Institutional policies and readiness in management of critical illness among patients with viral hemorrhagic fever
- 15 February 2021
- journal article
- research article
- Published by Cambridge University Press (CUP) in Infection Control & Hospital Epidemiology
- Vol. 42 (11), 1-6
- https://doi.org/10.1017/ice.2020.1416
Abstract
Objective: In response to the 2013–2016 Ebola virus disease outbreak, the US government designated certain healthcare institutions as Ebola treatment centers (ETCs) to better prepare for future emerging infectious disease outbreaks. This study investigated ETC experiences and critical care policies for patients with viral hemorrhagic fever (VHF). Design: A 58-item questionnaire elicited information on policies for 9 critical care interventions, factors that limited care provision, and innovations developed to deliver care. Setting and participants: The questionnaire was sent to 82 ETCs. Methods: We analyzed ordinal and categorical data pertaining to the ETC characteristics and descriptive data about their policies and perceived challenges. Statistical analyses assessed whether ETCs with experience caring for VHF patients were more likely to have critical care policies than those that did not. Results: Of the 27 ETCs who responded, 17 (63%) were included. Among them, 8 (47%) reported experience caring for persons under investigation or confirmed cases of VHF. Most felt ready to provide intubation, chest compressions, and renal replacement therapy to these patients. The factors most cited for limiting care were staff safety and clinical futility. Innovations developed to better provide care included increased simulation training and alternative technologies for procedures and communication. Conclusions: There were broad similarities in critical care policies and limitations among institutions. There were several interventions, namely ECMO and cricothyrotomy, which few institutions felt ready to provide. Future studies could identify obstacles to providing these interventions and explore policy changes after increased experience with novel infectious diseases, such as COVID-19.Keywords
This publication has 14 references indexed in Scilit:
- Update on Ebola Treatment Center Costs and Sustainability, United States, 2019Emerging Infectious Diseases, 2020
- An update on US Ebola treatment center personnel management and trainingAmerican Journal of Infection Control, 2020
- A Randomized, Controlled Trial of Ebola Virus Disease TherapeuticsThe New England Journal of Medicine, 2019
- High-Containment Pathogen Preparation in the Intensive Care UnitInfectious Disease Clinics of North America, 2017
- Preparedness and the importance of meeting the needs of healthcare workers: a qualitative study on EbolaJournal of Hospital Infection, 2017
- Overview, Control Strategies, and Lessons Learned in the CDC Response to the 2014–2016 Ebola EpidemicMMWR Supplements, 2016
- Clinical Management of Ebola Virus Disease in the United States and EuropeThe New England Journal of Medicine, 2016
- Ethical and Practical Considerations in Providing Critical Care to Patients With Ebola Virus DiseaseSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2015
- Ebola and provision of critical careThe Lancet, 2015
- Successful Delivery of RRT in Ebola Virus DiseaseJournal of the American Society of Nephrology, 2015