“Patient” David Jones slumped, head down, in a wheelchair, his arms wrapped around a plastic bowl as his “wife’’ rushed him into the Emergency Department (ED) from a UTMB parking garage. At the triage desk, a nurse quickly donned a mask and a protective gown after learning that the patient had recently visited West Africa. And it was clear from the bowl in his lap that he was experiencing nausea, a symptom of Ebola.
After measuring his vital signs, the triage nurse quickly notified the ED charge nurse and pushed the patient outside the ED waiting room, into an isolated waiting area. Meanwhile, inside the ED, a series of coordinated actions were set into motion from the capable command-and-control center, also known as the ED charge nurse.
UTMB’s infectious disease and epidemiology staff were notified of a “positive Ebola screen,” meaning a patient with symptoms that could be an Ebola infection and a recent travel or exposure history. A dispatch notice was sent out to alert appropriate leaders and action teams to provide comprehensive management of the patient care and protection of staff, other patients and visitors.
While an ER technician prepared a special isolation room, ticking off steps from a check list, an RN and another ER tech began the meticulous process of donning the personal protective equipment (PPE) they would wear while caring for the patient. A monitor trained by experts from the Galveston National Lab helped each of them dress to ensure that every step in the donning protocol was followed, down to wrapping duct tape around their two layers of gloves.
In reality, this was a drill and “patient’’ Jones was actually a standardized patient who works with staff at the Office of Clinical Simulation to simulate scenarios for training purposes. Playing his wife was Dr. Karen Szauter, Director of the Office and Clinical Simulation in the School of Medicine and an Internal Medicine (Gastroenterology) physician.
Just the week before, a real-life situation provided an “unplanned drill” for UTMB staff. A patient who had recently traveled from Africa was rushed to John Sealy Hospital from a non-UTMB League City clinic after staff there believed he was exhibiting Ebola-like symptoms. UTMB health care workers, however, determined that the patient did not exhibit any signs of Ebola and that he had not traveled to any of the African countries that have had an Ebola epidemic.
The real-life situation was considered a “good drill,’’ said UTMB President Dr. David Callender, demonstrating that UTMB’s ED staff, the Galveston County Health Department and EMS personnel were well-prepared and “did an excellent job.”
That incident and feedback from the real patient, who provided some helpful advice from a patient perspective, helped UTMB clinical and simulation experts plan a formal drill. “His input added some of the human interest into the simulation – a scared patient who is asking questions about his family and asking the staff to help him communicate with them. I was so proud to hear that our staff gave safe and compassionate care to the patient; I want to showcase those aspects of what we do so well here,’’ said Dr. Kimberly Brown, Associate Professor, Department of Surgery, and Director of the Sealy and Smith Laboratory for Surgical Training Assessment and Research (LSTAR), who helped coordinate the Oct. 28 drill.
The formal drill allowed a collaborative UTMB team, which included health care staff, police, epidemiology, infection control, and institutional preparedness, to assess what worked well and what didn’t. And it was just the first of many drills to come, as UTMB has been designated by Texas Gov. Rick Perry as a specialized center to treat Ebola patients, if a need arises.
“Our health care teams stand ready, but we know that consistent practice and preparation will benefit both our patients and our staff,” said Christine Wade, Director, Patient Care Services and Assistant Chief Nursing Officer in the Emergency Department.
As a leader in the research and understanding of the Ebola virus, UTMB is extremely well-prepared to treat a patient with the virus. Lessons learned from the false alarm and formal drills are helping to improve processes all the more. At all times, UTMB’s top priority is the safety of patients and staff. For more information on UTMB’s readiness and facts about Ebola, visit http://www.utmb.edu/ebola-response and http://www.utmb.edu/newsroom/.