Survey of Emergency Department staff on disaster preparedness and training for Ebola virus disease
Keywords:disaster planning, emergency department, Ebola virus disease, survey, epidemic training
Introduction: In the domestic response to the outbreak of Ebola virus disease from 2013 to 2015, many US hospitals developed and implemented specialized training programs to care for patients with Ebola. This research reports on the effects of targeted training on Emergency Department (ED) staff's Ebola-related perceptions and attitudes.
Methods: One hundred fifty-nine members of the UNC Health Care System ED staff participated in a voluntary cross-sectional, anonymous Web survey administered using a one-time “post then pre” design. Participants responded to questions about risk, roles, willingness to provide care, preparedness, and the contributions of media, training, or time to opinion change using a Likert agree-disagree scale. The authors conducted t test comparisons of Likert responses to pretraining and post-training attitudes about Ebola preparedness. The authors conducted multinomial logistic regression analyses of index scores of change and positivity of responses, controlling for the effects of independent variables.
Results: ED staff's opinions supported training; 73 percent felt all workers should receive Ebola education, 60 percent agreed all hospitals should prepare for Ebola, 66 percent felt UNC was better prepared, and 66 percent felt it had done enough to be ready for an Ebola case. Most staff (79 percent) said they had gotten more training for Ebola than for other disease outbreaks; 58 percent had experienced prior epidemics. After training, workers’ attitudes were more positive about Ebola preparation including perceived risk of transmission, readiness and ability to manage a patient case, understanding team roles, and trust in both personal protective equipment and the hospital system's preparations (13 measures, p < 0.0001 to p < 0.001). Overall, total opinion indices also changed significantly over the training period (Mean Difference [MD] = 17.45, SD = 9.89) and in the intended positive direction (MD = 15.80, SD = 0.91, p < 0.0001). Positive change and overall change from pre to post were significantly associated with more hours of training (p = 0.003). Despite different occupations, mean scores were similar. Staff rated training most important and media least important, as the sources of change in their attitudes (p < 0.0001).
Conclusions: These findings suggest that disease-specific training for novel pathogens such as Ebola may result in positive staff perceptions of self-efficacy and occupational efficacy to treat potentially infected patients in the ED setting. Training, in this case, outweighed media content in changing staff perceptions of Ebola management.
Gostin LO, Waxman HA, Foege W: The President's national security agenda curtailing Ebola, safeguarding the future. JAMA. 2015; 313(1): 27-28.
Emily J: Exclusive nurse Nina Pham after Ebola: Terrible side effects, lawsuit against employer. The Dallas Morning News. February 28, 2015. Available at http://res.dallasnews.com/interactives/nina-pham/. Accessed March 29, 2015.
Fernandez M, Healy J: CDC says it should have responded faster to the Dallas Ebola case. N Y Times Web. October 14, 2014. Available at http://www.nytimes.com/2014/10/15/us/cdc-says-it-should-haveresponded-more-quickly-to-dallas-ebola-case.html?_r=1. Accessed March 29, 2015.
Bell MA, Dake JA, Price JH, et al.: A national survey of emergency nurses and Avian Influenza threat. J Emerg Nurs. 2012; 40(3): 212-217.
Barnett DJ, Balicer RD, Thompson CB, et al.: Assessment of local public health workers' willingness to respond to pandemic influenza through application of the Extended Parallel Process Model. PloS One. 2009; 4(7): e6365.
Martin SD: Nurses’ ability and willingness to work during pandemic flu. J Nurs Manag. 2009; 19(1): 98-108.
Gershon RR, Magda LA, Qureshi KA, et al.: Factors associated with the ability and willingness of essential workers to report to duty during a pandemic. J Occup Environ Med. 2010; 52(10): 995-1003.
Imai T, Takahashi K, Hasegawa N, et al.: SARS risk perceptions in healthcare workers, Japan. Emerg Infect Dis. 2005; 11(3): 404-410.
Jaakkimainen RL, Bondy SJ, Parkovnick M, et al.: How infectious disease outbreaks affect community-based primary care physicians comparing the SARS and H1N1 epidemics. Can Fam Physician. 2014; 60(10): 917-925.
Centers for Disease Control and Prevention: Interim guidance for U.S. hospital preparedness for patients under investigation (PUIs) or with confirmed Ebola Virus Disease (EVD): A framework for a tiered approach. Ebola Virus Disease. February 20, 2015. Available at http://www.cdc.gov/vhf/ebola/healthcare-us/preparing/hospitals.html. Accessed April 18, 2015.
Wadman MC, Schwedhelm SS, Watson S, et al.: Emergency department processes for the evaluation and management of persons under investigation for Ebola Virus Disease. Ann Emerg Med. 2015; 66(3): 306-314.
Goodman B, Cassoobhoy A: Survey reveals concerns over Ebola. WebMD Health News. October 31, 2014. Available at http://www.webmd.com/news/20141031/survey-reveals-concerns-over-ebola. Accessed January 20, 2015.
National Nurses United: National nurses statement on new CDC Ebola guidelines. National Nurses United Press Release. October 21, 2014. Available at http://www.nationalnursesunited.org/press/entry/national-nurses-statement-on-new-cdc-ebola-guidelines/. Accessed March 29, 2015.
Schwedhelm S, Beam EL, Morris RD, et al.: Reflections on interprofessional team-based clinical care in the Ebola epidemic: The Nebraska medicine experience. Nurs Outlook. 2014; 63(1): 27–29.
Isakov A, Jamison A, Miles W, et al: Safe management of patients with serious communicable diseases: Recent experience with Ebola virus. Ann Intern Med. 2015; 161(11): 829-830.
Agency for Healthcare Research & Quality: AHRQ issue brief: Health care simulation to advance safety: Responding to Ebola and other threats. February 2015. Available at http://www.ahrq.gov/research/findings/factsheets/errors-safety/simulproj15/index.html. Accessed March 29, 2015.
Tebruegge M, Pantazidou A, Ritz N, et al.: Perception, attitudes and knowledge regarding the 2009 swine-origin influenza A (H1N1) virus pandemic among health-care workers in Australia. J Paediatr Child Health. 2010; 46(11): 673-679.
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