glockgirl wrote:It now appears, along with the revelation that a second "healthcare worker" (who could be anything from a janitor to a doctor), that Texas Presbyterian had extremely sloppy isolation protocols in place when Mr. Duncan was admitted and may not even had appropriate basic isolation PPE available for use by staff. It's not even that they didn't have an "Ebola protocol" in place--only a handful of hospitals really did--they didn't have anything approaching standard isolation protocol in place at all. SMH.
I would be very interested in knowing the number of nosocomial infections per year originating at Texas Presbyterian, because this is for sure not the first time a staff member has either acquired an infection from a patient in isolation or transmitted an infection to another patient or patients--but of course, hospitals are not required to make that information public. As a nurse, you accept the risks that come with the job--accidental needle sticks, the possibility of acquiring a virus like cytomegalovirus (CMV) when pregnant, the very real possibility of being physically assaulted by a patient--but you also expect that your employer will provide you with the necessary equipment to protect yourself (well, except for against the whole assault thing).
I now sincerely hope that Texas Presbyterian is brought up on criminal negligence charges, as well as facing civil suits and worker's compensation claims from those infected.
Glockgirl,
I admire your courage and willingness to work with these sort of patients and the risks you take to perform your chosen occupation on a daily basis.
This sort of thing is what has concerned me the most about this situation, I do not think Texas Presbyterian is by any means the only hospital in this situation. I will admit I have no hard data, but I have a feeling that if a detailed survey/research was done less than 50% of the hospitals in this country are currently equipped to handle this sort of isolation requirement. If for no other reason than the fact that until now, it has not been an issue for concern, as diseases like this have not been in the country. That does not even touch the issue of the millions of Dr offices and urgent care clinics that will not have the proper equipment. Now we will see billions spent by US hospitals rushing to gear and more fully train up. Not a bad thing, but betting we will see a eventual increase in medical costs as well.
I do not agree that they should be held liable or sued for this (yet). Our own CDC has not been pro-active in working with our customs/immigration agencies to put effective entry screening in place until after the fact. Until now there has been little reason for US healthcare workers to have concern for aggressive screening for this disease, that is not the fault of the hospital or negligent on their part. We have had little risk of diseases of this type in the US to drive such aggressive protocols to all levels of healthcare. Now moving forward, say a few months to a year from now, sure I would agree completely that hospitals should be held accountable as it now IS a cause for concern and requires proper protocols in place in all hospitals in the US.
The other link to this chain is how/when the diagnosis occurs and what are the procedures before that and after that. Post diagnosis protocols only go so far. Can or do we really expect every flu patient to be received with full isolation protocols? It is just not a realistic expectation and that should be reason for concern for everyone. The infected person is going to come in and be in waiting rooms until a initial screening/questionare is done before any staff member knows that they have enough indicators to warrant isolation and testing. That means exposure to those in the waiting room and staff there as well. The protocols for handling those aspects are what really need to be addressed.
I am curious and hoping one of you more knowledgeable of Ebola can fill me in on the basic timeline for the disease? Namely the time between when a patient becomes infected to the time they are infectious to others.
It would be interesting to lay that timeline down on this 1st patient to see possible exposure to others prior to his isolation. Was he already infectious when he came to the hospital on Sept 28th and was then sent home? That should be the strong focus right now, where he was and everyplace he went and touched and who was in those rooms at the time and afterwards. I would hope CDC has already done this as well, but...