Kim Pase says she now feels better prepared if an Ebola patient were to walk through the door of her Puyallup neurology clinic.
The longtime medical assistant for MultiCare Health System was already talking with colleagues about how to implement training techniques they learned Thursday at an equipment demonstration at Tacoma General Hospital.
A crowd of more than 100 workers from various MultiCare clinics turned out for the optional presentation, organized in response to reports of American health care workers contracting Ebola in Texas, where a Liberian man died of the virus last week.
Pase said she previously had little knowledge about Ebola beyond her own personal Web research and news reports.
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“Our clinic is calm, but very concerned,” said Pase, one of many in the crowd designated to teach Ebola procedures to staff members throughout the MultiCare system. “This is exactly what we need.”
Officials didn’t plan for the size of the group that showed up, said Susan Gustafson, program director for MultiCare’s infection prevention department, who led Thursday’s demonstration. But in hindsight, the crowd was not surprising.
“We have people’s attention,” she said. “The public has a lot of questions. Until people get that information, there will be a lot of fear.”
The hospital’s Jackson Hall was packed with people — some in scrubs, others in suits — asking questions and watching techniques for putting on and taking off personal protective equipment.
No details were skipped: how best to remove disposable booties, where to step once they’re off, exactly how to dispose of them, where to store waste.
The most important detail: repetition.
“The key factor here is practice,” Gustafson said.
MultiCare and CHI Franciscan Health are the largest medical systems in South Sound. In the past several days, both have distributed Ebola information widely among their staffs, through emails, postings on internal websites, department meetings and town hall-style meetings.
Nikki Graham, a MultiCare educator who’s worked as a nurse for 25 years, said Thursday her department is using all its time and resources to inform staff about treating patients with the virus that’s raging in three West African countries.
“We kind of dropped everything for Ebola,” Graham said, adding that some have sacrificed vacation to help. “We’ve been working all hours because people are afraid. I feel like I should work 24/7 until they feel safe.”
Educators will make 11 site visits by the end of the hands-on training marathon, she said. Many trainings were planned for Friday (Oct 17).
About 35 people were expected at Thursday’s session, with the expectation that everyone could try the equipment. When participants started spilling into the lobby, the plan shifted to more observation.
But, Graham said, all employees will have an opportunity to practice.
“We didn’t want to turn people away,” she said. “Anyone who didn’t get a chance to touch (the equipment) today will touch it tomorrow.”
Thursday’s demonstration modeled how MultiCare advises staff to treat potential Ebola patients. The process included two health care workers — the person administering care and an assistant — and focused heavily on the caregiver’s protective equipment and how to properly handle it. Participants eventually broke into groups to practice and observe closer.
The assistants would be “checking, watching and helping,” Gustafson said. That includes checking and helping to remove the caregiver’s protective gear and keeping track of those who come in contact with the patient.
The protective equipment used in the demonstration included disposable caps, gowns, booties, two pairs of gloves and a full-face shield. Some were made of reusable linens — not normally used while treating Ebola patients — because the typical equipment is in short supply nationwide.
Some attendees expressed concern about the safety gear, specifically exposure of the neck, which is emerging as a major talking point with nurses in Dallas.
Gustafson acknowledged that the equipment is still evolving, and reminded staff that it’s important to avoid touching areas around their faces when dealing with a patient. The virus is easily killed with soap and water and many basic sanitizing products, she added.
Educators stressed the importance of carefully removing all clothing to minimize risk of infection, and avoiding use of unnecessary equipment. Using too much likely was a factor in Ebola cases in Dallas, they said.
Karen Koch, MultiCare’s administrator for quality and incident command for Ebola treatment and response, said preparation for the virus started several months ago before any cases were confirmed in the United States. Everything was fast-tracked when U.S. health care workers tested positive for the disease in the past several days.
“This was not new work to us,” she said.
Koch acknowledged that some people might worry the training hasn’t happened fast enough.
“Dallas didn’t get the training that you’re getting today,” Koch said to the crowd. “We wanted to substitute quickness with thoroughness.”
MultiCare plans to develop a unit where all Ebola patients would be treated, Koch said. The staff in that unit, from the doctors treating patients to janitors disposing of waste, would be experts in keeping everyone safe.
“The goal is to create a specialized team of folks to practice procedures over and over again,” Koch said.
Gustafson said some details still need vetting, such as best practices for handling bio-hazardous waste, but health care workers are working hard to stay informed as they learn more about treating Ebola.
“We’re building the plane as we’re flying it,” Gustafson said.
Pase, the medical assistant, said she doesn’t know how likely it is that an Ebola patient could come to her Puyallup clinic, but she’s glad she’s more knowledgeable today.
“I feel very comfortable with what (MultiCare wants) us to do,” she said.