Sacred Encounters Perfect Care Healthiest Communities Infection Prevention Ebola Viral Disease (EVD) EBOLA PREPAREDNESS PLAN 03/22/202 2
Dec 31, 2015
Sacred Encounters Perfect Care
Healthiest Communities
Infection PreventionEbola Viral Disease (EVD)
EBOLA PREPAREDNESS PLAN
04/19/2023
Sacred Encounters Perfect Care
Healthiest Communities2
INTRODUCTION TO EBOLA VIRUS DISEASE (EVD)
An epidemic viral infection effecting multiple countries in West Africa including:
–Liberia–Sierra Leone–Guinea
Sacred Encounters Perfect Care
Healthiest Communities
04/19/2023
3
Sacred Encounters Perfect Care
Healthiest Communities
How Does Ebola Cause Disease?
• Virus enters the body via infected blood/body fluid in contact with a mucosal surface or a break in intact skin
• Virus replicates in many different cell types throughout the body
• Strong cytokine/inflammatory response
4
Sacred Encounters Perfect Care
Healthiest Communities
How Does Ebola Cause Disease?
• Endothelial damage, increased vascular permeability and shock
• End organ damage and multi-organ dysfunction
• Diffuse intravascular coagulopathy (DIC) with platelet and coagulation factor consumption leads to hemorrhage
• IgM antibodies starts forming in 2 day and IgG antibodies form in 5-8 days post infection. Immunologic response correlates with survival
5
Sacred Encounters Perfect Care
Healthiest Communities6
GENERAL PATIENT CARE AND PRECAUTIONS
Isolation Practices: after positive infection screen• Place a mask on the patient until
placed in isolation room• Airborne isolation• Environmental cleaning and
disinfection of equipment• Appropriate waste disposal• Injection safety and prevention of
sharps injuries
Sacred Encounters Perfect Care
Healthiest Communities
Ebola Virus Disease
7
• Incubation 2-21 days- In the current outbreak, in 90% of patients for whom information is available, <15 days
• Case fatality ratio 24-89%- 54.9% for current outbreak
• Average time between symptom onset and death is 7 days
• Average time from symptom onset to recovery is 15 days
Sacred Encounters Perfect Care
Healthiest Communities
Transmission of EVD
• EVD is transmitted through direct contact with blood or other body fluids of a symptomatic patient
• Urine, breast milk, semen, saliva and tears may also carry risk – especially during later stages of illness
• Whole virus has never been isolated from sweat of EVD patient
• Risk of transmission from contaminated surfaces is exists, but is low and can be further reduced with appropriate cleaning and disinfection
8
Sacred Encounters Perfect Care
Healthiest Communities
Transmission of EVD
• Unlike most viral illnesses, transmission is only possible from symptomatic patient
• Increasingly infectious as patient becomes sicker
9
Sacred Encounters Perfect Care
Healthiest Communities
Risk AssessmentEVD Risk Level Criteria
No Risk• No travel to or residence in affected
country/area• No contact with EVD patient caregiver
Low Risk
• Household member of EVD patient• Brief direct contact (e.g. hand shake) with an
EVD patient without PPE• Healthcare workers who have been in care area
of EVD patients without recommended PPE
High Risk
• Needle stick or mucous membrane exposure to blood/body fluid from EVD patient
• Direct skin contact with skin, blood, or body fluid from EVD patient
• Processing blood/body fluids from EVD patient without appropriate PPE
• Direct contact with dead body in Ebola-affected area without appropriate PPE
Centers for Disease Control and Prevention, www.cdc.gov/vhf/ebola
Sacred Encounters Perfect Care
Healthiest Communities11
PPE
• A disposable coverall to cover clothing and exposed skin
• N95 mask and eye protection (disposable goggles or face shield) to prevent splashes to the nose, mouth and eyes
• Closed, puncture and fluid resistant shoe covers to avoid contamination with blood or other body fluids or accidents with misplaced, contaminated sharp objects.
