Peggy O’Hara knows that removing protective equipment is one way health care workers can be exposed to the deadly Ebola virus.
But as the country comes to grips with its own Ebola fears, the Greenville Health System nurse has volunteered to care for patients with the virus who may be admitted.
“If you do what you’re supposed to do, you should be fine,” O’Hara told The Greenville News. “I’m really not afraid.”
In recent weeks, O’Hara and some 200 other GHS nurses, doctors and respiratory therapists have volunteered for Ebola duty should they be needed.
Health care workers are at greater risk for contracting Ebola. So to make sure they are safe as well as effective in their jobs, they’ve undergone extensive preparedness training.
It’s all part of the protocol for dealing with Ebola that GHS unveiled on Tuesday.
“We hope that Ebola will not present itself in South Carolina, but we understand we need to be prepared for whatever does happen,” said Dr. Angelo Sinopoli, chief medical officer.
“We want to assure that patients receive appropriate care,” he added, “and at the same time be assured that health care workers receive special training and resources to ensure the safety of our workforce.”
Since two Dallas nurses came down with the deadly virus earlier this month after caring for a Liberian national who was the first patient diagnosed with Ebola in the U.S., there has been public concern about whether the health care system is ready for such a threat.
And hospitals around the country have been scrambling to develop procedures to care for patients while keeping the staff and public safe.
As one of four regional Ebola referral centers in South Carolina, GHS has been updating its policies along U.S. Centers for Disease Control and Prevention guidelines, said Dr. Scott M. Sasser, chair of the department of emergency medicine.
In addition to the enhanced training for employees, patients arriving at any GHS hospital, clinic or doctor’s office are screened for symptoms, such as fever, and for travel history to affected countries and possible Ebola exposure, he said. Anyone with suspected Ebola would be immediately isolated, he said.
The isolation unit has room for three patients, is equipped with positive air pressure and monitored round the clock, said chief nursing officer Michelle Taylor-Smith.
Any staff who work there won’t be assigned to other patient care areas to prevent the spread of infection, she said, and will voluntarily isolate themselves afterward for up to 21 days, the incubation period of the disease.
Because management of tainted equipment and supplies is critical to safety, all contaminated disposable materials will be triple-bagged, disinfected and stored in drums before removal by a certified waste hauler, she said. Other medical equipment and furniture will be cleaned and disinfected, she said.
Nurses in the unit will work in teams of two observed by a monitor, said Sue Boeker, an infection preventionist. They’ll wear a full, impermeable suit that covers them from neck to ankles as well as a gown, leg and shoe covers, three layers of gloves, and a hood with a respirator that forces air through and out small openings under the chin, she said.
Inside the hood, they’ll also wear N-95 masks, which filter up to 95 percent of airborne particles, even though Ebola is not an airborne virus and is only spread by contact with bodily fluids, she said. Hydrogen peroxide wipes, which can kill Ebola, will also be on hand.
“We wanted to make sure our health care workers were protected,” Boeker said. “We tried to think of all those little pieces and make sure we have a way to manage it.”
The protective equipment is cumbersome and somewhat uncomfortable. So the nurses wear it only for three or four hours at a stretch, she said.
And they will follow a checklist for removing it, which also will be overseen by the monitor to prevent infection.
“There’s been a problem in previous experiences where health care workers have contaminated themselves while removing the PPE (personal protective equipment),” Boeker said.
O’Hara said it takes about 30 minutes to doff the gear properly.
“It’s a step-by-step process and we want to make sure we don’t miss a step,” she said. “It makes you feel very confident ... because you realize that as long as you follow the steps you should be OK.”
Despite the risk, O’Hara said she volunteered so that patients get the care they need to keep them safe and get them well. And though she’s concerned about spreading any infections to her family, including her pregnant daughter, she said she’d isolate herself after caring for an infected patient to prevent that from happening.
“I would not go home until I know that I’m safe,” she said. “I don’t want to risk exposing anyone in the family or in the community.”