MEMORANDUM From: Phyllis Beasley, Planning Manager, Office of Public Health Preparedness Date: October 8, 2014 Re: Clarifications and recommendations on hospitals’ Ebola virus concerns This memo and supplied attachments include information and guidance that was requested during an October 2 conference call regarding the Ebola virus. We would appreciate your assistance in further distributing this information to your membership. This memo will also be submitted to our HPP Healthcare Coalitions. 1. In response to the request for clarification on waste control in the hospital setting for Ebola patients: DHEC is recommending adherence to the CDC’s interim guidance which provides information related to safe handling of waste and linens and the PPE for environmental services staff. The link to that information is: cdc.gov/vhf/ebola/hcp/environmental-infection-control-in-hospitals.html While CDC states that sanitary sewers may be used for the safe disposal of patient waste, there was concern from hospitals that choose to use waste streamer companies that those companies will not accept Ebola waste. The CDC and Department of Transportation are expected to issue joint guidance on waste disposal next week. OPHP will work with Health Regulation and EQC to determine if there are waste streamer vendors who would be willing to take this waste. Once this guidance is available DHEC will forward it. 2. Concerns were raised about the conflict between the PPE recommendations for healthcare workers by the CDC and the photos that were being seen in the media of healthcare workers in Level A PPE. The CDC currently recommends the following for appropriate PPE to care for patients with Ebola virus disease (EVD): All persons entering the patient room should wear at least: Gloves, Gown (fluid resistant or impermeable), Eye protection (goggles or face shield), a Facemask, and a N95 respirators (if aerosol-generating procedures will be performed) Additional PPE might be required in certain situations (e.g., copious amounts of blood, other body fluids, vomit, or feces present in the environment), including but not limited to: Double gloving Disposable shoe covers Leg coverings Ensure that all PPE meets the nationally recognized standards as defined by OSHA, CDC, and FDA, or the Interagency Board for Equipment Standardization and Interoperability (IBESI website: https://iab.gov/SELint.aspx) For re-useable PPE, clean and disinfect according to the manufacturers reprocessing instructions and hospital policies. PPE should be removed carefully to avoid touching contaminated outer surfaces of the PPE and discarded in designated containers after patient care is completed and before leaving the isolation area or when soiled or damaged Hand hygiene should be performed immediately after removal of PPE 3. A need to ensure that Emergency Departments are screening adequately for the possibility of the Ebola virus. Attached is a copy of the CDC’s screening checklist and screening algorithm. Please forward these documents to your membership, including Emergency Department Directors and Infection Control Practitioners. 4. Clarification on the ratings for the recommended PPE was requested. The CDC currently recommends to use gowns that are fluid resistant or impermeable. There are no specific recommendations on the gown level from the CDC. Given that each vendor or manufacturer may vary in their level rating criteria, it is advised that hospitals do the following: Ensure that all PPE meets the nationally recognized standards as defined by OSHA, CDC, and FDA, or the Interagency Board for Equipment Standardization and Interoperability (IBESI website: https://iab.gov/SELint.aspx) Ensure the use of isolation gowns that will provide fluid-resistance and impervious protection according to the description provided by the manufacturer. 5. Recommendation for a standardized policy on releasing information and recommendations on Ebola. DHEC will continue to evaluate the need for future conference calls to provide Ebola updates and feedback from healthcare workers. We appreciate the SCHA working with us to ensure that timely and accurate information on the Ebola virus is distributed to hospitals and healthcare workers. We are continuing to work on the items that were requested during the conference call that are not addressed in this memo. Please let me know if you receive other requests for information or recommendations from your membership. My office phone is 803-898-4557, cell is 803-636-7362 and my email is [email protected].
Posted on: Fri, 10 Oct 2014 05:06:34 +0000