Nurses union: U.S. hospitals not prepared for Ebola patients

National Nurses United says hospitals must upgrade emergency preparations
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As international agencies fight to contain the world's worst Ebola outbreak in nearly 40 years amid reports that a Dallas hospital misdiagnosed a patient infected with the deadly virus, a survey of registered nurses reveals most believe their hospitals aren't prepared to handle patients with Ebola.

Although the Centers for Disease Control and Prevention (CDC) last month issued a checklist for hospitals to help clinicians manage patients carrying the virus, 80 percent of nurses surveyed by the National Nurses United said their hospitals haven't provided them with a policy regarding potential admissions of patients infected by Ebola. The survey involved 700 registered nurses at more than 250 hospitals in 31 states.

The survey also revealed that:

  • Eighty-seven percent report their hospitals haven't educated them on Ebola

  • One-third say their hospitals don't have a sufficient supply of eye protection (face shields or side shields with goggles) and fluid resistant/impermeable gowns

  • Nearly 40 percent say their hospitals don't have plans to equip isolation rooms with plastic-covered mattresses and pillows and discard all linens after use

  • More than 60 percent say their hospitals fail to reduce the number of patients they must care for to accommodate caring for an "isolation" patient

As a result of the survey results, the union called on all U.S. hospitals to implement a full emergency-preparedness plan for Ebola and other infectious diseases. In addition to sufficient staffing, those plans must include full training of hospital workers on proper protocols for responding to outbreaks and adequate supplies of personal protective equipment, according to the union's statement.

"What our surveys show is a reminder that we do not have a national healthcare system, but a fragmented collection of private healthcare companies, each with their own way of responding," Bonnie Castillo, R.N., director of the union's registered nurse response network.

Amid reports that a flaw in the Dallas hospital's electronic health record system may have led clinicians to misdiagnose and release the U.S. patient later confirmed to have Ebola (which the hospital now denies), Castillo said the case serves as reminder that hospitals must not rely on automated protocols with computerized scripts for interacting with patients. That patient, Thomas Eric Duncan, is in critical condition, NBC News reports.

"As we have been saying for many months, electronic health records systems can, and do, fail. That's why we must continue to rely on the professional, clinical judgment and expertise of registered nurses and physicians to interact with patients, as well as uniform systems throughout the U.S. that is essential for responding to pandemics, or potential pandemics, like Ebola," Castillo said.

CDC Director Thomas Frieden, M.D., said Saturday during a telebriefing that healthcare workers must remain on alert and ensure that they take a travel history if patients arrive in the emergency room with a fever. The travel history, he said, must be specific and identify whether they traveled to West African countries in the past 21 days. If so, clinicians must conduct a rapid test for the virus.

"Our number one priority is the safety of Americans," he said, adding that essential measures involve controlling the outbreak in West Africa. "That's what we're working very intensively to do and we're beginning to see some progress there.  But it's going to be a long, hard road."

Meanwhile, a freelance NBC News cameraman who was diagnosed in Liberia with Ebola arrived at a Nebraska hospital for treatment, NBC News reports. And American doctor Richard Sacra, who was successfully treated for Ebola last month and hospitalized again Saturday, tested negative for the virus and was removed from isolation, according to a separate NBC News report.

To learn more:
- read the statement by the National Nurses United
- here's the NBC News report on Duncan
- check out the transcript from the CDC briefing
- read the second and third NBC News reports

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