CDC Issues New Infection Control Protocols for Hospitals Employers also have role in stopping spread of Ebola

By Bill Leonard Oct 17, 2014
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When officials with the Centers for Disease Control and Prevention (CDC) announced on Oct. 15, 2014, that a second health care worker at a Dallas-area hospital had tested positive for the deadly Ebola virus, the number of employers calling A. Kevin Troutman, chair of the national health care practice group for Fisher & Phillips LLP, jumped dramatically.

“I would say that last week employer interest was more regionally based. Businesses in Texas and especially the Dallas area were looking for information and trying to understand what they needed to do,” said Troutman, who worked for 17 years as an HR executive in the health care industry. “After the announcement that the second health care worker tested positive for Ebola, then interest became national.”

CDC officials said that breaches of health care protocols most likely led to the Ebola virus spreading to two nurses at Texas Health Presbyterian Hospital in Dallas who provided care for Thomas Eric Duncan, the first patient in the United States to be diagnosed with Ebola. Duncan had traveled to the U.S. from Liberia about 10 days before being diagnosed with the disease. In response to the nurses contracting the disease, the CDC issued a new set of health care protocols for hospitals that treat patients who have been exposed to the Ebola virus. Further guidelines will be released soon which cover skin exposure, safely donning and removing protective wear, and properly disposing of infected medical waste.

New Health Safety Protocols

The new CDC protocols focus on standardizing personal protective equipment (PPE) suits at hospitals, and include instructions on how and when the suits should be worn and removed. In addition, the protocols address proper oversight at hospitals and training for health care workers who might come in contact with Ebola patients.

The CDC plans to provide additional onsite intensive infection control training and education for health care workers, and has deployed two infectious control nurses to Dallas who have experience treating Ebola patients.

CDC officials emphasized that all hospitals must be prepared to follow the new health care protocols and communicate to their staffs the importance of staying vigilant.

“Strict infection control is critical to stopping chains of transmission,” the CDC’s announcement stated. “Standard infection control practices in U.S. health care facilities apply to the safe management of patients with Ebola, but must be adhered to rigorously and meticulously. Hospitals should have staff practice the procedures and practice using the protective garb in advance.”

Officials with National Nurses United (NNU), the largest union of registered nurses in the U.S., have been highly critical of the CDC’s and the Texas hospital’s responses to the Ebola outbreak. RoseAnn DeMoro, executive director of NNU, claimed during a recent media briefing that protocols on how to manage Ebola patients did not exist until after the Texas hospital began treating Duncan.

“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,” DeMoro said.

CDC officials claim that the new protocols specifically address problems revealed with the mismanagement of the Ebola cases in Texas. The hospital’s chief clinical officer, Dr. Daniel Varga, admitted on Oct. 16 during testimony to a U.S. House of Representatives oversight committee that the hospital had made mistakes in treating the Ebola patient and apologized.

“[D]espite our best intentions and a highly skilled medical team, we made mistakes. We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry,” he said.

Lapses in Proper Preparation

Officials with the NNU also point to a survey of their members that showed serious deficiencies in training and health care supplies may exist in the efforts to combat Ebola in the U.S. More than 80 percent of the respondents to the union’s survey reported that they had not received adequate training on treating Ebola patients. In addition, only 36 percent of the survey participants said that their hospitals have adequate supplies, such as proper PPE suits.

“We are seeing that U.S. hospitals are not prepared,” said Bonnie Castillo, director of the Registered Nurse Response Network, which is part of National Nurses United. “They are not doing active drilling and education that they need to be doing. There is the potential for many more Dallases if hospitals are not mandated and do not commit to more vigorous standards. We see potential gaping holes for this to spread.”

The Ripple Effect on Employers

The Texas Ebola cases are beginning to have ripple effects on private employers throughout the country. Officials with FirstEnergy Corp in Ohio confirmed that two of its employees came in contact with one of the Dallas nurses who treated Duncan and subsequently traveled to Cleveland, Ohio, before she was diagnosed with the disease. As a precaution, FirstEnergy has arranged for the employees to work at home for 21 days.

In addition, a lab technician employed at the Dallas hospital was put into isolation on a cruise ship in the Caribbean. The technician had handled test samples gathered from Duncan in early October and then went on a vacation cruise. This expanding circle of contact and cascading impact on other businesses led the CDC to issue a travel ban for all employees of the Texas hospital who have had direct contact with the Ebola patients.

Steps for All Employers

Although the CDC protocols apply mostly to hospitals and employers of health care providers, Troutman said the new guidelines can be helpful to all employers in responding to the Ebola outbreak.

“The CDC protocols are a great place to start for employers on how to develop a proper and effective response,” he said.

Troutman recommended that employers take the following steps, adding that “there’s something we can all do, and these steps can help alleviate worries and anxieties that many employees might be feeling right now.”

*Designate someone in charge of your organization’s response team.

*Communicate with employees, tell them where they can get information and to whom they should address questions.

*Be aware of any potential exposure: Talk to employees who may have traveled to West Africa or been in contact with friends and family who have traveled to the area.

*Consult with attorneys about any potential issues that could arise regarding anti-discrimination laws, such as the Americans with Disabilities Act and Title VII of the Civil Rights Act of 1964.

*Discuss good hygiene and health practices with employees, such as washing hands and using hand sanitizers. Flu season starts in the fall, so encourage employees not to come to work if they are sick—especially if they are running a fever.

Bill Leonard is a senior writer for SHRM.​

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