Home Health & Hospice

NAHC creates Ebola task force for homecare workers

Homecare Insider, October 27, 2014

Last week, the National Association for Home Care & Hospice (NAHC) announced the creation of an Ebola task force, which is intended to help homecare agencies protect their workers and patients from the spread of the Ebola virus.
Prior to the announcement, the trade group wrote a letter to the Centers for Disease Control Prevention (CDC) and the U.S. Department of Health and Human Services requesting appropriate Ebola protocols  for homecare and hospice workers.
“We respectfully request that you develop and issue explicit guidance focused on protocols for agencies providing health and supportive services in the home,” NAHC President Val J. Halamandaris wrote in the letter. “The guidance should include protocols on proper advance screening for potential patients related to travel history and symptoms, proper referral of suspected cases, and other protective measures that should be taken. Home care and hospice agencies want to respond according to the most effective Ebola protocols.”
According to another recent news release from NAHC, the chances of homecare workers encountering a patient who is acutely ill from Ebola are “slim,” but the trade group contends that providers in this frontline setting need to be prepared to protect patients and staff if the need arises. In the release, Barbara Citarella, MS, RN, MS, CHCE, CHS-V, president of RBC Limited and chair of NAHC’s new Ebola task force, offers some tips for providers to prevent the spread of Ebola, a list that will be updated as protocols evolve. Current suggestions include:
  • Implementing a comprehensive infection prevention education program for all staff—especially those in the field—that includes intensive, repetitive training in the use of personal protective equipment (ppe), such as gloves, masks (either surgical or N95 respirator), gowns, and face shields. Staff should know how to don and doff ppe without contaminating themselves and apply effective hand washing techniques. Agencies should increase supervision of field staff by adopting a “buddy system” approach to monitoring infection prevention techniques. Agencies should NOT equip staff with outdated ppe equipment. Instead, order additional supplies, including booties and head coverings, immediately.
  • Reassure staff by providing them with accurate updates on Ebola daily. People are anxious, and inaccurate information can spread easily. Have a communication plan for staff and patients, and stress the agency’s mission to protect staff while they provide care. Agencies should also consult their state health department’s website, which will have the most recent general and state-specific information.
  • Review and update relevant policies, such as the pandemic plan, influenza protocols, and processes for monitoring staff that may have been exposed. Don’t forget to include the intake process of new patients. All new patients, and the referral source, should be asked questions following the CDC algorithm. If a possible Ebola patient (i.e., one who meets the CDC criteria) is identified during a home visit, staff should immediately don ppe and place the patient in a room (with a door, if possible) by him or herself. Staff should then call the health department and 9-1-1 to explain the situation and wait for guidance. Emergency dispatchers are being trained to arrange possible transports. No one, including staff, should leave the home until clear guidance has been given.

Citraella was one of two presenters at NAHC’s annual meeting, which was held in Phoenix, Arizona, last week, to address Ebola prevention strategies in their sessions.

Read the full list of Ebola protocol suggestions for homecare workers from the NAHC news release here.
Read Ebola guidelines and recommendations from the CDC here.