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Survey of Ebola Preparedness in Washington State Emergency Departments

Published online by Cambridge University Press:  04 March 2016

C. Hayes Wong ,
Susan Stern  and
Steven H. Mitchell
C. Hayes Wong*
Affiliation:
University of Washington, Division of Emergency Medicine, Seattle, Washington.
Susan Stern
Affiliation:
University of Washington, Division of Emergency Medicine, Seattle, Washington.
Steven H. Mitchell
Affiliation:
University of Washington, Division of Emergency Medicine, Seattle, Washington.
*
Correspondence and reprint requests to Hayes Wong, MD, 325 9th Ave, Box 359702, Seattle, WA 98104-2499 (e-mail: [email protected]).
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Abstract

Objective

The 2014 Ebola virus disease (EVD) outbreak in West Africa remains the most deadly in history. Emergency departments (EDs) are more likely to come into contact with potential EVD patients. It is important for EDs to be prepared to care for suspected EVD patients. Our objective was to understand the perceived challenges experienced by Washington State ED medical directors in EVD preparedness.

Methods

An anonymous, electronic survey was sent to a convenience sample of ED medical directors across Washington State between November and February of 2014–2015. The perceived challenges of and attitudes toward EVD preparations were assessed and reported as stratified proportions.

Results

Of 85 medical directors contacted, 59 responses (69%) were received. This included EDs with annual patient volumes of <20,000 (20 hospitals, 34%), 20,000 to 40,000 (21 hospitals, 36%), 41,000 to 60,000 (4 hospitals, 6.8%), and >60,000 (12 hospitals, 20%). Among the perceived challenges in EVD preparations were spatial modifications (eg, building an anteroom for donning and doffing of personal protective equipment) and waste management planning. Ninety-five percent of respondents moderately or strongly agreed that it is important to have a predesignated hospital to care for EVD patients.

Conclusions

Washington State ED medical directors have faced significant challenges in ensuring their EDs are prepared to safely care for suspected EVD patients. Attitudes toward EVD preparations are mixed. Varying levels of perceived importance may represent an additional barrier to statewide EVD preparedness. (Disaster Med Public Health Preparedness. 2016;10:662–668)

Keywords

disease outbreaksemergency preparednessdisaster planningepidemics
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 10 , Issue 4 , August 2016 , pp. 662 - 668
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2016 

