Officials: Local Ebola protocol in place
By Steve Herring
Published in News on October 15, 2014 1:46 PM
Wayne Memorial Hospital
Wayne County has been preparing for a crisis like the evolving Ebola threat for decades, County Commissioner Joe Gurley told the Wayne Memorial Hospital board on Tuesday.
Gurley, who is the former director of the county emergency services office, described the preparations for a potential crisis such as an outbreak of the disease to those of a hurricane.
"These (preparations) you are talking about with Ebola have been practiced and exercised in this setting, the hospital and Wayne County government, I know, for at least 25 plus years on an annual basis. But until you actually have it affect you, you don't know what the final result is. I think everybody is probably looking in the right direction and trying their very best," Gurley said.
Hospital President and CEO Bill Paugh said the hospital is preparing to meet the potential threat, but that he hopes plans will not have to be activated. However, the hospital and the community need to be alert and prepared, Paugh said.
"This is a continuing evolving situation," said Shirley Harkey, vice president of patient services and chief nursing officer at Wayne Memorial. "We are learning something new just about every day. The CDC (Centers for Disease Control and Prevention) director came out yesterday, saying that we really do need to rethink the things that we put in place before, and we really need to rethink a lot of our infection control practices.
"Just know that we are monitoring this to make sure that we keep up with this continuously evolving situation."
The hospital began its "full-court press" on readiness nearly a month ago, she said.
"Our emergency room staff, 100 percent of our nurses, have been educated on the basic screening of the symptoms," Ms. Harkey said. "We have hardwired that into our electronic medical record. We have established personal protective equipment. You hear the press call it PPE.
"We have increased our inventory of that in the ED (emergency department). One of the things that we need to be mindful of is that we are training our staff on PPE. But as we are continuously reminded by the CDC, the biggest risk to the health care worker is removing the contaminated personal protective equipment. Whether it is the gown, whether it is the tie-back suit."
It is very easy for people to contaminate themselves when they remove the PPE, she said.
Hospital staff met last week with officials from Seymour Johnson Air Force Base, the Wayne County Health Department and the county's emergency management team to share information.
Also discussed were plans and strategies.
More meetings are planned.
"We wanted to talk about our risks," Ms. Harkey said. "It is good for us to know that Seymour Johnson Air Force Base does not have any airmen deployed to Africa. There are other Department of Defense folks across the United States though who are deployed to Africa, but none from Seymour Johnson Air Force Base at this time.
"In my opinion that lowers our risk a bit."
Hospital officials also have been talking with Duke Medical Center, she said.
Ms. Harkey said Wayne Memorial would like to have a transfer agreement with Duke, but is still exploring options.
There are activities at the state and federal level concerning the creation of regional treatment centers, she said.
"We are being mindful that this is a complex plan," she said. "It involves having adequate supplies, having adequate diagnostic equipment. We would send blood specimens to Raleigh. Raleigh would send it to the CDC in Atlanta."
Communicating is vital, as is being mindful of waste, both solid and liquid, she said.
The CDC has guidelines for each of those things, Ms. Harkey said.
"We are well-schooled on those," she said. "We are continuing educating people on those opportunities."
Board member Jack Best asked Gurley what EMS workers are doing to protect themselves.
They are meeting on a regular basis, and there are universal precautions that can be taken, Gurley said.
Board Chairman Ray McDonald Jr. talked about transferring a possible Ebola patient.
"I am assuming that means you identify somebody and you get them out of here and get them to a place," he said. "I can see us, let's say we happen to have a case come here.
"You hate to talk about the financial part of it, but it would shut this hospital. I mean nobody is going to come to the hospital at that point if there is an Ebola case that walks into that ED."
The state has not yet established locations where the patients could be taken, Ms. Harkey said. It is still evolving, she said.
Most hospitals do not have separate buildings or facilities to house people with such diseases. Mostly they have isolation rooms, she said.
"There's lots of moving parts when you do make a decision to transfer a patient no matter what is wrong them," she said. "Whether it is a heart attack or whether they have an infectious process, you have to make sure they are stable for transfer.
"You have to make sure that the people who are transferring them are equipped to take care of the patient during the transfer because we have to be mindful that whoever is unfortunate to have this infection, they are still a human being, and they still deserve the utmost of our medical care and treatment. We have to be very mindful of our ethical, moral (obligations) to provide the best care for whoever is unfortunate to have this. But at the same time we have to be mindful that whoever is doing any kind of transfer is well equipped to protect themselves."