Medical staff care for an Ebola patient in this simulation, video-recorded by cameras on the wall.
Courtesy of Rosemarie Fernandez
During the 2014 Ebola virus outbreak, infectious disease experts scrutinized the disease and its spread, particularly among healthcare workers in West Africa. Medical personnel represented three of the four cases of Ebola diagnosed in the United States, where hospitals scrambled to prepare staff with new processes to treat potential cases coming from other countries.
Researchers at the University of Washington and Virginia Tech Carilion Research Institute recently documented how simulations can help identify safety threats and inform Ebola clinical-care protocols. Their paper was published in the June 2016 issue of Infection Control and & Hospital Epidemiology.
Simulation provides a safe way to study systems, test protocols, and detect safety threats, said Dr. Rosemarie Fernandez, a UW associate professor of emergency medicine and the study's lead author.
Ebola turns even the simplest hospital procedures, such as changing bedsheets, into high-risk activity. For instance, patients with the virus produce large quantities of watery stool, making it a challenge to maintain patient hygiene and to ensure providers are appropriately protected and able to carry out their usual daily work. Heavy protective gear can make it awkward for caregivers to move patients or handle their linens.
To identify risks associated with Ebola patient hygiene and linen change, a multidisciplinary team reviewed video recordings of simulated Ebola patient care. Guided by Fernandez and human-factors expert Dr. Sarah Henrickson Parker, of Virginia Tech, the team identified high-risk activities and proposed potential solutions. For example, detailed checklists and team time-outs can increase situational awareness among providers and mitigate contamination stemming from a lack of attention.
The team also identified several equipment-related hazards previously unrecognized. When large volumes of linens were dumped in biohazard containers, the containers that were on wheels moved. Soiled linens could be accidentally dropped on the floor. Use of linen or a solidifier to contain liquid stool spilled on the floor could create a fall hazard and a new challenge: removing the soiled linen from the floor. The recommended tongs to pick up the linen were unwieldy and using them made it difficult to quickly pick up heavy linens.
The study team was diverse, including an occupational health microbiologist, industrial hygienists, clinical care professionals, and human-factors psychologists. The study was supported by the Washington State Department of Labor and Industries Safety and Health Investment Projects.