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As the Centers for Disease Control and Prevention (CDC) admitted that he previous Ebola guidance was confusing and inadequate, and health care workers felt unprepared, federal health officials issued new guidelines Monday to promote head-to-toe protection for health workers treating Ebola patients.
Workers at Texas Health Presbyterian Hospital were trying to follow earlier CDC guidance. Organizations representing nurses and other health workers have pressed the CDC, saying the old advice was confusing and inadequate, and health workers felt afraid and unprepared.
It’s not clear exactly how the two nurses at Texas Health Presbyterian Hospital became infected, but clearly there was some kind of problem, said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention.
“The bottom line is the guidelines didn’t work for that hospital,” Frieden said, in announcing the revised guidelines Monday evening.
The incident with the two nurses made it clear that U.S. health-care workers must cover all parts of their skin with protective gear when treating patients, because the level of care that hospitals in this country provide for Ebola patients includes “more hands-on nursing care and more high risk procedures.”
The agency is also toughening its guidelines to emphasize some steps taken in Africa: rigorous training requiring health-care workers to be fully versed in putting on and taking off protective gear before they are allowed to treat Ebola patients, Dr. Frieden said. A trained monitor must supervise health-care workers as they don and doff their equipment, he said.
“The greatest risk in Ebola care is in the taking off of whatever equipment a health care worker has on,” Dr. Frieden said. The process, he says, must be “ritualized.”
The CDC cannot require hospitals to follow the guidance; it’s merely official advice. But these are the rules hospitals are following as they face the possibility of encountering patients with a deadly infectious disease that a few months ago had never been seen in this country.
The CDC guidance was expected as early as Saturday, but its release has been pushed back while it continues to go through review by experts and government officials.
Apparently the older guidelines were designed for dealing with Ebola in Africa, as opposed to the U.S. healthcare system where hospitals use invasive, life-saving equipment like dialysis machines.