How Ebola Highlights The Negative Consequences Of A Reactive Health & Safety Management System

The 2014 Ebola epidemic is the largest outbreak in history, with 8,914 cases and 4,447 deaths reported by the World Health Organization.

Ebola has now reached North America, claiming the life of Thomas Eric Duncan on October 8, 2014. Since Mr. Duncan’s admittance to the Texas Health Presbyterian Hospital, two healthcare workers have tested positive for Ebola.

Texas Health Presbyterian Hospital has already faced allegations from the Duncan family for sending Mr. Duncan home after he first sought treatment at the hospital, despite him informing medical personnel that he had recently returned from Liberia. The hospital is now under scrutiny again from the National Nurses United Union (NNU) for not taking the proper precautions to protect the healthcare workers from infection.

RoseAnn Demaro, the Executive Director of NNU, stated: “Our nurses are not protected. They are not prepared to handle Ebola.^[2]” The nurses have reported several issues to the NNU which suggest that the Texas Health Presbyterian Hospital’s health and safety management system has failed to take the proper precautions to keep their healthcare workers safe from this deadly infection. These claims demonstrate alarming flaws in the hospital’s health and safety management system and are as follows:

Not Having Proper Protocols in Place

The nurses began anonymously speaking out to the NNU after hospital administration suggested that Nina Pham, the first healthcare worker to test positively for Ebola within the United States, contracted the virus by failing to follow proper protocol. According to the nurses, there were no protocols in place when Mr. Duncan was admitted and the guidelines were constantly changing. “The protocols that should have been in place in Dallas were not in place, and those protocols are not in place anywhere in the United States as far as we can tell,” NNU Executive Director RoseAnn DeMoro said. “We’re deeply alarmed.^[3]“

Despite nurses requests, when Mr. Duncan was first admitted to the hospital he was not put in isolation. Rather, Mr. Duncan was initially put in a room with other patients, increasing the chance of further spreading the virus. Not only were the nurses unprepared for dealing with Ebola patients, but when they tried to enforce proper protocols themselves, they were met with resistance from hospital administrators.

Not Supplying Proper Protective Gear

Another alarming issue the nurses addressed was that the hospital failed to supply proper protective gear when they were first treating Mr. Duncan. The nurses claimed that the gowns they were first given still exposed their necks and left the majority of their heads exposed. Their initial scrubs they were given only went down to their knees and they were not even given surgical bootees nor were they advised of the number of pairs of gloves to wear.^[4]

Furthermore, after the nurses expressed concern regarding their exposed necks, the hospital administration instructed the nurses to wrap their necks with medical tape, rather than providing the surgical cap which is regularly included in the protective Ebola suit.

Failing to Provide Proper Training

The nurses also claim that they did not receive hands-on training for dealing with Ebola patients. “There was no mandate for nurses to attend training,” Deborah Burger, Co-President of the NNU said, “though they did receive an e-mail about a hospital seminar on Ebola. This was treated like hundreds of other seminars that were routinely offered to staff.^[5]”

These claims from the nurses suggest two very important issues with regards to the hospital’s health and safety management system: that there is a lack of communication between the workers and management of the hospital and a lack of preventative and proactive measures with regards to healthcare worker’s health and safety.

Lack of Communication

When the nurses voiced their concerns to the hospital management about proper protocols not being in place, they were allegedly met with resistance. This indicates a major problem in the hospital’s health and safety management system. Workers are more commonly exposed to the day to day health and safety hazards that exist in a workplace. It’s imperative that they feel comfortable in voicing concerns regarding “unsafe behaviours” or “hazardous situations” that surround them.

What if the hospital administration had addressed the nurses’ concerns about Mr. Duncan being put into isolation when he was first admitted to the hospital? What if the hospital provided proper protocols and protective gear for dealing with Ebola? The outcome might have been better. The role of communication is vital in an effective health and safety management system; and as the Ebola case in Dallas demonstrates, failing to have an open and safe dialogue between the workers and upper management can have drastic consequences for the health and safety of your workers.

Lack of Preventative and Proactive Measures

The nurses’ claims of having no protocols, training or protective gear begs the question: why are hospitals waiting until an Ebola victim is identified before taking adequate measures to protect their workers from exposure? Why wasn’t proper Ebola personal protective equipment available at the hospital before the outbreak in Dallas? Furthermore, why weren’t Ebola protocols and training introduced to hospitals as soon as the outbreak in West Africa occurred?

Choosing a reactive rather than proactive approach to health and safety issues can result in workplace incidents. Dr. Thomas R. Frieden, the Director of the Center for Disease Control and Prevention suggested: “If a robust team of experts had been on the ground the day Mr. Duncan was diagnosed, the spread of infection might have been prevented.^[6]” Being prepared for the worst is always better than reacting to incidents after they occur, and in this case, it may have prevented the two diagnosed healthcare workers and over 70 people under observation from coming into contact with the deadly virus.

Nurses in Alberta have begun speaking out about their concerns of being unprepared for caring for an Ebola patient. Hospitals across North America (and around the world) need to begin taking a more proactive approach to health and safety. A heavier emphasis should be placed on training healthcare workers on how to safely care for Ebola patients rather than waiting for the first diagnosed patient to arrive at their facility.

Sources

[1] http://www.bbc.com/news/health-29628481
[2] http://www.cnn.com/2014/10/15/health/texas-ebola-outbreak/
[3] http://www.cnn.com/2014/10/15/health/texas-ebola-outbreak/
[4] http://www.nytimes.com/2014/10/16/us/ebola-outbreak-texas.html
[5] http://www.cnn.com/2014/10/15/health/texas-ebola-outbreak/
[6] http://www.nytimes.com/2014/10/16/us/ebola-outbreak-texas.html

http://www.nbcnews.com/storyline/ebola-virus-outbreak/ebola-outbreak-tip-iceberg-experts-say-n137081