Survey of Emergency Department staff on disaster preparedness and training for Ebola virus disease

Abstract

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.