PBMC implements training, screening and infection control measures to combat Ebola

Peconic Bay Medical Center is busy training its staff in appropriate infection control procedures and protocol in the event that an Ebola patient arrives at the Riverhead hospital for care. It’s a situation considered very unlikely, according to health officials, but one that all hospitals must be equipped and prepared to handle.

“We started educating approximately two months ago, when it first broke,” Patricia McArdle, R.N., infection control coordinator for PBMC.

“Early recognition is really the key to this this,” McArdle said. “Emergency Department staff is asking travel history questions, so we know early on whether we have to isolate a patient who presents in the emergency room.”

PBMC has posted large stop signs at entrances to its emergency department and walk-in care center, advising anyone who has traveled to Liberia, Guinea, Sierra Leone, Laos, Nigeria, China or the Arabian peninsula who has complaints of fever over 100.8, malaise, headache, vomiting, diarrhea or flu-like symptoms to put on a mask and notify a health care worker immediately. Masks and gloves are available at displays next to the signs.

Communications from the state health department and the federal Centers for Disease Control having been coming to hospital administrators at a rapid pace over the past week, McArdle said.

After confirming that a nurse who’d treated an Ebola patient at a Dallas hospital contracted the disease, the CDC on Sunday said it would provide hospitals with more training. The federal agency urged hospitals to conduct drills to practice dealing with Ebola patients.

That is exactly what PBMC has been doing, McArdle said in an interview this morning. The hospital has been conducting drills on almost a daily basis, she said.

“We have also used ‘secret shoppers,’ for lack of a better word, to test staff on their response to someone who comes in reporting illness and a travel history to an affected region,” McArdle said.

The nurse infected at Texas Health Presbyterian Hospital in Dallas was reportedly following all infection control protocols for Ebola patient care. The CDC director said yesterday the agency was “rethinking” its approach to containing the disease.

The patient who infected the nurse, Thomas Duncan, of Liberia, died Oct. 9.

A World Health Organization official said today the mortality rate for the Ebola outbreak in West Africa had risen to 70 percent. The number of new cases could reach 10,000 per week by December, according to the organization. The WHO had been saying that the number of new cases was about 1,000 per week for the past four weeks, and that the mortality rate for Ebola had been around 50 percent, according to a N.Y. Times report.

Local hospital workers are certainly concerned, but “there’s no panic in the streets by any means,” said PBMC senior vice president and chief operating officer Gerry Zunno, the hospital’s chief nursing officer and director of patient care services.

In the event an Ebola patient is admitted, the patient is isolated and all health care workers must wear protective clothing that is removed and discarded after every patient interaction.

“All equipment used is disposable. They tell us to plan on 30 contaminated bags of red-bag waste per patient per day,” Zunno said.

“All of the red-bag waste is disposed of through a regulated medical waste carting company called SteriCycle,” McArdle said.

The Ebola virus is extremely virulent, Zunno said, but it is not transmitted through the air. It is transmitted by contact with bodily fluids such as saliva, mucus, vomit, feces, sweat, tears, breast milk, urine, and semen. The virus in bodily fluids can live for days outside the body, according to the CDC. Ebola on dried on surfaces such as doorknobs and countertops can survive for several hours. The virus is killed with hospital-grade disinfectants, such as household bleach.

The hospital is still working on a solution to provide an appropriate area for removing protective clothing, since the ER rooms and patient rooms do not have ante-rooms where workers can remove protective clothing in an isolated environment. They can’t exit the patient room with the protective clothing still on but they can’t remove it inside the patient room without contaminating the clothing they’re wearing underneath the protective gear.

“We’re looking at multiple options, including the use of portable ante-rooms,” Zunno said.

EMS workers may come into contact with an infected patient before the hospital ever sees him, so the CDC and Suffolk Regional Emergency Medical Services Council publish protocols and guidelines for handling Ebola patients.

“We follow those guidelines,” Riverhead Volunteer Ambulance Corps Assistant Chief Lisa Corwin said. “We do a lot of training with our volunteers and paid responders.”

“Unfortunately, a lot of times, people don’t tell you what’s wrong with them,” Corwin said. “And the symptoms of Ebola — fever, malaise, vomiting etc – are pretty common symptoms for a lot of different things,” she said. “If we suspect it’s a contagious disease such as Ebola, protocol requires that we inform the hospital prior to arrival,” she said. “That way they can be prepared.”