The Dallas Hospital where America’s index case of Ebola died, and where at least two nurses were infected, has issued a pair of statements overnight.
The first is an offer to employees who have had a potential exposure to the Ebola virus that they can self quarantine at the hospital. The second refutes a number of the claims lodged yesterday by local nurses regarding the infection control protocol used in the treatment of their index case (see Nurses Claim Lack Of Safety Protocols For Dealing With Ebola).
Ebola Update, Oct. 15, 9:44 p.m. CDT
With a second one of our health care workers now infected with the Ebola virus despite following recommended protection procedures, Texas Health Dallas is offering a room to any of our impacted employees who would like to stay here to avoid even the remote possibility of any potential exposure to family, friends and the broader public.
We are doing this for our employees’ peace of mind and comfort.
This is not a medical recommendation. We will make available to our employees who treated Mr. Duncan a room in a separate part of the hospital throughout their monitoring period.
We want to remind potentially affected employees that they are not contagious unless and until they demonstrate any symptoms, yet we understand this is a frightening situation for them and their families. We will be coordinating this effort with the county monitors who are already regularly checking on their temperatures for any sign of infection.
The hospital will contact directly those being monitored to make arrangements. We also ask our potentially affected employees to be the good citizens that we know they are by avoiding using public transportation or engaging in any activities that could potentially put others at risk.
With regard to the charges made yesterday by the coalition of nurses, and the denials today by the hospital, I can only hope that a full and open hearing of the facts will be held, so that we can find out what actually happened.
Ebola Update, Oct. 16, 4:00 a.m. CDT
National Nurses United recently made allegations regarding the protocols and equipment in place during Thomas Eric Duncan’s treatment at Texas Health Presbyterian Hospital Dallas.
The assertions do not reflect actual facts learned from the medical record and interactions with clinical caregivers. Our hospital followed the Centers for Disease Control (CDC) guidelines and sought additional guidance and clarity.
The following are facts about procedures and protocols in place during Mr. Duncan’s treatment:
- When Mr. Duncan returned to the Emergency Department (ED), he arrived via EMS. He was moved directly to a private room and placed in isolation. THD staff wore the appropriate personal protective equipment (PPE) as recommended by the CDC at the time.
- Regarding the ED tube delivery system utilized during Mr. Duncan’s initial visit, all specimens were placed into closed specimens bags and placed inside a plastic carrier that travel through a pneumatic system. At no time did Mr. Duncan’s specimens leak or spill — either from their bag or their carrier — into the tube system.
- During Mr. Duncan’s second visit, the tube system was not used at all. His specimens were triple-bagged, placed in a container, and placed into a closed transport container and hand-carried to the lab utilizing the buddy system. Additionally, while Mr. Duncan was in the MICU, all lab specimens were hand-carried and sealed per protocol. Routine labs were done in his room via wireless equipment.
- Nurses who interacted with Mr. Duncan wore PPE consistent with the CDC guidelines. Staff had shoe covers, face shields were required, and an N-95 mask was optional — again, consistent with the CDC guidelines at the time.
- When the CDC issued updates, as they did with leg covers, we followed their guidelines.
- When the CDC recommended that nurses wear isolation suits, the nurses raised questions and concerns about the fact that the skin on their neck was exposed. The CDC recommended that they pinch and tape the necks of the gown. Because our nurses continued to be concerned, particularly about removing the tape, we ordered hoods.
- Protective gear followed governing CDC guidelines at the time.
- The CDC classified risk/exposure levels. Nurses who were classified as “no known exposure” or “no risk” were allowed to treat other patients per the CDC guidance.
- Per the CDC guidelines, patients who may have been exposed were always housed or isolated per the CDC guidance.
- Regarding hazardous waste, the hospital went above and beyond the CDC recommendations. Waste was well-contained in accordance with standards, and it was located in safe and containable locations.
- Admittedly, when we received Tyvek suits, some were too large. We have since received smaller sizes, but it is possible that nurses used tape to cinch the suits for a better fit.
According to an employee satisfaction survey by Press Ganey, Texas Health Dallas is in the top one percent in the country when it comes to employee engagement and partnership. We support the tireless and selfless dedication of our nurses and physicians, and we hope these facts clarify inaccuracies recently reported in the media.