Ebola virus a 'wake-up call' for U.S. hospitals, Johns Hopkins emergency preparedness expert says

Tener Goodwin Veenema is an associate professor at the Johns Hopkins University School of Nursing and an internationally recognized expert in disaster nursing and public health emergency preparedness.

We spoke with her recently about the Ebola response in West Africa and in the United States, and about the critical role nurses play in hospital preparedness.

What factors are contributing to the rapid spread of the Ebola virus in West Africa?

There are many factors contributing to the rapid spread of the Ebola virus in several West African nations, including poverty, malnutrition, and concurrent illnesses, along with social, economic, and education-related factors. A weak public health infrastructure characterized by poor sanitation and inadequate plumbing are other contributing factors.

What can be done to contain it?

Infection control is a key strategy in stopping the Ebola epidemic and in preventing future outbreaks of disease. In West Africa, preventing transmission of the Ebola virus requires a well-considered infection control plan that prioritizes four main actions:

• Identifying and isolating patients with suspect Ebola cases
• Providing care in a way that protects patients and health care workers
• Cleaning up safely after caring for a possible Ebola patient
• Managing patients with suspected Ebola safely and compassionately

Infection control must begin before the patient even enters the health care facility. Facility staff should designate appropriate areas for screening patients and for safely isolating suspect Ebola patients. In the U.S., heightened surveillance of all travelers coming from West Africa and of health care workers and others who fall into the CDC categories of medium to high risk for exposure will be critical to disease containment.

Are U.S. hospitals well-prepared to deal with isolated Ebola cases?

Clearly, not all hospitals in the U.S. are prepared to deal with Ebola patients. Now is certainly the time to prepare—and not just for Ebola. This has been a wake-up call for all U.S. hospitals with respect to capacity to deal with highly infectious diseases. With MERS, Ebola, and pandemic influenza looming on the horizon, hospitals would be well-served to ramp up their preparedness programs. Recently released guidelines from the Centers for Disease Control and Prevention can assist hospitals with preparedness activities. Education and training of all staff (nurses and other health care workers, and environmental services staff) on the appropriate selection and proper use of personal protective equipment will be critical to enhancing readiness.

What is nursing's role with respect to hospital preparedness efforts?

Today's nurse is a competent professional with a broad scope of practice grounded in science of both public health and acute patient care. Nurses can provide leadership in reviewing and enhancing their organization's current disease containment strategies. Nurses are well-versed in the need for consistent use of standard, droplet, and respiratory precautions in daily practice and now if needed, can ensure the implementation of the CDC revised guidelines for the use of PPE by health care workers caring for Ebola patients. Nurses provide health education to patients, families, and the community that can dispel myths and calm the fear that many have experienced as a result of this outbreak.