The information on this website is provided to facilitate learning how evidence guides infection control policies and protocols, using Ebola as an exemplar. It is NOT intended to replace any guidelines or policies currently in effect. A brief summary of each link is provided as well as guidance as to how these resources might serve as learning activities for students.The 7 learning outcomes are listed together, then links and learning activities are provided for each outcome.
The following learning outcomes are expected:
Students will:
Maintain awareness of current events from multiple perspectives. Jump to the resources for outcome one.
Explain how to discern best evidence when learning about new diseases/protocols. Jump to the resources for outcome two.
Explain how transmission of infectious diseases is determined and measured. Jump to the resources for outcome three.
Explain which personal protective equipment would be needed for different types of isolation. Jump to the resources for outcome four.
Explain the process of protecting oneself from both acquiring and transmitting an infectious disease. Jump to the resources for outcome five.
Recognize breaches of infection control measures and impact on patient safety. Jump to the resources for outcome six.
Advocate for patients and healthcare providers when protocols are ambiguous or contrary to evidence. Jump to the resources for outcome seven.
Maintain awareness of current events from multiple perspectives. Each news source has their biases. Politics, the economy, and foreign affairs have connections to our lives. Downloading apps onto mobile devices for quick access is recommended,
Explain how to discern best evidence when learning about new diseases/protocols
Learning activity:
Compare and contrast information from current events, and sites such as CDC, WHO, Medecins Sans Frontieres (Doctors without Borders), and Red Cross.
- Doctors without Borders, updates on Ebola:
- CDC guidelines and news on Ebola: (these are changing constantly)
- American Red Cross, news and updates on Ebola
- World Health Organization (WHO) response roadmap
Learning activity:
i. View a video and analyze the information, and discuss where opportunities for interventions were missed. A sample video link is providedExplain how transmission of infectious diseases is determined and measured
Basic principles of epidemic theory
This link brings you to a section of the Public Health Textbook on the United Kingdom-based, Health Knowledge website. The authors of the text are well qualified in the area of epidemiology and infectious disease control. This particular section of the website covers basic principles of epidemic theory, defining basic terms suchs as Basic Reproduction Rate and Effective Reproduction Rate, Herd immunity
Early transmission dynamics of Ebola virus disease (EVD), West Africa, March to August, 2014
The journal article that you will be connected to via this link illustrates the use of mathematical models to calculate the effective reproduction rate for the EVD. It provides a clinical application of the information provided in the first link above, shedding light on EVD transmission dynamics and provides concrete data to support the fact that this 2014 EVD outbreak represents a Public Health Emergency of International Concern.
Quantifying Pathogen Surveillance Using Temporal Genomic Data
Genomic surveillance is a contemporary method for the detection of infectious disease, supplementing the information gleaned from classical approaches used to trace the origins of an infectious disease transmission (e.g., clinical and/or serological techniques).
Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak
This recent article published in a leading science journal provides an example of how the genomic surveillance technique was used to determine where the EVD originated and how it is transmitted.
Outbreak of Ebola Virus Disease in Guinea: Where Ecology Meets Economy
This link brings you to an open-access article published by the Public Library of Online Science (PLOS) Neglected Tropical Diseases Journal. It provides insight into the etiology and evolution of EVD transmission from an ecological and economic perspective.
An Ebola update from an NIH medical expert
This video was posted on the White House blog. Dr. Anthony Fauci, infectious disease chief at the National Institutes of Health (NIH), recently sat down to share an update on Ebola. He spoke about the measures the Administration is taking to respond to Ebola cases at home, while containing the epidemic at its source in West Africa. Dr. Fauci stressed that Ebola is not an easily transmitted disease and laid out the facts on how the disease spreads
Epidemiology, pathogenesis, and clinical manifestations of Ebola and Marburg virus disease
This succinct summary of these two filoviruses that are among the most virulent human pathogens contains a section describing EVD transmission that provides references for those who wish deeper insight into the science behind the transmission phenomenon.
Explain which personal protective equipment (PPE) would be needed for different types of isolation
Guidelines from CDC on PPE, including slides, posters
http://www.cdc.gov/hai/prevent/ppe.html
Hospital Videos: There are many hospital videos available on PPE. This video from University of Iowa was chosen as it covers standard precautions and three types of isolation, showing correct and incorrect PPE usage. This video is typical of how healthcare providers in hospitals are trained. Discuss how such guidelines might be contrary to emerging evidence for unfamiliar viruses, and how healthcare providers might be placing themselves and patients at risk. Use this video to discuss how the first two nurses in the US may have become infected, despite following their hospital procedures.
