders have from the start of the Ebola outbreak in West Africa
been outspoken regarding the need to provide immediate support for
health-care personnel in Liberia, Sierra Leone and other countries. The
union has raised money and offered support for those initiatives.

At the same time, the union has focused attention on the need for greater preparation by US hospitals.

Weeks ago, NNU leaders and members began to sound the alarm -- highlighting what Castillo
described in September as  “the critical need for planning,
preparedness and protection at the highest level in hospitals throughout
the nation.” And the union took action, launching a national survey of hospital preparedness.

So far, 2,000 registered nurses at more 750 facilities in 46 states
and the District of Columbia have weighed in, providing evidence of
serious gaps in readiness.

 To wit:

•   “76 percent of those surveyed say their hospital has
not communicated to them any policy regarding potential admission of
patients infected by Ebola”

•   “85 percent say their hospital has not provided education on
Ebola with the ability for the nurses to interact and ask questions”

•   “37 percent say their hospital has insufficient current supplies
of eye protection (face shields or side shields with goggles) for daily
use on their unit; 36 percent say there are insufficient supplies of
fluid resistant/impermeable gowns in their hospital”

•   “39 percent say their hospital does not have plans to equip
isolation rooms with plastic covered mattresses and pillows and discard
all linens after use; only 8 percent said they were aware their hospital
does have such a plan in place.”

NNU leaders have also outlined a response agenda

The “full emergency preparedness plan” they propose includes a call for:

• “Full training of hospital personnel, along with proper
protocols and training materials for responding to outbreaks, with the
ability for nurses to interact and ask questions.”

• “Adequate supplies of Hazmat suits and other personal protective equipment.”

• “Properly equipped isolation rooms to assure patient, visitor, and staff safety.”

• “Proper procedures for disposal of medical waste and linens after use.”

The emphasis on the need for rigorous training is echoed by other unions that have a major presence in the nation's hospitals. Service Employees International Union occupational health and safety director Mark Catlin told Politico that, even when medical facilities have protocols, “it’s not clear how well facilities implement them."

This lack of clarity is the issue that must be addressed.

NNU's DeMoro warns that: “There is no standard short of optimal in protective equipment and hands-on-training that is acceptable."

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