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October 26, 2014 01:00 AM

Hospitals revamp infection control amid Ebola scare

Sabriya Rice
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    Fears over the spread of the Ebola virus have intensified long-standing concerns that U.S. hospitals may not be prepared to deal with infectious diseases. Although focus on Ebola may be diverting attention from other issues, like hospital-associated infections and antibiotic-resistant superbugs, infectious disease experts say the education and training efforts surging in response to the disease may lead to more hospitals revamping their protocols and being more prepared in the future.

    The Ebola situation is exacerbating the fact that infection prevention and control is generally under-resourced, said members of the Association for Professionals in Infection Control and Epidemiology during a news briefing Friday. “The current crisis really sheds light on how critically important properly resourced infection prevention programs are,” said Linda Green, a member of APIC's regulatory review panel. “If you don't have the resources, you don't know where the gaps are.”

    A new APIC survey released Friday finds most healthcare workers don't feel confident their hospital is Ebola-ready.

    Only 6% of respondents felt their facility could handle a case, found the poll of 1,039 acute-care hospital workers surveyed Oct. 10-15. Of the respondents, 40% said their facility was only “somewhat prepared.” About half said their facility staffed at least one full-time infection preventionist, an expert who identifies sources of infections and helps limit their transmission in healthcare facilities.

    “The results paint a disturbing picture” and point to an urgent need to bolster infection prevention resources, said Katrina Crist, APIC's CEO. Facilities, already inadequately staffed, are now being stretched beyond capacity. APIC called on hospitals to hire infection preventionists to provide the appropriate in-house training and ensure guidelines are followed proficiently. They also recommended investments in infection-monitoring technology and equipment, to be able to provide real-time data.

    Many hospitals already are beefing up their efforts. North Shore-Long Island Jewish Health System, a 16-hospital system based in Great Neck, N.Y., announced this week plans to create a multibillion-dollar biological containment unit so it can quickly isolate patients during infectious disease outbreaks.

    “It's not just an Ebola-isolated issue,” said Dr. Mark Jarrett, senior vice president and chief quality officer at North Shore-LIJ. In a global society, rare viruses are just a plane ride away and an isolation facility makes the most sense as the physiology and pathology of these diseases are being evaluated, Jarrett says. “You learn from what goes on, and (from Ebola fears) we have learned a biocontainment unit is probably the best method for a health system our size.”

    When Community Hospital in Munster, Ind., became the first U.S. hospital to handle a patient with Middle East respiratory syndrome in April, staff was able to isolate that patient quickly and no staff tested positive for the disease. The hospital already has an infectious disease team, and the facility contains several negative air flow rooms, where air is drawn up and out of the hospital through a special ventilation system. Now, the hospital is ramping up to face the potential threat of Ebola, but says the preparation comes with some challenges.

    “There's an enormous expense involved,” said Dr. Alan Kumar, chief medical information officer for the 429-bed facility. Stocking the protective gear, which can only be worn once before being disposed, the cooling equipment to ensure staff do not overheat in full-body gear, the proper disposal equipment for handling the waste, as well as retraining staff on how to use all of the updated equipment for Ebola preparation, takes time and money.

    The hospital is making that investment, and Kumar says the Ebola situation is forcing all hospitals to re-evaluate what is needed to manage infections on a day-to-day basis.

    “It is creating reinforcement for things that should have been happening all along,” Kumar said. “It's forcing the entire education process to come full circle, so every hospital is going to be better at dealing with any infections.”

    The costs associated with Ebola preparedness remain unclear, but they also may be unavoidable as hospitals prepare for eventualities, said Jennie Mayfield, APIC president. But in the end, the goal is to ensure safety, both for staff and the patient, she said.

    APIC encourages every hospital in to be prepared to identify, isolate and take initial care of an Ebola patient and to take advantage of regional resource centers to mitigate some of the costs.

    Follow Sabriya Rice on Twitter: @Sabriyarice

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