Ebola-Related Health Information Wanted and Obtained by Nurses and Public Health Department Employees: Effects of Formal and Informal Communication Channels.

OBJECTIVES: The aim of this study was to (1) understand types and amounts of Ebola-related information that health organization employees wanted and obtained through formal, informal, internal, and external organizational communication channels; (2) determine potential discrepancies between information wanted and obtained; and (3) investigate how organizational structure might affect information wanted and obtained through these communication channels. METHODS: Primary data were collected from 526 health workers in 9 hospitals and 13 public health departments in Texas from June to November 2015. Survey data were collected for 7 types of Ebola-related information health organization employees wanted and obtained through various types of organizational communication channels. Descriptive statistical analyses, mixed design analysis of variance, regression analyses, and multilevel analyses were used to analyze the data. RESULTS: Hospital employees (mostly nurses in our sample) received more self-care information than they wanted from every communication channel. However, they received less about all other types of information than they wanted from every communication channel separately and combined. Public health department employees wanted more information than they received from every communication channel separately and combined for all 7 types of information. CONCLUSIONS: Discrepancies existed between the types of Ebola-related information wanted and obtained by employees of hospitals and public health departments.

When a clinical crisis strikes: Lessons learned from the reflective writings of nursing students.

AIM: The following is a qualitative study of reflective journaling related to an unexpected crisis situation as it unfolded through the eyes of nursing students. BACKGROUND: In September 2014, nursing students in clinical rotations at a Texas hospital were faced with the arrival of the first unplanned patient soon to be diagnosed with Ebola virus disease (EVD) in the United States. Reflective journaling was a technique used by nursing students to help process thoughts and feelings during this public health crisis. DESIGN: The students' unedited experiences were captured through the technique of reflective journaling and written comments were analyzed using qualitative design with thematic analysis. RESULTS: Three main themes were identified as an array of emotions, nursing as a calling, and personal protection. CONCLUSION: This study demonstrates how reflective journaling can help reduce the stress of an unexpected clinical situation involving nursing students and encourages immediate coping strategies for those affected. With recent reports from Africa of patients newly diagnosed with EVD, being aware of how to facilitate the learning of nursing students in all clinical settings becomes essential.

Multi-professional simulation and risk perception of health care workers caring for Ebola-infected patients.

INTRODUCTION: Treatment of infections that require high-level isolation can cause anxiety and fear among health care workers. Adequate and complete multi-professional simulation-based training could reduce those feelings and improve patient care. OBJECTIVE: The purpose of this study was to assess the impact of multi-professional simulation-based training on the risk perception and preparedness of health care workers (registered nurses, doctors and ancillary staff) who care for patients assessed to be at risk or confirmed to have Ebola, level 3-4 biohazard. METHODS: A prospective before-after study was designed. Health care workers who participated in a multi-professional simulation training course to improve the care of patients potentially infected with Level 3 and 4 biohazards were evaluated about their risk perception. The training was based on clinical scenarios. The evaluation was conducted using questionnaire based on Likert scale. After the training, a satisfaction survey about the most important aspects of the course was also conducted. RESULTS: Fifty-eight health care workers participated in the training course, 22 of whom were registered nurses. Participants presented positive changes after the training, increasing their sense of security, predisposition and confidence (p < 0.000001 for all). CONCLUSION: Multi-professional simulation-based training significantly improves the perception of safety and preparedness of health care workers regarding the care of patients potentially infected with Ebola virus and other Level 3-4 biohazards. RELEVANCE TO CLINICAL PRACTICE: The implementation of educational training strategies - such as simulations - is beneficial in improving the capacity of response and coping, as well as in reducing feelings of fear and insecurity.

Reality Check: Preparing Nursing Students to Respond to Ebola and Other Infectious Diseases.

Escalating uncertainty regarding the international impact of Ebola virus disease and other infectious diseases prompted educators to develop interactive, multidisciplinary training for senior-level baccalaureate nursing students. A three-hour clinical learning session was scheduled within the curriculum. Nurse faculty utilized 11 activities to increase students' awareness and understanding of the potential and actual impact of Ebola virus disease and other infectious diseases. Feedback reflected a positive student experience highlighting several key areas related to increased knowledge and confidence. This session highlighted the importance of adjusting focus and priorities within curricula to meet core baccalaureate essentials and address current public health needs.

