What policies are you developing for those returning from trips to West Africa to care for ebola patients?
Mary C Giovannetti, APRN, BC-FNP
Nurse Practitioner/Interim Manger | Employee Health
853 North Church St, Suite 400 | Spartanburg, SC 29303
o: 864-560-1482 | f: 864-560-6509
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net]
On Behalf Of Hudson, T. Warner
Sent: Wednesday, October 22, 2014 6:22 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Medical clearance for Ebola PPE
Not a bad idea. Some considerations as follows highlighted
Occupational Health Considerations: Working with HFV
Preparation
prior
to caring for Ebola patients
·
Undergo PPE training (including donning and doffing PPE) and CAPR.
·
Review
the
possible
impact
of
Ebola
on
your
own
health,
especially
for individuals
with chronic
diseases
and
/ or
taking
medication.
·
Considerations include pregnancy, immune suppressing conditions and medications, difficulty donning and doffing PPE, poorly controlled seizures or narcolepsy, claustrophobia, planned surgery, chemotherapy,
current illness which could be confused with Ebola.
·
Ensure vaccines are up to date; especially influenza
·
Train to provide
care
for
Ebola
patients
wearing the
correct
personal
protective
equipment
(PPE) and become proficient and comfortable with this.
·
Understand
the
travel
restrictions
for
"known
exposures
and
contacts"
with Ebola patients.
·
Wear scrubs only under PPE.
While on Ebola care duty
·
Your temperature will be checked twice daily and logged by Infection Prevention officer.
·
If temperature or any possible Ebola symptoms, or any potential exposure, contact Medical Director of Infection Prevention on call: Dr. XXXXX or Dr. XXXXXX)
·
Make a daily check in call to Occupational Health at xxxxxxxxxx while on Ebola Response Team duty.
Preparation
prior
to returning
to non-Ebola UCLA patient care duties
·
Undertake
an "Exit
Exposure
Review"
by Occupational Health officer.
·
Employees
should
be
aware
that
current CDC
guidelines
indicate
that asymptomatic
persons
with
“Close
Contact”
(defined
below)
should not
travel
by commercial
conveyance
(airlines,
ships,
trains)
for 21
days
after
last
contact.
·
Healthcare
workers
in Ebola
facilities
who
observe
strict
infection
control
measure
with
consistent
and
appropriate
PPE
use
are not
considered
as having
“close
contact”.
·
Brief
interactions,
such as
walking
by
a person
or
through
a hospital,
do
not
constitute
close
contact.
·
For
health
care
workers
classified
as "no
known
Ebola
exposure",
there
will still
be medical surveillance
for
21
days
as
follows:
1.
Self-monitoring:
daily
symptom
review
and
twice
daily
temperature
check
for 21
days
following
return
from
West Africa.
2.
Daily
contact
with local
Occupational
Health
3.
Notification of Infection Prevention
on the
presentation
of
any symptoms.
·
Health
care
workers
who
appropriately
use
PPE
in the
presence
of known
cases
should also
understand
the
potential
for
risk
that
may
arise
from unprotected
contact
with asymptomatic,
or
individuals
assumed
ill
with
another
disease,
who
develop
EVD
a few
days later.
·
Medical
surveillance
during
the
21
days
following
last
exposure
will
include
risk
assessment for
direct
patient
contact
. Decisions
regarding
fitness
for
duty
will
be
locally
determined
and
coordinated
with local
Infectious
Disease
and Infection
Control
hospital/clinic
personnel,
and based
on
characteristics
of
patient
population,
scope of services
and
setting
of
services
provided
by
clinician.
Close
contact
is
defined
as
·
being
within
approximately
3 feet
(1 meter)
of
an EVD patient
or
within
the
patient’s
room
or care
area
for a
prolonged
period
of time
(e.g.,
health
care personnel,
household
members)
while
not
wearing
recommended
personal
protective
equipment
(i.e., standard,
droplet,
and
contact
precautions;
see Infection
Prevention
and
Control
Recommendations);
or
·
having
direct
brief contact
(e.g.,
shaking
hands)
with
an
EVD
patient
while
not
wearing
recommended
personal
protective
equipment.
·
Individuals
with
brief interactions,
such
as
walking
by a
person
or
moving
through
a hospital,
do
not
constitute
close contact
and
no
travel
restrictions
apply,
however
should
self-monitor
for
21
days
following
last exposure.
T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health
UCLA
Health System and Campus
Office 310.825.9146
Fax 310.206.4585
Pager 800.233.7231 ID 27132
E-mail
twhudson@mednet.ucla.edu
Website
www.ohs.uclahealth.org
From: MCOH-EH [mailto:mcoh-eh-bounces+twhudson=mednet.ucla.edu@mylist.net]
On Behalf Of Foley MD, Deborah
Sent: Wednesday, October 22, 2014 2:08 PM
To: 'MCOH/EH'
Subject: [MCOH-EH] Medical clearance for Ebola PPE
Is anyone developing a medical evaluation tool to help determine an employee’s ability to work in the PPE recommended for Ebola patient care? We think that a nurse may be in the gear for up to a 4 hour shift.
I am considering the long form respiratory questionnaire as a possibility. What are others thinking?
Thanks,
Deborah Foley MD
Employee Health and Safety
Northwest Community Healthcare
Arlington Heights IL
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