During the 2014 Ebola outbreak, medical personnel accounted for three of the four cases diagnosed in the US, where countless facilities scrambled to prepare medical staff for potential new cases.
A new paper coauthored by researchers at the University of Washington School of Public Health documents how a systematic healthcare simulation can help develop clinical care protocols to identify safety threats while caring for infectious patients. The paper was published in the June 2016 issue of Infection Control & Hospital Epidemiology.
Ebola turns even the simplest hospital procedures, such as changing bedsheets, into high-risk activities. 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. 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 Rosemarie Fernandez, a University of Washington associate professor in the Division of Emergency Medicine, and human-factors expert Sarah Henrickson Parker, of Virginia Tech, the team identified high-risk activities and proposed potential solutions.
The reviewer team included Scott Meschke, Nancy Simcox and Sarah Wolz from the Department of Environmental and Occupational Health Sciences in the University of Washington School of Public Health and Steven Mitchell from the University of Washington’s Department of Surgery and Institute for Simulation and Interprofessional Studies.
The team 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. The recommended tongs to pick up the linen were unwieldy and using them made it difficult to quickly pick up heavy linens.
Researchers found that detailed checklists and team time-outs can increase situational awareness among providers and mitigate contamination stemming from a lack of attention. Simulation provides a safe way to study systems, test protocols and detect safety threats, Fernandez said. When combined with risk analysis methods, these simulations can help identify unanticipated threats to safety.
The work was funded by the Washington State Department of Labor and Industries Safety and Health Investment Projects.