A Difference of Degrees
As news spread that a Texas healthcare worker had contracted Ebola when treating Thomas Eric Duncan, the CDC announced that the United States (US) needs to re-think its infection controls. The healthcare worker likely contracted the virus during a breach in protocols, although the Centers for Disease Control and Prevention (CDC) is quick to state it is not blaming the healthcare worker. Rather, the case underscores the difficulty of providing medical care for those sick with this highly infectious disease, and the importance of clear protocols that are closely followed by everyone.
The CDC has been issuing guidance for US healthcare facilities for months. However, it has stated it will step up its training for hospitals and other facilities, as more healthcare workers express concern about adequate training and screening protocols. Others have stated that the CDC suiting up and de-suiting procedures could be improved by more closely following the World Health Organization’s (WHO) procedures for putting on and removing personal protective equipment (PPE). Two characteristics in WHO’s procedures are of particular note: the prominence of hand sanitizing between every step, and the recommendation that dressing and undressing of PPE should “be supervised by another trained member of the team.” Although the CDC guidelines state that one should “perform hand hygiene between steps if hands become contaminated and immediately after removing all PPE,” the hygiene step is not as prominently portrayed in pictures. Nor does the guidance mention supervision during the process.
While these may seem like minor differences, they could have a major impact: a buddy system can cut down on mistakes, and requiring hand sanitizing at every step (whether hands are known to be contaminated or not) helps lessen the chance the virus can be inadvertently passed along.