Are American hospitals ready for Ebola?

[texarkana 551]

I retired from a major trauma hospital in 2009 and even then I knew they weren't going to be able to handle a large epidemic of any kind. Most ICU's only have 1 or 2 negativepressure isolation units.I also don't trust the CDC especially after their most recent mishaps of sending out supposedly deactivated anthrax and "finding" still live samples of smallpox forgotten in a storage room. I also find it disturbing that after the reports coming out now about the 1st US case of ebola I am finding little discussion on other nursing boards about this. We should be scared, we all know how administrators water down things,that's their job.Also patients lie,the CDC doesn't really know how many people this man came in contact with,also I believe he knew he was infected and fled Liberia before he couldn't hide his symptoms anymore.We all knew we were only one air flight from a pandemic ,well the plane has landed and from one reply on this board apparently Houston has a large population of Nigerian immigrants. This man will not be the last one, there are clouds on the horizon.In a lot of hospitals infection control is a joke, put that with understaffing and cost cutting. We need to start communicating with each other. Start looking at your own hospitals infection control policies, are they being followed.Start asking questions that could save your life,look at the numbers of health care workers in Africa that have already died doing their job.This is a health care emergency, you might say don't panic, well if panic involves having hospitals actually doing and enforcing their own infections control policies well then let the PANIC begin.Emergency rooms are going to start being overwhelmed by anybody that has a temp or upset stomach. I guess we will all know in about 21 DAYS.(mark your calendar)

[duskyjewel]

Judging from how the first US hospital to get an Ebola case handled it, the answer is clearly no.

[RNsRWe, ASN, RN]

Absolutely not. The "average" hospital is not equipped to equip all the staff with appropriate PPE, for starters.

Frankly, since nosocomial infections are the norm (how many times do we see patients come in with one bug but before discharge they've accumulated another?)....this would spread like nobody's business.

Gonna get ugly.

[nightbreak]

Saw this earlier in a press report from the Dallas hospital where the ebola patient was originally sent home from the ED:

"The hospital said in a statement today that the physician and the nurses followed protocol, but his travel history didn't automatically appear in the physician's standard workflow.

"The documentation of the travel history was located in the nursing workflow portion of the EHR, and was designed to provide a high reliability nursing process to allow for the administration of influenza vaccine under a physician-delegated standing order," read the statement. "As designed, the travel history would not automatically appear in the physician's standard workflow.""

I'm worried that our computerized charting systems, along with constant understaffing and stress, will lead to more cases being missed. And, of course, we can barely isolate for MRSA, given that none of the families want to follow protocols and the hospital admin is so focused on patient scores, they won't enforce anything that might make patients unhappy.

[Caffeine_IV]

I think some are but most are not.

[xoemmylouox, ASN, RN]

No they are not! Neither are the walk in clinics or outpt primary care offices. Things could get realy ugly real quick.

[nynursey_]

He fled Libera because he knew he had Ebola? You're not serious, right? That sounds like a conspiracy theory.

Do I think all American hospitals are ready for Ebola? No, absolutely not. But do I feel as though banning international travel is the solution? No. Infection control policies leave a lot to be desired, but perhaps in the face of Ebola, we can now start looking to hospitals to spend the money it takes creating units in which to house these infections individuals.

[nynursey_]

Saw this earlier in a press report from the Dallas hospital where the ebola patient was originally sent home from the ED:

"The hospital said in a statement today that the physician and the nurses followed protocol, but his travel history didn't automatically appear in the physician's standard workflow.

"The documentation of the travel history was located in the nursing workflow portion of the EHR, and was designed to provide a high reliability nursing process to allow for the administration of influenza vaccine under a physician-delegated standing order," read the statement. "As designed, the travel history would not automatically appear in the physician’s standard workflow.""

I'm worried that our computerized charting systems, along with constant understaffing and stress, will lead to more cases being missed. And, of course, we can barely isolate for MRSA, given that none of the families want to follow protocols and the hospital admin is so focused on patient scores, they won't enforce anything that might make patients unhappy.

Not for nothing, but when physicians (and midlevel providers) are trained to take a history and physical, part of the questions they need to ask involve recent travel, especially if a physician knows that international illnesses can present in the US. In my hospital, there are signs EVERYWHERE about recent travel and presenting with symptoms. What physician relies soley on prompts to take their H&P? Where is the accountability for the physician to take a full H&P on every single patient regardless of EHR prompts?

[Laurie52]

He fled Libera because he knew he had Ebola? You're not serious, right? That sounds like a conspiracy theory.

Do I think all American hospitals are ready for Ebola? No, absolutely not. But do I feel as though banning international travel is the solution? No. Infection control policies leave a lot to be desired, but perhaps in the face of Ebola, we can now start looking to hospitals to spend the money it takes creating units in which to house these infections individuals.

I think he absolutely knew he was infected. He lied to get out of the country. Where would you want to be treated? I would chose a hospital in USA versus somewhere in a third world country with resources already stretched past the breaking point.

[guest769224]

My major hospital system sent out this email a few days back. It appears as though they are trying their best to be equipped should the virus present itself. I deleted the hospital and state name for anonymity.

_________ Hospital, and other large referral hospitals in _________, have been developing an Ebola preparedness plan for more than two months. This planning has taken place in consultation with the __________ Department of Health and the CDC. We are prepared to isolate persons who may have exposure, test for Ebola, and provide care. We are confident if we had a patient with Ebola that we could provide care safely.

[nynursey_]

I think he absolutely knew he was infected. He lied to get out of the country. Where would you want to be treated? I would chose a hospital in USA versus somewhere in a third world country with resources already stretched past the breaking point.

You honestly believe this individual knew he was infected with Ebola ... for certain Ebola. And lied to leave Liberia. And then allowed himself to be discharged with a diagnosis of a viral illness. And then went back? ...

If he were really seeking medical treatment in the US for a better survival rate, don't you think he would have essentially told health care personnel he had Ebola?

[nynursey_]

I think he absolutely knew he was infected. He lied to get out of the country. Where would you want to be treated? I would chose a hospital in USA versus somewhere in a third world country with resources already stretched past the breaking point.

Conspiraracy theories like this lead to public panic. We're nurses, for crying out loud. Our job should be to educate ourselves and provide knowledge that reassures the public but with honesty, not promote conspiracy theories that cultivate panic.