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1.
Nurs Clin North Am ; 54(2): 169-180, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31027659

RESUMEN

The 2014 to 2016 Ebola outbreak response resulted in many lessons learned about biocontainment patient care, leading to enhanced domestic capabilities for highly infectious and hazardous communicable diseases. However, additional opportunities for improvement remain. The article identifies and describes key considerations and challenges for laboratory analysis, clinical management, transportation, and personnel management during the care of patients infected with Ebola or other special pathogens. Dedication to maintaining preparedness enables biocontainment patient care teams to perform at the highest levels of safety and confidence.


Asunto(s)
Contención de Riesgos Biológicos/normas , Brotes de Enfermedades/prevención & control , Guías como Asunto , Fiebre Hemorrágica Ebola/diagnóstico , Fiebre Hemorrágica Ebola/terapia , Medidas de Seguridad/normas , África Occidental , Humanos , Estados Unidos
2.
Health Secur ; 17(1): 35-45, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30779607

RESUMEN

The 2013-2016 epidemic of Ebola virus disease (EVD) that originated in West Africa underscored many of the challenges to conducting clinical research during an ongoing infectious disease epidemic, both in the most affected countries of Guinea, Liberia, and Sierra Leone, as well as in the United States and Europe, where a total of 27 patients with EVD received care in biocontainment units. The Special Pathogens Research Network (SPRN) was established in the United States in November 2016 to provide an organizational structure to leverage the expertise of the 10 Regional Ebola and Other Special Pathogen Treatment Centers (RESPTCs); it was intended to develop and support infrastructure to improve readiness to conduct clinical research in the United States. The network enables the rapid activation and coordination of clinical research in the event of an epidemic and facilitates opportunities for multicenter research when the RESPTCs are actively caring for patients requiring a biocontainment unit. Here we provide an overview of opportunities identified in the clinical research infrastructure during the West Africa EVD epidemic and the SPRN activities to meet the ongoing challenges in the context of Ebola virus and other special pathogens.


Asunto(s)
Investigación Biomédica/métodos , Ebolavirus/patogenicidad , Servicios Médicos de Urgencia/organización & administración , Control de Infecciones/métodos , Contramedidas Médicas , África/epidemiología , Contención de Riesgos Biológicos/métodos , Epidemias/prevención & control , Europa (Continente) , Fiebre Hemorrágica Ebola/epidemiología , Humanos , Centros de Atención Terciaria , Estados Unidos
3.
Health Secur ; 17(1): 11-17, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30779612

RESUMEN

During the outbreak of Ebola virus disease that struck West Africa during 2014-2016, a small handful of expatriate patients were evacuated to specialized high-level containment care units, or biocontainment units, in the United States and Western Europe. Given the lower mortality rate (18% versus 40% for those treated in Africa) among these patients, it is likely that high-level containment care will be used in the future with increasing frequency. It is also likely that children infected with Ebola and other highly hazardous communicable diseases will someday require such care. The National Ebola Training and Education Center convened a pediatric workgroup to consider the unique and problematic issues posed by these potential child patients. We report here the results of those discussions.


Asunto(s)
Conferencias de Consenso como Asunto , Contención de Riesgos Biológicos , Brotes de Enfermedades/prevención & control , Fiebre Hemorrágica Ebola/terapia , Control de Infecciones/métodos , Pediatría/métodos , África Occidental , Niño , Europa (Continente) , Humanos , Padres/psicología , Aislamiento de Pacientes/métodos , Estados Unidos
4.
Health Secur ; 15(4): 432-439, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28805464

RESUMEN

The Ebola outbreak of 2014-2016 highlighted the need for the development of a more robust healthcare infrastructure in the United States to provide isolation care for patients infected with a highly hazardous contagious disease. Routine exercises and skills practice are required to effectively and safely prepare care teams to confidently treat this special population of patients. The Nebraska Biocontainment Unit (NBU) at Nebraska Medicine in Omaha has been conducting exercises since 2005 when the unit was opened. Previous activities and exercises conducted by the Nebraska Biocontainment Unit have focused on transporting and caring for up to 3 patients with Ebola virus disease or other special pathogens. Changes in regional and national mandates, as well as the increased potential for receiving multiple patients at once, at a single location, have resulted in a greater demand to exercise protocols for the treatment of multiple patients. This article discusses in detail the planning, execution, and outcomes of a full-scale exercise involving 10 simulated patients with a highly infectious pathogen transmitted by the airborne route.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Planificación en Desastres , Brotes de Enfermedades/prevención & control , Simulación de Paciente , Enfermedades Transmisibles , Infecciones por Coronavirus/epidemiología , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Coronavirus del Síndrome Respiratorio de Oriente Medio , Nebraska , Estados Unidos
5.
Health Secur ; 15(3): 253-260, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28636442

