Employee health professionals step up, lead hospital efforts to protect HCWs from Ebola
We have more volunteers than we can use’
As news shows broadcast seemingly endless loops about Ebola, every community in America wanted to know: Is my local hospital ready to safely handle an Ebola patient?
Behind the scenes, that was a question that employee health professionals had already been addressing, through enhanced training, protocols and personal protective equipment.
"There is a huge response across the nation," says Sharon Petersen, MHA, BSN, RN, COHN/CM, who was a founder of the Rocky Mountain chapter of the Association of Occupational Health Professionals in Healthcare (AOHP). "As occupational health nurses, our primary focus has been ensuring that health care organizations across the country are responding so our employees can feel confident that the provisions provided for them are safe and effective."
Here are some areas of focus and strategies used:
Teamwork: Lakeland HealthCare in St. Joseph, MI, built an extensive interdisciplinary team that includes the three-hospital system’s CEO, vice president for emergency management, chief nursing executive and directors of nursing, frontline emergency room managers and chiefs of the ER medical staff, electronic medical records representative, nurse educators, the facilities director, materials management, infection prevention and associate (employee) health — among others.
Not everyone attends every meeting, but they can tap in through a video conference call. At first, the group was much smaller, but the health system wanted to access all the necessary expertise and perspective, says Rita Brandt, MSN, RN, manager of Associate Health & Wellness. "We believe we can keep safer if we work as a team," she says.
The health system has a longstanding policy of holding 15-minute safety huddles every day. Led by the CEO, key leaders discuss any safety incidents or concerns of the past 24 hours and any issues that might occur in the next 24 hours.
Some hospitals also have designated specialized teams of health care workers who would care for any Ebola patients. These teams have a higher level of training, much as trauma teams do, says Petersen.
Mayo Clinic in Rochester, MN, asked for volunteers for an Ebola care team and got a strong response. "We have more volunteers than we can use," says Andrew Vaughn, MD, MPH, medical director of Occupational Health and Safety.
Communication: Lakeland HealthCare places policies, screening tools and updates on an intranet for employees and was planning to create a blog for employees to post questions. Transparency is the best policy, says Petersen. "We don’t want our associates living in fear," she says.
Mayo has run simulation drills, making sure employees know how to don and doff the personal protective equipment. And Mayo has thought through the possible concerns of employees. For example, an employee who had a high-risk exposure might fear going home and possibly exposing family members. The health system is looking into alternate living arrangements for the 21-day monitoring period, Vaughn says.
Most importantly, Mayo continually updates and clarifies its policies. "We’ve taken the approach of trying to communicate as clearly and frequently as we can," he says.
Personal protective equipment: When it comes to keeping employees safe, "The first rule is to do a hazard assessment," says Lydia Baugh, communications director of the International Safety Equipment Association (ISEA) in Arlington VA. Then look for equipment that provides the necessary protection and meets safety standards, she says.
As of late October, the ISEA was not reporting supply shortages. But hospitals had begun seeking equipment not normally on their purchase list, such as Tyvek suits and hoods that cover the neck. (Some hospitals had full-body suits as emergency gear for chemical spills or other industrial incidents.)
Problems with having the proper gear emerged at Texas Presbyterian. In a statement, the health system acknowledged that some Tyvek suits given to nurses caring for Ebola patient Thomas Eric Duncan were too big, and that the nurses may have taped them to make the fit better.
HR policies: Ebola care raises a number of human resource questions. The PPE is difficult to tolerate, so occupational health clinicians evaluate employees to determine if they have any medical limitations. Some hospitals have limited the work time in hazmat suits to two hours, others allow up to four hours.
Employees who are pregnant and those with certain conditions, such as seizure disorders, chronic skin conditions, or claustrophobia, or those taking immune-suppressing medication have been excluded from caring for Ebola patients.