CDC head slammed for blaming nurse infected with Ebola

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CDC head slammed for blaming nurse infected with Ebola
By Julie Steenhuysen
October 13, 2014

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, made the declaration on Sunday at a news conference and called for an investigation into how the unidentified nurse became infected while caring for Liberian national Thomas Eric Duncan, the first Ebola patient diagnosed in the United States. Duncan died last week at Texas Health Presbyterian Hospital.

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Some experts also question the CDC’s assertion that any U.S. hospital should be prepared to treat an Ebola patient as the outbreak ravaging West Africa begins to spread globally. Given the level of training required to do the job safely, U.S. health authorities should consider designating a hospital in each region as the go-to facility for Ebola, they said.

"You don't scapegoat and blame when you have a disease outbreak," said Bonnie Castillo, a registered nurse and a disaster relief expert at National Nurses United, which serves as both a union and a professional association for U.S. nurses. "We have a system failure. That is what we have to correct."

In recent months, the CDC has published detailed guidelines on how to handle various aspects of Ebola, from lab specimens and infectious waste to the proper use of protective equipment.

How that information gets communicated to frontline workers, however, varies widely, Castillo said.

In many cases, hospitals "post something on a bulletin board referring workers and nurses to the CDC guidelines. That is not how you drill and practice and become expert," she said.

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Dr. Gavin Macgregor-Skinner, an expert on public health preparedness at Pennsylvania State University, also disagreed with the talk of a breach of protocol, saying it just puts the onus on the nurse.

"I think that is just wrong," said Macgregor-Skinner, who helped the Nigerian government train healthcare workers when a traveler from Liberia touched off an outbreak of Ebola this past summer.

“We haven't provided them with a national training program. We haven't provided them with the necessary experts that have actually worked in hospitals with Ebola," he added in reference to U.S. hospital staff.

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Sean Kaufman, president of Behavioral-Based Improvement Solutions in Atlanta, helped train healthcare staff at a special isolation unit at Atlanta's Emory University which treated U.S. aid workers Dr. Kent Brantly and Nancy Writebol, the first two Ebola patients to be treated on U.S. soil.

He would observe the nurses and doctors as they cared for patients and keep detailed notes when someone would accidentally touch their sleeve or mask with an infected glove.

He then helped coach them through the process of carefully removing their infected gear. Facilities caring for Ebola patients are encouraged to use a buddy system so that colleagues are watching each other to make sure they don't take risks.

"Doctors and nurses get lost in patient care. They do things that put themselves at risk because their lens is patient-driven," Kaufman said. In Dallas, "I suspect no one was watching to make sure the people who were taking care of the patients were taking care of themselves," he said.

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