From Baptist Health South Florida
5 min. read
In our 21st century world, deadly viruses have the potential to spread like a global wildfire, from one continent to another, originating with a simple plane trip or two. We all got a glimpse of that scary reality in 2014, with the largest outbreak of Ebola in history.
A different kind of threat in 2016 involves Zika, a virus spread by Aedes mosquitoes, which are known to live in all countries in the Western Hemisphere, except for Canada and Chile. Zika is not a deadly, infectious threat like Ebola, but it can cause a mild, flu-like illness that has been linked to devastating brain defects in the babies of infected pregnant women.
The World Health Organization on Monday declared the Zika virus an international public health emergency, a designation it has made only three previous times. The official “emergency” status can trigger action and funding from governments and non-profits around the world. The last time the WHO made such a declaration was in August 2014 with Ebola in West Africa.
The W.H.O. has convened an emergency international committee to study the quickly spreading Zika outbreak, centered in South America, with more than 30 confirmed travel-related cases in the United States. And the U.S. Centers for Disease Control & Prevention (CDC) has issued travel alerts, recommending that pregnant women postpone travel to certain countries through Latin America and the Caribbean where Zika cases are most prevalent.
Public health experts expect more cases in the United States due to travelers and the existence of Aedes mosquitoes here. The mosquitoes can transmit Zika by biting an infected person and becoming a carrier, and then biting other people. Eliminating pooling water, where mosquitoes reproduce, and avoiding mosquito bites are the best ways to protect yourself from Zika, said Barbara Russell, R.N., Baptist Hospital’s director of Infection Control and a longtime leader in the field.
“We are learning more and more about Zika,” said Ms. Russell, adding that “it’s only a matter of time” until the United States sees more cases. Ms. Russell said Baptist Health is working to educate the public about Zika and the importance of avoiding mosquito bites, especially if you are pregnant or trying to become pregnant.
Stay tuned to the CDC for the most up-to-date information about Zika.
The Zika virus does not require the high level of precaution that Ebola does when treating possibly infected patients. Unlike Zika, Ebola is often fatal and spread through direct contact with body fluids or objects, like needles, that have been contaminated.
The spread of Ebola in 2014 (the death toll has reached 11,300) highlighted not only the potential for a worldwide pandemic, but also the importance of developing an emergency preparedness strategy for biological diseases. Though no Florida cases were confirmed, several people in South Florida with Ebola symptoms (who had traveled to the affected countries in West Africa) were isolated, tested and treated at Baptist Health hospitals during the scare.
“It frankly had providers, nurses and doctors quite nervous,” said John Braden, M.D., medical director of Baptist Health’s acclaimed Emergency Preparedness and Security Department.
The appearance of possible Ebola patients triggered Baptist Health’s infection control and emergency preparedness plans. Though not commonly used, out came the full-body suits and breathing apparatus necessary for nurses and doctors to treat patients safely.
Taking lessons learned from that experience, Baptist Health recently launched a new training program as part of its enhanced biological disease preparedness plan. Dozens of employees from every Baptist Health hospital and urgent care center are receiving the detailed, hands-on training to become their facility’s experts in the protocols for caring for patients potentially infected with a dangerous, contagious illness. The plan focuses on keeping staff and all patients and visitors safe.
“Whether it’s Ebola or MERS [Middle East Respiratory Syndrome] or smallpox, something is going to affect us further down the line,” said Rick Whitehurst, R.N., Baptist Health’s longtime trainer for Emergency Preparedness, who has decades of field experience in disaster response.
The protocols for treating a potentially infectious patient focus on the donning and doffing—or the putting on and taking off—of special protective clothing and equipment. That is when the inadvertent spread of germs is most likely to occur. Baptist Health has acquired new and redesigned equipment, including lightweight, fluid-impenetrable, disposable splash suits; N95 medical masks; face shields; and powered air purifying respirators (PAPRs, pronounced “pappers”).
“Having a perfect protocol is essential to maintain a pristine, sterile environment,” Dr. Braden said.
The standards Baptist Health has developed meet or even exceed the recommendations of the Centers for Disease Control & Prevention and the World Health Organization, said Jean Arias, R.N., director of Emergency Preparedness. The employees who are being trained as instructors in turn will train selected staff at their hospital or facility.
“Our goal is to have 24/7 coverage [by a trained team] in every hospital Emergency Department,” Ms. Arias said.
Practice is crucial to preparedness and to creating confident caregivers who are comfortable in their roles. “It has been shown over and over that continuous education is essential in preventing transmission of all types of infections, especially those that are highly infectious,” said Ms. Russell, who helped develop infection control protocols that are followed internationally.
Baptist Health Infection Control experts such as Ms. Russell act as the liaisons with the Miami-Dade County Health Department during a possible infectious disease outbreak.
Donning and doffing the personal protection equipment is a three-person operation — the care provider, a doffing assistant who helps with disinfection and a trained observer who ensures that a multi-step checklist is followed to the T. All three wear personal protection equipment.
For caregivers, the equipment must completely cover all parts of the body to provide the highest level of protection. In fact, Baptist Health designed and commissioned longer hoods to provide overlapping coverage.
“You can’t have any leaks whatsoever,” Dr. Braden said.
At the end of the daylong course, the trainees don real, disposable splash suits and equipment, rather than simulated ones, for their final exam. After they’re in full gear, Mr. Whitehurst squirts Glo Germ, a gel or mist that’s used to practice infection control protocols, onto the splash suits to simulate germ contamination. Even after it dries, the liquid will fluoresce under UV light. “This will show that you can do this donning and doffing without being contaminated,” Mr. Whitehurst told the group.
After the trainees doffed the equipment, Mr. Whitehurst shone a UV light on their hands, arms, head and neck. Nothing glowed. Everyone passed.
Baptist Health corporate leaders place a high priority on all types of emergency preparedness and approve the resources needed to create a safe environment for employees, patients and visitors.
“Those of us who work for Baptist Health are extremely fortunate that this dedication to preparedness is supported,” Ms. Russell said.
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