Global nursing in an Ebola viral haemorrhagic fever outbreak: before, during and after deployment.

BACKGROUND: Nurses are on the forefront and play a key role in global disaster responses. Nevertheless, they are often not prepared for the challenges they are facing and research is scarce regarding the nursing skills required for first responders during a disaster situation. OBJECTIVES: To investigate how returnee nursing staff experienced deployment before, during and after having worked for the Red Cross at an Ebola Treatment Center in Kenema, West Africa, and to supply knowledge on how to better prepare and support staff for viral haemorrhagic fever outbreaks. METHODS: A descriptive, cross-sectional approach. Questionnaires were administered to nurses having worked with patients suffering from Ebola in 2014 and 2015. Data collection covered aspects of pre-, during and post-deployment on clinical training, personal health, stress management, leadership styles, socio-cultural exposure and knowledge transfer, as well as attitudes from others. Data was analysed using both quantitative and qualitative methods. RESULTS: Response-rate was 88%: forty-four nurses from 15 different countries outside West Africa answered the questionnaire. The respondents identified the following needs for improvement: increased mental health and psychosocial support and hands-on coping strategies with focus on pre- and post-deployment; more pre-deployment task-oriented clinical training; and workload reduction, as exhaustion is a risk for safety. CONCLUSIONS: This study supplies knowledge on how to better prepare health care staff for future viral haemorrhagic fever outbreaks and other disasters. Participants were satisfied with their pre-deployment physical health preparation, whereas they stressed the importance of mental health support combined with psychosocial support after deployment. Furthermore, additional pre-clinical training was requested.

Salud Global: Ébola y Enfermería / Global health: nursing and ebola

El artículo reflexiona sobre los grandes desafíos y problemas enmarcados en la diseminación de enfermedades infecciosas que enfrenta la Salud Global, por efectos de esta sociedad móvil y coexistente. Se analiza el brote de la enfermedad por virus de ébola, que demostró lo importante que es el buen funcionamiento y eficacia de los sistemas internacionales, y la disponibilidad de profesionales competentes, como la mejor garantía de seguridad contra epidemias. Analizando los mayores retos de la Enfermería establecidos por el alto contacto y relación con el cuidado de los pacientes, en la toma de decisiones clínicas fundamentales en la recuperación, promoción y prevención de las personas y las comunidades en riesgo, requiriendo una mejor formación y difusión de las contingencias mundiales en materias de salud, salud pública y seguridad clínica

Article that reflects on the major challenges and issues framed in the spread of infectious diseases faced by Global Health, for purposes of this mobile society and coexisting. The disease outbreak of Ebola virus, which demonstrated the importance of the proper operation and effectiveness of the international system, and the availability of competent professionals as the best guarantee of security against epidemics. Analyzed the biggest challenges of Nursing established by the high contact and relationship with the care of patients, in making fundamental clinical decisions in recovery, promotion and prevention of individuals and communities at risk, and requiring better training dissemination of global contingencies in areas of health, public health and clinical safety

Emergency nurses' perceptions of emergency department preparedness for an ebola outbreak: A qualitative descriptive study.

BACKGROUND: Ebola Virus Disease is highly contagious and has high mortality. In 2014, when the outbreak in West Africa was declared a public health emergency, emergency departments in Australia commenced preparation and vigilance for people presenting with ebola like symptoms, to limit spread of the disease. RESEARCH AIM: To examine Australian emergency nurses' perceptions regarding their own and their emergency departments' preparedness to manage an ebola outbreak. METHOD: A qualitative descriptive design was used to collect and analyse data in one metropolitan emergency department in Victoria, Australia. Four focus groups were conducted with 13 emergency nurses. Data were thematically analysed. RESULTS: Major themes emerged from the data: organisational, personal and future preparedness. Participants' believed that both the organisation and themselves had achieved desirable and appropriate preparedness for ebola in their emergency setting. CONCLUSION: Participants trusted their organisation to prepare and protect them for ebola. Appropriate policies, procedures, and equipment infrastructure were reportedly in place. Nurses' decisions to care for a patient with ebola were informed by professional commitment, and personal responsibilities. Participants were concerned about transmitting ebola to their families, and suggested that more regular training in personal protective equipment would increase confidence and skill in self-protection.