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References

1. Ebola Situation Report - 15 April 2015. World Health Organization website. http://apps.who.int/ebola/current-situation/ebola-situation-report-15-april-2015. Published April 15, 2015. Accessed April 15, 2015.Google Scholar
2. Statement on the 1st meeting of the IHR Emergency Committee on the 2014 Ebola outbreak in West Africa. World Health Organization website. http://www.who.int/mediacentre/news/statements/2014/ebola-20140808/en/. Published August 8, 2014. Accessed April 14, 2015.Google Scholar
3. Briand, S, Bertherat, E, Cox, P, et al. The international Ebola emergency. N Engl J Med. 2014;371(13):1180-1183. http://dx.doi.org/10.1056/NEJMp1409858.Google Scholar
4. Meyers, L, Frawley, T, Goss, S, et al. Ebola virus outbreak 2014: clinical review for emergency physicians. Ann Emerg Med. 2015;65(1):101-108. http://dx.doi.org/10.1016/j.annemergmed.2014.10.009.CrossRefGoogle ScholarPubMed
5. McCarthy, M. Texas healthcare worker is diagnosed with Ebola. BMJ. 2014;349(oct13 6):g6200. http://dx.doi.org/10.1136/bmj.g6200.Google Scholar
6. Harris, P, Taylor, R, Thielke, R, et al. Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377-381. http://dx.doi.org/10.1016/j.jbi.2008.08.010.Google Scholar
7. Hospitals by County, Washington State Hospital Association website. http://www.wsha.org/. Accessed June 7, 2015.Google Scholar
8. Rural Health: Designated Critical Access Hospitals. Washington State Department of Health website. http://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/RuralHealth/HealthcareFacilityResources/CriticalAccessHospitals/DesignatedCriticalAccessHospitals. Accessed June 7, 2015.Google Scholar
9. Guidance on Personal Protective Equipment (PPE) To Be Used by Healthcare Workers during Management of Patients with Confirmed Ebola or Persons under Investigation (PUIs) for Ebola who are Clinically Unstable or Have Bleeding, Vomiting, or Diarrhea in U.S. Hospitals, Including Procedures for Donning and Doffing PPE. Centers for Disease Control and Prevention website. http://www.cdc.gov/vhf/ebola/healthcare-us/ppe/guidance.html. Version current August 27, 2015. Accessed April 15, 2015.Google Scholar
10. Doughton, S. Survey: state’s nurses uneasy about Ebola preparedness. Seattle Times. http://www.seattletimes.com/seattle-news/survey-statersquos-nurses-uneasy-about-ebola-preparedness/. Published October 13, 2014. Accessed May 9, 2015.Google Scholar
11. Nurses’ union: Dallas hospital lacked Ebola protocols. CBS/AP. http://www.cbsnews.com/news/nurses-union-dallas-hospital-lacked-ebola-protocols/. Published October 14, 2014. Accessed February 15, 2016.Google Scholar
12. Bogucki, S, Isakov, A. Patients under investigation for Ebola virus disease in the United States: hospital preparedness planning and alternate care facilities. Acad Emerg Med. 2015;22(5):600-604. http://dx.doi.org/10.1111/acem.12661.Google Scholar
13. Fox, J, Bornstein, B, Grant, S. Emory Healthcare Ebola Preparedness Protocols. Emory Healthcare. http://www.emoryhealthcare.org/ebola-protocol/ehc-message.html. Accessed May 5, 2015.Google Scholar
14. Lyon, GM, Mehta, A, Varkey, J, et al. Clinical care of two patients with Ebola virus disease in the United States. N Engl J Med. 2014;371(25):2402-2409. http://dx.doi.org/10.1056/NEJMoa1409838.CrossRefGoogle ScholarPubMed
15. Millard, WB. Ebola preparedness: on avoiding making a scary virus scarier. Ann Emerg Med. 2015;65(2):A15-A20. http://dx.doi.org/10.1016/j.annemergmed.2014.12.024.Google Scholar
16. Morton, M, Hsu, E, Shah, S, et al. Pandemic influenza and major disease outbreak preparedness in US emergency departments: a selected survey of emergency health professionals. Am J Disaster Med. 2011;6(3):95-187.Google Scholar
17. McCabe, C, Weaver, C. Ebola still weighs on Texas Hospital. Presbyterian sees patient visits decline even as no new cases have emerged. Wall Street Journal. http://www.wsj.com/articles/ebola-still-weighs-on-texas-hospital-1414009789. Published October 22, 2014. Accessed April 25, 2015.Google Scholar
18. Millard, WB. Channeling, high-level biocontainment and research. Ann Emerg Med. 65(2):A15-A22. dx.doi.org/10.1016/j.annemergmed.2014.12.023.Google Scholar
19. Interim Guidance for U.S. Hospital Preparedness for Patients Under Investigation (PUIs) or With Confirmed Ebola Virus Disease (EVD): A Framework for a Tiered Approach. Centers for Disease Control and Prevention website. http://www.cdc.gov/vhf/ebola/healthcare-us/preparing/hospitals.html. Last updated August 28, 2015. Accessed March 11, 2015.Google Scholar
20. de Jong, M, Reusken, C, Horby, P, et al. on behalf of the PREPARE consortium and affiliated clinical networks. Preparedness for admission of patients with suspected Ebola virus disease in European hospitals: a survey, August-September 2014. Euro Surveill. 2014;19(48):20980. http://dx.doi.org/10.2807/1560-7917.ES2014.19.48.20980.Google Scholar
21. Ebola Preparedness Continues in Washington Hospitals. Washington State Department of Health website. http://www.doh.wa.gov/Newsroom/2014NewsReleases/14170WashingtonEbolaPreparednessContinues. Published November 17, 2014. Accessed April 15, 2015.Google Scholar
22. Venkat, A, Asher, S, Wolf, L, et al. Ethical issues in the response to Ebola virus disease in United States emergency departments: a position paper of the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine. Acad Emerg Med. 2015;22(5):605-615. http://dx.doi.org/10.1111/acem.12642.CrossRefGoogle ScholarPubMed
23. Code of Ethics for Emergency Physicians. American College of Emergency Physicians website. https://www.acep.org/Clinical---Practice-Management/Code-of-Ethics-for-Emergency-Physicians/. Revised June 2008. Accessed May 10, 2015.Google Scholar
24. Farrar, JJ, Piot, P. The Ebola emergency - immediate action, ongoing strategy. N Engl J Med. 2014;371(16):1545-1546. http://dx.doi.org/10.1056/NEJMe1411471.Google Scholar
25. Koenig, K, Majestic, C, Burns, M. Ebola virus disease: essential public health principles for clinicians. West J Emerg Med. 2014;15(7):728-731. http://dx.doi.org/10.5811/westjem.2014.9.24011.Google Scholar