Department of Environmental, Agricultural, and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE.
Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington, IN.
Am J Infect Control. 2020 Apr;48(4):375-379. doi: 10.1016/j.ajic.2019.12.005. Epub 2020 Feb 6.
In 2014, 56 US hospitals were designated as Ebola treatment centers (ETCs). ETCs had minimum augmented capability requirements for Ebola virus disease care, including for staffing and training. We sought to identify current ETC staffing challenges and frequency of staff retraining.
In May 2019, an electronic survey was distributed to representatives of the 56 ETCs.
Sixty-six percent (37/56) of ETCs responded. Registered nurses comprised the majority of ETC staff. All responding units required orientation training (average = 15.21 hours) and all but one required retraining. Among the top challenges that ETCs reported to maintaining high-level isolation capabilities were staff training time, staff recruitment, staff retention, and training costs.
Five years after ETC designation, units face staffing challenges. Research is lacking on the effective number of hours and optimal frequency of staff training. ETCs reported smaller staffing teams compared to our 2016 assessment, but team composition remains similar. As units continue to maintain capabilities with decreasing external support and attention, the need for retraining must be balanced with logistical constraints and competing demands for staff time.
Our study shows that US preparedness capabilities are reduced. More research, support, and funding are needed to sustain the unique knowledge and proficiency acquired by ETC teams to ensure domestic preparedness for highly hazardous communicable diseases.
2014 年，美国有 56 家医院被指定为埃博拉治疗中心（ETC）。ETC 具备埃博拉病毒病护理的最低增强能力要求，包括人员配备和培训。我们试图确定当前 ETC 人员配备的挑战和员工再培训的频率。
2019 年 5 月，向 56 家 ETC 的代表分发了一份电子调查。
66%（37/56）的 ETC 做出了回应。注册护士构成了 ETC 工作人员的大多数。所有参与单位都需要入职培训（平均为 15.21 小时），除一家外，所有单位都需要再培训。ETC 报告的维持高水平隔离能力的最大挑战包括员工培训时间、员工招聘、员工留用和培训成本。
在 ETC 指定后的五年内，各单位面临人员配备挑战。关于员工培训的有效时间和最佳频率的研究还很缺乏。与我们 2016 年的评估相比，ETC 报告的人员配备团队规模较小，但团队组成仍然相似。随着各单位继续在外部支持和关注减少的情况下维持能力，再培训的必要性必须与后勤限制和员工时间的竞争需求相平衡。
我们的研究表明，美国的准备能力有所下降。需要更多的研究、支持和资金来维持 ETC 团队获得的独特知识和熟练程度，以确保为高危害性传染病做好国内准备。