RESUMEN

The National Ebola Training and Education Center (NETEC) was established in 2015 in response to the 2014-2016 Ebola virus disease outbreak in West Africa. The US Department of Health and Human Services office of the Assistant Secretary for Preparedness and Response and the US Centers for Disease Control and Prevention sought to increase the competency of healthcare and public health workers, as well as the capability of healthcare facilities in the United States, to deliver safe, efficient, and effective care to patients infected with Ebola and other special pathogens nationwide. NYC Health + Hospitals/Bellevue, Emory University, and the University of Nebraska Medical Center/Nebraska Medicine were awarded this cooperative agreement, based in part on their experience in safely and successfully evaluating and treating patients with Ebola virus disease in the United States. In 2016, NETEC received a supplemental award to expand on 3 initial primary tasks: (1) develop metrics and conduct peer review assessments; (2) develop and provide educational materials, resources, and tools, including exercise design templates; (3) provide expert training and technical assistance; and, to add a fourth task, create a special pathogens clinical research network.


Asunto(s)
Fiebre Hemorrágica Ebola/prevención & control , Control de Infecciones/métodos , África Occidental , Prestación de Atención de Salud , Brotes de Enfermedades , Ebolavirus , Humanos , Nebraska , Estados Unidos
7.
Am J Infect Control ; 43(5): 441-6, 2015 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-25952046

RESUMEN

The care of patients with Ebola virus disease (EVD) requires the application of critical care medicine principles under conditions of stringent infection control precautions. The care of patients with EVD requires a number of elements in terms of physical layout, personal protective apparel, and other equipment. Provision of care is demanding in terms of depth of staff and training. The key to safely providing such care is a system that brings many valuable skills to the table, and allows communication between these individuals. We present our approach to leadership structure and function--a variation of incident command--in providing care to 3 patients with EVD.


Asunto(s)
Prestación Integrada de Atención de Salud , Transmisión de Enfermedad Infecciosa/prevención & control , Servicios Médicos de Urgencia/métodos , Fiebre Hemorrágica Ebola/epidemiología , Fiebre Hemorrágica Ebola/prevención & control , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Humanos
8.
J Nurs Adm ; 45(6): 298-301, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26010276

RESUMEN

Planning and design of a unique biocontainment unit specifically for care of patients with rare and highly infectious diseases presented an opportunity for nurse leaders to engage staff in crucial groundbreaking decisions. The Magnet® philosophy and framework were used to structure committees with key stakeholders and staff to ensure best and safe practices. Members of the biocontainment unit are engaged in active research and outreach training.


Asunto(s)
Control de Enfermedades Transmisibles/instrumentación , Control de Enfermedades Transmisibles/métodos , Contención de Riesgos Biológicos/instrumentación , Transmisión de Enfermedad Infecciosa/prevención & control , Arquitectura y Construcción de Hospitales , Equipos de Seguridad/normas , Enfermedades Transmisibles/transmisión , Contención de Riesgos Biológicos/métodos , Diseño de Equipo , Humanos , Nebraska , Seguridad del Paciente
10.
Am J Surg ; 203(4): 454-60, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21906718

RESUMEN

BACKGROUND: Trauma centers are closing at an alarming rate, but the need for trauma care persists. This article shows the sustainability and feasibility of a joint trauma system whereby 2 university-affiliated hospitals function as a single trauma center system in a moderate-sized city. METHODS: Since 1994, 3 days per week, trauma patients are transported by emergency medical services (EMS) to hospital A. The other 4 days they are transported to hospital B. Trauma registry data from 1994 to 2008 were analyzed. Cost data were also examined. RESULTS: The joint system admitted 28,338 trauma patients. On each center's nontrauma days, trauma team activation was required infrequently. The 2 centers share costs; they perform joint outreach, educational training, and quality control. The joint trauma system has been sustained since 1994. CONCLUSIONS: Two hospitals functioning as a single trauma center system is a viable model of care for injured patients in a moderate-sized city with mostly blunt trauma.


Asunto(s)
Ahorro de Costo , Mortalidad Hospitalaria/tendencias , Hospitales Universitarios/organización & administración , Centros Traumatológicos/organización & administración , Centros Médicos Académicos/organización & administración , Adolescente , Adulto , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Traumatismo Múltiple/diagnóstico , Traumatismo Múltiple/mortalidad , Traumatismo Múltiple/terapia , Innovación Organizacional , Sistema de Registros , Medición de Riesgo , Tasa de Supervivencia , Estados Unidos , Heridas y Traumatismos/diagnóstico , Heridas y Traumatismos/mortalidad , Heridas y Traumatismos/terapia , Heridas no Penetrantes/diagnóstico , Heridas no Penetrantes/mortalidad , Heridas no Penetrantes/terapia , Adulto Joven
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