The Canterbury Health System is conducting training and ongoing work to ensure staff are familiar with the equipment and procedures in the unlikely event we were to get a suspected Ebola case.
Canterbury DHB is well practised in preparing for pandemics and in simple terms works to a 'Keep it out – Stamp it out – Manage it – Recover from it' – plan.
Currently we are in the "Keep it out" phase of a potential Ebola pandemic, where the focus in New Zealand is on border control. Those people who will be involved in the isolation of any suspect case (St John's and Infectious Protection Control staff) are already skilled in the use of specialised Personal Protective Equipment (PPE).
The key to containing the Ebola outbreak and prevent it from entering New Zealand is primarily contact tracing and contact management, which has already been clearly demonstrated in Nigeria and in some parts of Sierra Leone. This is the remit of Public Health staff and does not require them to use PPE.
While the Canterbury DHB is conducting training in PPE, specifically for Ebola, it is typically only required beyond a small number of specialised staff once we reach the "Manage it" phase. Notwithstanding this, the Canterbury DHB has started training staff in the use of specialised PPE in the event that we have unidentified Ebola cases in the community who present at random to emergency departments or other medical facilities. This is a worst case scenario and is unlikely to occur unless significant numbers spread beyond the borders of West Africa.
All Personal Protective Equipment at Canterbury DHB meets the current international equipment standards.
The PPE that will be used will be as per the Ministry of Health and Centre for Disease Control (CDC) guidelines.
Staff member to wear the following PPE:
blue scrubs and sturdy enclosed footwear
Disposable, long sleeved, cuffed impervious gown
Disposable booties or shoe coverings
Disposable gloves – two pairs
Surgical face mask
Impervious head covering/cap
Full face visor/shield over the face mask
In certain circumstances staff members will wear an all in one coverall (Tyvek type suit) where exposure to copious body fluids is anticipated.Where aerosol generating procedures are undertaken the staff member will wear an N95 NIOSH approved respirator mask.
It's important to note that recommendations are regularly changing and we need to be responsive to those. This is a fluid environment where we need to be able to adapt quickly and ensure staff are kept up to date and informed of any new developments.
The training and education of staff wearing PPE for an Ebola case is well underway and a train the trainer strategy has been developed. Key trainers in the relevant departments have been identified. Training for the Gown ensemble is currently underway but this type of PPE is familiar to staff and used for other infectious diseases and the training is primarily a reminder of the correct donning and doffing of this type of PPE. There are clear step-by-step posters and check lists developed to ensure the staff member's safety.
The training for safe removal of the all-in-one coverall is being finalised as this involves a two staff members or a buddy to assist with the removal of this equipment and the safest sequence of steps requires care to get it right. Frontline staff from ED and Infectious Disease have been involved in developing this training and multiple donning and doffing exercises have been undertaken to ensure that we get this process right. To date the all-in-one has not been used regularly as PPE for an infectious patient in developed countries so a safe process must be established before training can be implemented. In the meantime the gown ensemble provides a safe process for the care of an Ebola patient.
Training will concentrate initially on the few departments that will be directly involved with the care of a suspected Ebola patient but an overall awareness and reminder of the safe use of PPE is also being promoted.
We've already run a simulation for the Emergency Department on what to do should a suspected Ebola case present to the department. These simulations will be ongoing and help us to ensure our systems are robust and identify any areas we need to improve.
For more information please contact the Canterbury DHB Media Advisor
Media Release - Canterbury Health System preparing for Ebola
Links to information about Ebola provided by Canterbury DHB
Ministry of Health Ebola information
Media Releases Archive