Healthy Choices

New Ebola guidelines require more protection for California nurses

Karrin Dunbar, clinical nurse educator at UC Davis Medical Center, provides training for ebola preparedness and personal protective gear at the UC Davis Medical Center on Thursday, Nov. 6, 2014, in Sacramento, Calif.
Karrin Dunbar, clinical nurse educator at UC Davis Medical Center, provides training for ebola preparedness and personal protective gear at the UC Davis Medical Center on Thursday, Nov. 6, 2014, in Sacramento, Calif. Aseng@sacbee.com

New Ebola guidelines, released Friday by the Department of Industrial Relations and the California Department of Public Health, raise the bar on safety measures for health care workers treating the virus and satisfy the demands of a nurses’ union that rallied nationwide last week for increased protection.

National Nurses United and its state subsidiary, California Nurses Association, staged a two-day strike of 18,000 nurses against 86 Kaiser Permanente facilities across the state Tuesday and Wednesday. The strikers, who rallied in conjunction with nurses in 16 states, sought to draw attention to the risks incurred by health care workers who might treat patients with Ebola. There are currently no confirmed cases of Ebola in California.

RoseAnn DeMoro, executive director of the California Nurses Association and National Nurses United, said she’s pleased the administration took action.

“We needed regulation desperately,” she said. “The disaster was the lack of preparedness across the country. If there had been an outbreak, it would have been horrendous.”

The new guidelines, which build on the department’s Interim Guidance for Ebola released Oct. 15, require workers at risk of contracting the virus to be covered head to toe in fluid-resistant protective garb. The measures go a step further than the current Centers for Disease Control and Prevention standards by requiring battery-powered air purifying respirators, which must include full hoods to cover the face, neck and torso. They also require the hospital to provide in-person training to staff on the donning and removal of the equipment.

The rules apply to any hospital inpatient settings in which confirmed or suspected cases of Ebola may receive intensive treatment, and also includes special recommendations for emergency departments regarding the isolation and possible transfer of Ebola patients.

“We have focused these guidelines to provide additional direction for inpatient settings, where infectious disease transmission risk is highest,” said Juliann Sum, acting chief of Cal/OSHA, in a written statement. “These updated guidelines clarify the requirements hospitals must meet to maintain workplace safety and to prevent exposure to Ebola.”

The California Nurses Association has been demanding better protection since August, saying they lacked proper equipment and training to fight the virus.

Jan Emerson-Shea, vice president and chief spokeswoman for the California Hospital Association, said earlier this week that the nurses were using the “mask of Ebola” as a negotiating tactic. A prior three-year contract between Kaiser and the nurses union expired at the end of August.

The union has stated that it intends to push on nationally in their efforts, using California as a model for establishing Ebola guidance.

“Really, we’re talking about a public safety issue,” said Chuck Idelson, spokesman for National Nurses United. “What should be apparent to everyone is this is an extremely dangerous disease … It has such a propensity to affect the people who provide care for people with Ebola. We knew it was critical.”

UC Davis Medical Center, one of five facilities in California designated by the state health department as an Ebola treatment center, has had full protective gear and respirators for several weeks and recently updated its protocols. Nurses there have access to in-person training five days a week on how to use the equipment. Getting in and out of the gear is a high-risk time for contracting the virus, which is transmitted through bodily fluids.

Editor’s note (Nov. 19): This story has been updated to reflect that the state instituted new Ebola guidelines rather than regulations.

Call The Bee’s Sammy Caiola, (916) 321-1636.

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