Lessons from the Ebola Crisis

Health-System Edition, January 2015, Volume 4, Issue 1

With the recent news and corresponding fear about the Ebola crisis, all health care providers have needed to reorient their previously held beliefs. No longer was this a disease confined to certain countries geographically isolated from us, but one that had the potential to infect all people. With today’s global air travel infrastructure, people are routinely crisscrossing the world. Also, most cities have various cultural communities living within them and expect visitors from different countries. Because of these issues, infectious diseases can be easily spread and transmitted across borders.

As much as this Ebola crisis is a singular event, there are broader implications for all of us. I wanted to point these out so that we can try to address them within our departments and be prepared.

Being a health care provider is an awesome calling—Each hospital developed a team to respond to any suspected patient who might show up in its emergency department. While the hope was that none would present, it was prudent to be ready. Hospitals asked for volunteers who would be ready to care for suspected patients. It was great to see so many people willing to put their own safety on the line in order to treat others. This is our calling when we enter the health care field, but very rarely are we asked to sacrifice our own well-being for those under our care. However, we need to be reminded that our first priority is the well-being of our patients.

Employee protection is paramount— It was observed that appropriate garbing is essential to protecting the health care worker from Ebola. Not only is using the correct equipment essential, but the process of protective gear removal is also critical. While only a few of us will ever be in a situation this dangerous, there are activities we are involved in daily that require employee protection.

Hazardous drugs have been shown through numerous studies to be present in the environment of preparation and administration areas. Because of this, pharmacies need to provide protection for their employees. While these data and protective devices have been present for years, there are still many hospitals that do not monitor their contamination levels or provide protection in the preparation of hazardous drugs. USP 800 will soon be approved and will require organizations to monitor their environment and protect their employees against the concerns of hazardous drugs. However, just as with the Ebola crisis, we should be doing everything we can to protect our employees from exposure to hazards and should accept no compromise.

Adherence to policies and procedures is important—When people do not follow all policies and procedures when interacting with patients infected with Ebola, the repercussions can be serious in that they can get infected. It is critical that all steps be followed to prevent this from happening. The same level of care should be taken when making sterile products. Personnel should follow all steps and not have any deviations in their process as this could lead to a contaminated product. While a deviation from procedure would not have the same kind of impact on the health care worker as in the Ebola example, the need for following all steps is just as critical. There is no place for reckless behavior in our intravenous rooms. We need to adhere to USP 797 in its entirety to prevent contaminated products from being prepared.

All communicable diseases might impact us—Diseases like Ebola were historically detected and confined to small geographic areas. That is not true in today’s society. Because of globalization, we need to be ready for the time when these diseases will be found among us. Not only should pharmacists become educated about all of these diseases, no matter how rare, but we also need the pharmaceutical industry to discover therapies to treat them. We might not know when we will need them before the situation occurs.

While it looks like this Ebola crisis might be waning, it is just a matter of time before the next one impacts us. The principles that are necessary to protect health care workers are ones we should be adhering to daily, but unfortunately, I have seen enough instances to know that guidelines are not always followed. We need to hardwire these safety principles into our departments to ensure we are protecting our employees and patients maximally.

Stephen F. Eckel, PharmD, MHA, BCPS, FCCP, FASHP, FAPhA, is associate director of pharmacy, University of North Carolina Hospitals, and clinical associate professor and director of graduate studies at the University of North Carolina Eshelman School of Pharmacy.