Cummings Kristin J, Choi Mary J, Esswein Eric J, de Perio Marie A, Harney Joshua M, Chung Wendy M, Lakey David L, Liddell Allison M, Rollin Pierre E
Ann Intern Med. 2016;165(1):41-49. doi: 10.7326/M15-2944. Epub 2016 May 10.
Health care personnel (HCP) caring for patients with Ebola virus disease (EVD) are at increased risk for infection with the virus. In 2014, a Texas hospital became the first U.S. community hospital to care for a patient with EVD; 2 nurses were infected while providing care. This article describes infection control measures developed to strengthen the hospital's capacity to safely diagnose and treat patients with EVD. After admission of the first patient with EVD, a multidisciplinary team from the Centers for Disease Control and Prevention (CDC) joined the hospital's infection preventionists to implement a system of occupational safety and health controls for direct patient care, handling of clinical specimens, and managing regulated medical waste. Existing engineering and administrative controls were strengthened. The personal protective equipment (PPE) ensemble was standardized, HCP were trained on donning and doffing PPE, and a system of trained observers supervising PPE donning and doffing was implemented. Caring for patients with EVD placed substantial demands on a community hospital. The experiences of the authors and others informed national policies for the care of patients with EVD and protection of HCP, including new guidance for PPE, a rapid system for deploying CDC staff to assist hospitals ("Ebola Response Team"), and a framework for a tiered approach to hospital preparedness. The designation of regional Ebola treatment centers and the establishment of the National Ebola Training and Education Center address the need for HCP to be prepared to safely care for patients with EVD and other high-consequence emerging infectious diseases.
照顾埃博拉病毒病（EVD）患者的医护人员（HCP）感染该病毒的风险增加。2014年，一家得克萨斯州医院成为美国第一家收治EVD患者的社区医院；2名护士在提供护理时被感染。本文介绍了为增强医院安全诊断和治疗EVD患者的能力而制定的感染控制措施。第一名EVD患者入院后，疾病控制与预防中心（CDC）的一个多学科团队与该医院的感染预防人员共同实施了一套职业安全与健康控制体系，用于直接护理患者、处理临床标本以及管理受管制医疗废物。现有的工程和管理控制措施得到了加强。个人防护装备（PPE）套装实现了标准化，医护人员接受了PPE穿脱培训，并实施了一个由经过培训的观察员监督PPE穿脱的系统。照顾EVD患者给一家社区医院带来了巨大压力。作者及其他人的经验为EVD患者护理和医护人员保护的国家政策提供了参考，包括PPE的新指南、向医院部署CDC工作人员的快速系统（“埃博拉应对小组”）以及医院准备工作的分级方法框架。指定区域埃博拉治疗中心以及设立国家埃博拉培训与教育中心满足了医护人员为安全护理EVD患者及其他高后果新发传染病患者做好准备的需求。
