Only 6% of Hospitals Well Prepared for Ebola, Poll Finds

October 27, 2014

Infection prevention experts say only 6% of US hospitals are deemed well-prepared to receive a patient with Ebola, according to a survey by the Association for Professionals in Infection Control and Epidemiology (APIC).

The survey findings, released October 24, underscore the growing consensus in public health that Ebola care should be the domain of a few select hospitals with the necessary resources and expertise. Just 3 weeks ago, the head of the Centers for Disease Control and Prevention (CDC) was asserting that any hospital in the country could care for a patient with Ebola, provided it complied with agency recommendations. In the aftermath of two nurses contracting the virus from a patient at a hospital in Dallas, Texas, CDC Director Thomas Frieden, MD, MPH, now supports funneling these patients to designated facilities.

One of those facilities is Bellevue Hospital in New York City, which last week admitted an American physician who tested positive for Ebola after returning from an assignment with Doctors Without Borders in Guinea.

Earlier this month, APIC polled its infection preventionist members in acute care hospitals on Ebola readiness and received answers from 1039 of them.

The participants were asked to rate their hospital on a scale of 1 to 5, with 5 signifying "well-prepared" for a patient with the virus and 1 "not prepared." Six percent said their hospital was well-prepared, but another 5% said their facility was not. Nearly 40% percent rated their hospital as a 3.

Table. How Prepared Is Your Hospital to Receive a Patient With Ebola?

Score Percentage
1 (not prepared) 5.11
2 16.78
3 39.83
4 31.82
5 (well prepared) 6.46

Source: Member survey of the Association for Professionals in Infection Control and Prevention

Confidence level appears correlated to the number of infection prevention experts on staff at a given facility. Among hospitals with 11 or more of these professionals, 31% were judged to be well-prepared. When the number of infection preventionists on staff was between zero and one, however, only 4% of hospitals fell into the well-prepared category. The survey found that 51% of hospitals had a staffing level of one or fewer infection preventionist.

"Facilities that are inadequately staffed to begin with are stretched beyond capacity at a time like this," said APIC President Jennie Mayfield, BSN, MPH, in a news release. "The current [Ebola] crisis demonstrates our lack of surge capacity and should concern everyone."

Waste Management a Big Worry

The APIC also asked respondents to identify areas in which their hospitals needed more information for the sake of better caring for patients with Ebola. Topping the list — selected by more than half of the respondents — were waste management, waste removal, and donning and doffing personal protective equipment. At the bottom of the list were isolation procedures (23%) and isolation capacity (26%).

Eighty-one percent of infection preventionists surveyed said they had initiated Ebola training in their hospitals, whereas 18% said they had not (the rest did not know). Professionals in hospitals with 100 or more beds were slightly more likely to have begun Ebola training than their peers in hospitals with fewer than 100 beds.

Most of APIC's 15,000 members are nurses, physicians, public health professionals, epidemiologists, and medical technologists, according to the group.

More information on the Ebola-readiness survey is available on APIC's website.

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