Impacts on Global Health from Nursing Research.

AbstractInfectious disease continues to adversely affect populations in low- and middle-income countries. Investments in solutions often focus on technology, yet health-care workers remain in short supply. Nurses are the largest cadre of health-care workers and are largely responsible for patient care around the world. In fact, it is estimated that nurses care for nine out of every 10 patients seen. Importantly, sound nursing science contributes to solutions that directly impact patient care, especially those that pertain to infectious disease. Here we share several examples of nursing science that are improving care delivery in three global health areas: human immunodeficiency virus testing and prevention strategies in Malawi, family planning in Kenya, and response to Ebola virus disease.

Prevention and nursing care in the first case of Ebola virus disease contracted outside Africa. / Prevención y cuidados de enfermería en el primer caso de enfermedad del virus Ébola adquirida fuera de África.

After the evacuation from Africa to Western hospitals of several international workers with the Ebola virus disease, the first case of contagion outside Africa occurred in Madrid, Spain. A nursing care assistant who had attended a missionary repatriated from Sierra Leone contracted the disease. On October 7th 2014, the patient arrived at the University Hospital La Paz-Carlos III in Madrid. She remained in the hospital for 30 days, 25 of which were in strict isolation in a negative pressure room with air lock anteroom; personal protective equipment was required. During the last five days, the patient was moved to a standard room. Protection measures were used in accordance with the Hospital Occupational Health Department. According to its evolution, we differentiate three phases with specific care demands which were conditioned by the risk of transmission, forcing extreme measures of prevention. The largest numbers of direct interventions fall within the realm of the nursing profession. It is essential that specialized units with regular training be created for highly contagious diseases. In addition, this and other cases should be analyzed from the point of view of nursing, to allow standardized care. We also recognize the importance of managing communication to prevent social unrest and stigmatization of staff.

Ebola virus disease: caring for patients in Sierra Leone - a qualitative study.

AIM: The aim of this study was to describe Norwegian healthcare staffs' experiences of participating in care of patients with Ebola virus disease in Sierra Leone. BACKGROUND: Ebola is one of the most feared viruses known. Ebola virus disease is highly contagious with high mortality. The few qualitative studies made on experiences among healthcare professionals have highlighted problems as lack of protective resources, insufficient personnel and risk of societal stigmatization. DESIGN: Descriptive study with qualitative approach. METHOD: Individual narrative and focus group interviews were obtained during 2015 with eight nurses and one physician who had worked in Ebola care in Sierra Leone. The interviews were analysed using qualitative content analysis. RESULT: The analysis resulted in the two themes: 'Experiencing security by learning to manage risks'; and 'Developing courage and growth by facing personal fears'. Subthemes were: 'Relying on safeguard actions', 'Managing risk of contagion', 'Developing strategies for care despite risks', 'Constantly reminded of death', 'Successively defeating fears' and last, 'Increasing motivation through meaningfulness'. The participants described the reliance on training, organized effort, strict guidelines and equipment. They were respectful of the risk of transmission, made risk assessments, took responsibility, handled risky situations and were reminded of suffering and death. CONCLUSION: Despite challenges, the hazardous work with Ebola virus disease patients was experienced as meaningful which was an important motivator. Safe care was central in working with Ebola patients, but the care relation was challenged.

Korean infection control nurses' knowledge and awareness of infection control against Ebola virus disease.