• Impervious shoe covers will be used • Gloves- double Education will be provided to all caregivers on use of PPE including donning and doffing of PPE
Sacred Encounters Perfect Care
Healthiest Communities12
Taking off PPE
• Use the Buddy System• Remove the most contaminated PPE items first.• Hand hygiene must be performed immediately
after glove removal– Perform hand hygiene whenever ungloved
hands touch contaminated PPE items• Be careful to avoid any contact between the
soiled items (e.g. gloves, gowns) and any area of the face (i.e. eyes, nose or mouth) or skin
• Discard disposable items in a biohazardous container located inside the room. Nothing is to be removed from the room until treated with bleach and double bagged in a manner to ensure no contamination to outside bag.
Sacred Encounters Perfect Care
Healthiest Communities13
Hand hygieneHow to perform hand hygiene:• Clean your hands by rubbing them with an
alcohol based formulation, as the preferred mean for routine hygienic hand antisepsis if hands are not visibly soiled– It is faster, more effective, and better tolerated by
your hands than washing with soap and water.
• Wash your hands with soap and water when hands are visibly dirty or visibly soiled with blood or other body fluids or after using the toilet
Sacred Encounters Perfect Care
Healthiest Communities14
Visitors
• Visitors will be restricted as determined by Public Health Department or the CDC.
• Only essential staff members will be allowed in the patient care room
Sacred Encounters Perfect Care
Healthiest Communities15
Laboratory Specimens
• Limit testing only to those essential to diagnosis and care
• All specimens will be double bagged and will be hand carried. No pneumatic tubes to be used for transport
• CDC will guide EVD specific testing including packaging and transportation
Sacred Encounters Perfect Care
Healthiest Communities16
Laboratory Specimens
• Education specific to lab will be provided to ensure safety of lab personnel
Sacred Encounters Perfect Care
Healthiest Communities17
Safe Injection Practices
• Limit the use of needles and other sharp objects as much as possible.
• Limit the use of phlebotomy and laboratory testing to the minimum necessary for essential diagnostic evaluation and patient care
Sacred Encounters Perfect Care
Healthiest Communities18
If the use of sharp objects cannot
be avoided:
Sacred Encounters Perfect Care
Healthiest Communities19
ENVIRONMENTAL CLEANING &
MANAGEMENT OF LINEN
Sacred Encounters Perfect Care
Healthiest Communities20
Cleaning and Disinfecting
• Environmental surfaces or objects contaminated with blood, other body fluids, secretions or excretions should be cleaned and disinfected as soon as possible using bleach wipes
• Cleaning should always be carried out from “clean” areas to “dirty” areas, in order to avoid contaminant transfer
Sacred Encounters Perfect Care
Healthiest Communities21
Management of Linen
• When handling soiled linen from patients, use gloves, impervious gown, closed shoes (e.g., boots) and facial protection (mask and goggle or face shield)– No exposed skin
• Linen used on patients or in patient rooms will be placed in the bio-hazardous waste container located in the patient room
Sacred Encounters Perfect Care
Healthiest Communities22
POST-MORTEM CARE AND TRANSFER OF BODIES
The processes will be determined by the Local Health Department or CDC
Contact local health department for instructions
Sacred Encounters Perfect Care
Healthiest Communities23
Sources:
• http://www.cdc.gov/vhf/ebola/hcp/guidance-safe-handling-human-remains-ebola-patients-us-hospitals-mortuaries.html
• http://www.cdc.gov/vhf/ebola/• http://www.who.int/csr/resources/publi
cations/ebola/evd-guidance-summary/en/
• http://www.who.int/csr/disease/ebola/protective-measures-staff/en/
• WHO Power Point titled “Key Measuresfor Prevention and Control of Ebola Virus Disease” by Dr. Sergey Eremin presented on September 16, 2014