A joint report by East County Magazine and Reporting San Diego
By Miriam Raftery and Nadin Abbott
October 21, 2014 (La Mesa) – How prepared is East County's major hospital to handle an Ebola patient?
We contacted Grossmont Hospital to find out. Although the risk of this occurring here is considered low by experts, errors in a Dallas hospital's handling of an Ebola patient pointed out the importance of proper planning. Moreover, a survey published last week by National Nurses United revealed that 85 percent of hospitals had reportedly not provided any training for nurses on Ebola and most are short on equipment for handling a patient with the infectious disease that kills 70% of victims.
We sent a detailed list of questions to Sharp Grossmont Hospital’s director of marketing and communications, Bruce Hartman, on topics such as training and protective equipment for healthcare workers, whether patients are asked about their travel histories, and plans for sanitizing areas where an Ebola patient might have been waiting or treated. He responded with this detailed statement, followed by answers to our questions below.
The Hospital's responses include changes in procedures being made to reflect new guidelines just issued by the federal government, such as providing full protective suits with no skin exposed and training in how to safely remove such gear. Below is the full text of Hartman's response:
Statement by Bruce Hartman, Grossmont Hospital:
Sharp HealthCare continues to aggressively prepare for potential Ebola Virus Disease (EVD) in our community. Fortunately, the risk of EVD in San Diego remains very low; however, Sharp HealthCare will continue to ensure readiness for individuals who may present to our organization. To date, we have:
- Delivered Personal Protective Equipment (PPE) kits to primary points of entry at our medical facilities. PPE kits are hooded and offer full coverage so no skin is exposed.
- Developed a training protocol for health care personnel specific to safe donning and doffing of PPE. In addition to PPE training previously completed, Sharp is developing expert resource teams that will be available to each of our entities. These expert teams will undergo an intensive eight-hour training session this Friday and will subsequently be responsible for training additional teams at each Sharp facility.
- Established a system-wide steering committee to ensure Sharp’s EVD readiness. The committee holds frequent meetings each week and is comprised of executive, emergency department and nursing leaders and infectious disease physicians and disaster preparedness experts.
- Developed a Continuing Medical Education (CME) program on EVD epidemiology, clinical features and preparedness that is open to all Sharp-affiliated physicians and interested staff beginning next week.
- Held a two-hour EVD tabletop exercise with more than 100 representatives from across Sharp, including physicians, emergency department teams, executives and safety, disaster preparedness and communications personnel to guide our overall EVD response.
- Established coordination and collaboration with California and San Diego County’s Health and Human Services Agency, California Hospital Association, Base Hospital Nurse Coordinators, San Diego Healthcare Disaster Council, and Centers for Disease Control and Prevention (CDC) and with representatives from Emory University Hospital, University of Nebraska Medical Center and Texas Health Presbyterian Hospital for additional learning and best practices as we continue to augment our EVD program.
- Included messaging about Sharp’s Ebola virus readiness on the employee intranet site, Sharp.com, Sharp’s Facebook page and Twitter feed and with 82-SHARP and Nurse Connection.
Additional Actions in Progress
Sharp is currently:
- Developing an enhanced informational tool kit that will provide additional specific care protocols and instructions for care and treatment of potential patients with EVD. The tool kit, which will be distributed next week, will also define specific detailed roles and responsibilities for administrative and clinical personnel including registration clerks, triage nurses, charge nurses and administrative liaisons.
- Establishing four-person SWAT teams for ambulatory sites and acute care hospitals comprised of administrative, clinical, infection prevention and safety representatives. SWAT teams will serve as expert resources that will ensure guidance, protocol compliance and process checks and support acquisition of resources during the care of potential EVD patients.
- Finalizing a sanitation plan to maintain a clean and safe environment for our patients and staff members in the event Sharp receives any EVD cases.
- Producing public signage to notify patients and visitors of Sharp’s infection prevention precautions to decrease exposures. Hand sanitizer and masks will be made available where signage is posted at entry points in our facilities.
Our Questions to Sharp Grossmont Hospital and Responses provided by Bruce Hartman:
Do you provide education on Ebola for nurses?
Yes, basic Ebola virus education has been provided for all nurses and key staff have already been trained in donning and doffing of Personal Protective Equipment (PPE). All Emergency Department nurses and MDs will be trained this week.
Can they ask questions?
How many eye protection (face shields or side shields with goggles) do you have for daily use per unit, and is it enough if one or more ebola patients were to wind up at Grossmont?
We have an adequate supply, and we have access to Sharp Healthcare resources if we need additional supplies.
Do you have fluid resistant/impermeable gowns in the hospital and if so, is this supply adequate for handling ebola?
Yes, and Sharp purchased additional suits that our hospital has access to.
Do you have plans to equip isolation rooms with plastic covered mattresses and pillows?
At this time, I am not aware if this is taking place.
Do you discard all linens after use in an isolation room, or anywhere else an ebola or suspected ebola patient would be treated?
Yes, we have a process for safe disposal of used linens and our Environment Services (EVS) staff are all trained in proper removal protocals.
Do you have sanitation plans in place should an ebola patient wind up in your ER or waiting rooms, since this can be spread merely by touching items an ebola patient handled?
Yes, we have an entire response plan in place.
Do you have a positive pressure ventilated ICU bed?
We have multiple negative pressure rooms in the ICU units, and several rooms in the ER.
Are you asking the travel history of people who present with high fever and other symptoms consistent with Ebola?
Yes, we are asking travel history of every patient who presents in the ER. Also, if anyone has any cold/flu-like symptoms, they are asked to put on a mask and wash their hands with sanitizer.