- University of Iowa, 2012, detailing the different types of isolation: droplet/contact/airborne: 9 minutes
- Standard and Isolation Precautions. UIHC Department of Hospital Epidemiology: http://www.youtube.com/watch?v=VlUWsNC3ibs
Explain the process of protecting oneself from both acquiring and transmitting an infectious disease
Learning activity: Compare and contrast the two videos listed below:
4 minute video by Parkland Memorial hospital, posted on Oct. 9, 2014. http://www.youtube.com/watch?v=1GNKJL1_ejg
5 minute video by Dupont, Tychem 4000S: donning and doffing, posted June 19, 2014
This instructional video shows the steps of donning and doffing with a buddy system
http://www.youtube.com/watch?v=71i0IWVS99c
Learning activity: Use CDC fact sheets to compare and contrast the published factsheets from August 2014 and October 2014 based on emerging evidence regarding transmission of ebola. The documents are at the bottom of this section.
Learning activity: Compare and contrast the guidelines published by WHO and CDC, and the article by NPR on Ebola School.
WHO (World Health Organization) guide on clinical management of VHF (viral hemorrhagic fever), published March 2014. This document is at the bottom of this section.
This is document includes excellent illustrations and step-by-step guidelines. It is written for the front-line healthcare worker. It includes infection control, psychological support, discharge, and follow up. It also specifically addresses the care of children, and pregnant women (including the management of a mother in active labor), including considerations for birth and breastfeeding.
Pages 45-60 addressed infection prevention and control. P. 45 also addresses the aerosolization of the virus
CDC (Centers for Disease Control) guide: http://www.cdc.gov/vhf/ebola/pdf/hospital-checklist-ebola-preparedness.pdf
Lessons from Ebola School. Excerpts from Ebola School, detailed guide on lab specimen collection and cleaning contaminated fluids. Compare and contrast to current practices in clinical settings.http://www.npr.org/blogs/goatsandsoda/2014/10/16/356103120/lessons-from-ebola-school-how-to-draw-blood-wipe-up-vomit
Recognize breaches of infection control measures and impact on patient safety
see resources under objective 4, video shows examples of breaches of infection
Steps for Evaluating an infection control breach from the CDC:
http://www.cdc.gov/hai/outbreaks/steps_for_eval_IC_breach.html
Learning activity: Use the memorandum from Centers for Medicare and Medicaid Services (CMS) to discuss reporting of infection control breaches, and how such a memorandum becomes necessary (2 pages)
http://www.leadingage.org/CMS_Issues_Guidance_for_Reporting_Certain_Infection_Control_Breaches.aspx
Learning activity: Use the video below to discuss consumer knowledge, and how patients can recognize breaches of infection control
This two minute video discusses central line infections from a patient perspective; 2 minutes:
http://www.consumerreports.org/cro/2012/12/deadly-infections/index.htm
Advocate for patients and healthcare providers when protocols are ambiguous or contrary to evidence
TeamSTEPPS was developed by AHRQ and the Department of Defense (DoD) as a teamwork system that offers a powerful solution to improving collaboration and communication. “Mutual Support” is one of the program’s 12 modules and contains information on practical strategies for speaking up to address important safety issues. The slides from this module are available for free download from AHRQ.
AORN, AACN and VitalSmarts present: The Silent Treatment - This report shows how nurses’ failure to speak up when risks are known undermines the effectiveness of current safety tools. It then focuses on three specific concerns that often result in a decision to not speak up: dangerous shortcuts, incompetence, and disrespect. The Silent Treatment tracks the frequency and impact of these communication breakdowns, then uses a blend of quantitative and qualitative data to determine actions that individuals and organizations can take to resolve avoidable breakdowns.
Ebola: Nurses on the Front Line - October 20 article by a clinical ethicist from the Johns Hopkins Berman Institute of Bioethics about weighing personal risks against professional responsibilities
Worker’s Right to Refuse Dangerous Work- The US Occupational Safety and Health Administration outlines the conditions under which workers have a right to refuse dangerous tasks.