AIM: To assess the level of knowledge and awareness of Ebola virus disease infection control among infection control nurses and to identify a correlation between these factors. METHODS: The data were collected from 125 infection control nurses by using a self-report questionnaire. The data were collected on sociodemographic and hospital characteristics, as well as the level of knowledge and awareness of Ebola virus disease infection control. RESULTS: The respondents' mean level of knowledge (correct-answer rate) was 87.7% and their mean level of awareness was 3.86 (1 = "not important at all" to 4 = "very important"). Knowledge of Ebola virus disease infection control was significantly higher among those nurses who had received some Ebola virus disease education. There was a significant positive correlation between the level of knowledge and the level of awareness. CONCLUSION: The development of effective education and training systems is necessary to improve infection control nurses' knowledge and awareness of Ebola virus disease infection control. Moreover, each hospital should build effective and systematic Ebola virus disease infection control strategies.

Survey of Nursing Students' Self-Reported Knowledge of Ebola Virus Disease, Willingness to Treat, and Perceptions of their Duty to Treat.

The purpose of this study was to explore nursing students' self-reported knowledge of Ebola Virus Disease (EVD), willingness to treat patients with EVD, and student perceptions of duty to treat patients with EVD. The researchers developed the Survey of Nursing Student Self-Reported Knowledge of EVD, Willingness to Treat, and Perceptions of Duty to Treat, a quantitative tool with open-ended questions to inform the responses. On-line survey software was used for gathering anonymous data. A mixture of descriptive, nonparametric, and parametric statistics were used to describe, compare, and examine relationships between variables. Results demonstrated that licensed students scored significantly higher on self-reported knowledge of EVD than their prelicensure student counterparts (P=.039). Licensed students and prelicensure students did not differ on self-assessed willingness to treat (P>.05). The students had significantly higher willingness-to-treat scores when self-reported knowledge scores were higher (P=.007) and when they were older (P=.004). Willingness to treat was not influenced by whether one was partnered or single (P>.05) or had children or did not have children (P>.05). In conclusion, basic EVD knowledge and training appears to be critical to ensure willingness to treat. However, it is imperative that students have an indepth understanding of the principles of infectious diseases in general.

Actuación de enfermería ante un paciente con sospecha de enfermedad del virus del Ébola / The performance of nursing a patient with suspected case of Ebola

El virus del Ébola se detectó por primera vez en 1976 en la República democrática del Congo y en el sur de Sudán. Desde entonces, ha habido varios brotes en África occidental, pero es en 2014 cuando amenazó con convertirse en un problema de salud pública a nivel mundial. Una de las principales causas de este fenómeno es la expansión del virus desde zonas rurales a zonas urbanizadas desorganizadas. La epidemia avanzó de forma imparable a pesar de los esfuerzos de la OMS, Médicos Sin Fronteras y los gobiernos de Sierra Leona, Guinea y Liberia, y alcanzó una cifra de aproximadamente 5000 fallecidos, de los cuales un 5 % eran personal sanitario (noviembre 2014). España fue el primer país con un caso de contagio fuera de África. La infección de una trabajadora sanitaria de un hospital de Madrid hizo cundir el pánico en todo el Estado. Ello obligó a las autoridades sanitarias nacionales e internacionales a revisar y actualizar los protocolos de actuación ante casos de pacientes con sospecha de enfermedad del virus del Ébola. Se presenta un caso clínico en el que se describen los cuidados a un paciente con sospecha de enfermedad por virus del Ébola y las medidas de aislamiento de nivel IV (AU)

Ebola virus was first detected in Congo and south of Sudan in 1976. Since then, there have been several limited spreads in occidental Africa, but it is in 2014 when it became a worldwide public health problem. One of the main causes of this phenomenon was the migration of the virus from rural areas to marginal urban areas. The epidemic advanced despite the efforts of WHO, Medicines Sans Frontiers and the governments of Guinea, Liberia and Sierra Leone to stop it. The number of deaths was around 5000, and 5 % of these were sanitary workers. Spain was the first country with a contagion outside Africa. One sanitary person from a Hospital in Madrid got the virus and resulted in panic all around Spain. This forced the sanitary authorities to revise and actualize protocols when we treat patients under suspicion of Ebola virus infection. We report a case in which we describe the care we provide to a patient with suspected Ebola disease and isolation measures level IV (AU)