Franklin Sativa Michelle
Author Affiliation: Military Advanced Practice Nurse, 86th Combat Support Hospital, Ft Campbell, Kentucky.
Clin Nurse Spec. 2016 Mar-Apr;30(2):E1-8. doi: 10.1097/NUR.0000000000000183.
The purpose of this article is to discuss the variance in requirements for personal protective equipment (PPE) used among healthcare workers to treat patients actively infected with the Ebola virus in West Africa.
The Ebola virus is a highly contagious disease, which has killed 11020 people within the past year. In order to combat the disease and treat those with active infections, healthcare workers are required to use PPE. The guidelines for the PPE, in addition to the requirements of what should be worn, are varied between the World Health Organization (WHO) and the Centers for Disease Control and Prevention.
A military unit was composed of sister services (Army, Navy, and Air Force) deployed to Monrovia, Liberia, to assist in mitigating the devastating effects of the Ebola virus. Each service member was taught PPE standards according to the WHO and were assigned to teach healthcare workers from around the world on how to manage the care of patients infected with the Ebola virus, while simultaneously taking diligent precautions to protect themselves against the deadly disease.
More than 1500 healthcare workers were instructed on the latest PPE standards before they entered into the Ebola treatment units (ETUs) that were being constructed in Liberia. Cumulative death rates from the Ebola virus in Liberia increased from 2413 in October 2014 to 3686 by January 2015.
CONCLUSION/IMPLICATIONS FOR PRACTICE: The rapid decline in Ebola mortality is multifactorial. The efforts of US military medical personnel likely were a contributing factor in this rapid decline as those international health workers were afforded the latest in PPE training with strict attention to detail. US military medical personnel, in concert with other governmental agencies, created a potent force multiplier in the efforts to curb this deadly infection. The educational initiative was essential to the slowdown in the spread of the Ebola virus in Liberia. Recommendations for a detailed review of the PPE standards and variances in practice from both WHO and Centers for Disease Control and Prevention are necessary to standardize processes across international healthcare workers to expedite the care for future infectious disease outbreaks. A possible solution is to modify the PPE process to standardize with the WHO guidelines. Key stakeholders from all levels (staff nurse, clinical nurse specialist, nurse managers, infectious disease experts, etc) need to be heavily involved in this process.
本文旨在探讨在西非治疗埃博拉病毒活跃感染者的医护人员所使用的个人防护装备（PPE）要求的差异。
埃博拉病毒是一种高度传染性疾病，在过去一年中已导致11020人死亡。为了抗击该疾病并治疗活跃感染者，医护人员需要使用个人防护装备。世界卫生组织（WHO）和疾病控制与预防中心对个人防护装备的指导方针，除了应穿戴物品的要求外，也存在差异。
一个军事单位由部署到利比里亚蒙罗维亚的各军种（陆军、海军和空军）组成，以协助减轻埃博拉病毒的毁灭性影响。每个军人都按照世界卫生组织的标准接受了个人防护装备培训，并被分配去教导来自世界各地的医护人员如何护理感染埃博拉病毒的患者，同时采取严格的预防措施保护自己免受这种致命疾病的侵害。
在1500多名医护人员进入利比里亚正在建设的埃博拉治疗单元（ETU）之前，他们接受了最新的个人防护装备标准培训。利比里亚埃博拉病毒的累计死亡率从2014年10月的2413例增加到2015年1月的3686例。
结论/实践意义：埃博拉死亡率的迅速下降是多因素的。美国军事医务人员的努力可能是这一迅速下降的一个促成因素，因为那些国际卫生工作者接受了最新的个人防护装备培训，且严格注重细节。美国军事医务人员与其他政府机构协同合作，在遏制这种致命感染的努力中创造了强大的力量倍增效应。该教育倡议对于减缓埃博拉病毒在利比里亚的传播至关重要。有必要对世界卫生组织和疾病控制与预防中心的个人防护装备标准及实践差异进行详细审查，以规范国际医护人员的流程，加快对未来传染病爆发的应对。一个可能的解决方案是修改个人防护装备流程，使其与世界卫生组织的指导方针标准化。各级关键利益相关者（护士、临床护理专家、护士长、传染病专家等）需要深度参与这一过程。
