Mission Hospital Prepares for Ebola

A view inside a Mission Hospital operating room.
A view inside a Mission Hospital operating room.

In the wake of the disturbing news that two Dallas nurses contracted the deadly Ebola virus after caring for a patient, staff of Mission Hospital Laguna Beach has readiness protocols in place to both protect their personnel and treat a victim of the infection, officials confirmed this week.

“Mission Hospital staff, including physicians, have received infectious disease training related to the virus,” said Susan Solomon, a spokeswoman for St. Joseph’s Health System in Orange, which owns Mission Hospital. The training emphasis is on screening in the emergency room, isolation standards and the latest updates from the federal Centers for Disease Control and Prevention, Solomon said. The training so far has been through “learning modules” involving videos and discussion, but the hospitals “are preparing to do drills as well,” she said.

The California Department of Public Health said Wednesday there were no Ebola cases or suspected cases in California.

Since federal officials blame the infection of healthcare workers on a breach in medical protocols at Texas Health Presbyterian Hospital in Dallas, National Nurses United, the country’s largest nurses union, this week called on all hospitals to provide the highest standards for protecting personnel confronting Ebola. The union called for equipping hospitals staffs with protective gear, such as the full biohazard suits, and insisted they receive hands-on training about the disease as well.

In a national poll of 2,000 registered nurses, 76 percent responding say their hospital employers had so far failed to communicate to them a policy about the potential admission of patients infected by Ebola, the union said in a statement on Sunday, Oct. 12.

Local hospital officials believe they are adequately prepared to prevent spread of the virus, according to a statement issued by St. Joseph’s on Monday. They have the tools to properly screen patients for not only Ebola, but also other infectious conditions such as MERS-CoV (Middle East respiratory syndrome coronavirus) and avian influenza, the statement says.

St. Joseph’s follows the following protocols: Interviewing the patient and close contacts, such as family members, to obtain detailed information on their travel history and potential exposures; making sure the patient under observation or receiving treatment is isolated; ensuring all hospital staff use appropriate infection control measures; monitoring the health status of health care providers who are caring for the patient; and working closely with the local health departments.

For instance, the Laguna hospital maintains an isolation room that is a “specially designed room with an ante-room and negative air flow,” which could be used for Ebola patients, the hospital’s clinical team said in answer to a query. Protective gear consists of gloves, a gown impermeable to fluids, eye and face protection, mask and shoe covers – all single use and disposable, the team said. Any health care workers would be monitored twice daily for fever and symptoms for 21 days after their last known exposure, the team said. While the isolation measures are similar to those for other organisms, “Ebola has heightened them and taken them to the highest level of protection,” the team said.

The nurses union, which does not represent Mission Hospital’s nursing staff, called on hospitals to go beyond general guidelines and outline specific steps that nurses and staff should be trained to carry out, so there is no room for error.

“We need to hold our hospitals accountable for taking proper protective measures for their nurses and all of their staff in order to stop the spread of Ebola,” especially as those workers go out into the community, said registered nurse and union spokeswoman Rochelle Pardue-Okimoto in a telephone interview Tuesday. She works in a hospital in the San Francisco Bay Area.

Hospitals need to equip nurses with the highest standards of protective gear, including full hazmat suits, she said. Even if nurses wear gowns, masks, goggles, gloves and shoe coverings, fluids that spill on the floor can splash on personnel, said Pardue-Okimoto. In removing a shoe cover, a nurse can inadvertently touch a spattered ankle and then wipe an eye, “and it’s over,” she said. Instead of a guidance list taped to a wall, which is what some union nurses have reported as their hospital’s response, they need face-to-face training, including practice donning and removing protective gear, she said.

Since the Dallas nurse became infected despite protective gear, with a second nurse diagnosed with the disease as of Wednesday, some medical experts have suggested transferring Ebola patients to designated centers better equipped to handle the infectious disease.

Asked whether Mission Hospital would treat a patient with Ebola symptoms or send them elsewhere, Solomon said St. Joseph will follow CDC guidelines and direction from local, state and federal health authorities. “However, right now, we do know that we are prepared to respond to a patient who may suspect symptoms,” said Solomon.

Last week, the Orange County Health Care Agency issued an Ebola update that describes the disease’s symptoms and precautions required to avoid spreading the virus. In addition to isolation and protective equipment including gloves, gown, eye protection and facemask, their report notes that if “copious blood or other fluid is present in the environment,” additional protection is necessary, such as double gloving, disposable shoe covering and leg covering. It also notes that these items “should be discarded on leaving a room, taking care to avoid contamination when removing.”


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