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Dome - Preparing a Nation of Health Care Workers to Treat Ebola

Dome December 2014

Preparing a Nation of Health Care Workers to Treat Ebola

Date: December 5, 2014

Johns Hopkins Medicine leads the CDC’s effort to create Web-based training for hospital personnel nationwide.

TAKE TWO: Before a camera, infection control workers Simone Almeida, left, and Kerri Huber demonstrate how to don and doff personal protective equipment.
TAKE TWO: Before a camera, infection control workers Simone Almeida, left, and Pam Falk demonstrate how to don and doff personal protective equipment.

Spotlights and cameras are a new workday experience for Simone Almeida, an infection preventionist at Sibley Memorial Hospital, and Kerri Huber, an infection control manager at Johns Hopkins Bayview Medical Center. On Oct. 23, they traveled to a studio in the Park Heights section of northwest Baltimore to perform carefully rehearsed roles designed to protect the safety of patients and health care workers throughout the nation.

The protocol they demonstrated—safely putting on and removing the personal protective equipment (PPE) needed to treat patients with Ebola virus disease—is featured in training videos on the website of the Centers for Disease Control and Prevention (CDC), the nation’s public health agency charged with managing infectious diseases. The modules are also available to millions of users of Apple’s iTunes U.

“I do instruction for health care workers, but I have never been recorded in a formal video,” says Almeida. “With my microbiology background, I’m used to wearing PPE in the lab, but not to the extent that is needed with Ebola. I knew it would be a great opportunity to demonstrate how donning and doffing is done safely.”

When the CDC sought help creating Web-based training to illustrate its guidelines for properly using PPE, it chose Johns Hopkins Medicine to lead the effort. Spearheaded by Peter Pronovost, senior vice president for patient safety and quality improvement for Johns Hopkins Medicine and director of the Armstrong Institute for Patient Safety and Quality, the weeklong production effort brought together a diverse crew. 

The 40-member, multidisciplinary team included experts in infectious disease, nursing, systems engineering, content development and visual design from organizations including Johns Hopkins Medicine, The Johns Hopkins Hospital, The Johns Hopkins University, Howard County General Hospital, Sibley Memorial Hospital, Suburban Hospital, the CDC, the Association for Professionals in Infection Control and Epidemiology, and others.

They were given a challenging assignment: Create thorough and easy-to-understand training for health care providers in how to safely don PPE, how to remove it and how to best monitor the process.

They were also given a deadline: one week.

Overnight, the clean, organized work area at the Armstrong Institute became a whirlwind of Post-it notes, video cameras and mobile technology. Tables and chairs were scattered haphazardly. White boards filled with plans and reminders that were scribbled in many different colors.

Crews spent three days at the institute’s Inner Harbor offices deciding how to organize the instructional videos and practicing safe techniques for putting on and removing various combinations of PPE that conform to CDC guidelines. They then moved to the expansive studios of BlueRock Productions’ warehouse to begin actual filming.

“We were on set from 8 a.m. until well into the evening,” says Huber. “One minute we were running around trying to gather supplies and assign roles, and the next, we were all sitting around waiting for our scene.”

“Health care is not used to scaling this fast and this broad,” says Lawrence Ramunno, chief medical officer for Sibley. However, by Oct. 31, “Ebola Preparedness: PPE Guidelines” was available on the CDC’s website and shortly thereafter on iTunes U.

The training package consists of short, step-by-step video clips that supplement the CDC’s written guidance on the safe use of PPE for hospital personnel. An interactive component allows viewers to personalize the training by selecting which type of approved respirator and attire they intend to wear.

“People are visual learners,” says Ayse Gurses, a human factors engineer and patient safety faculty member with the Armstrong Institute. “To be efficient and effective, information must be presented contextually and visually to engage health care workers and help them retain the information.”

Pronovost, who provides an introduction to the video training, says the modules are crucial to the safety of anyone caring for a patient with Ebola. “But the bigger lesson here is what’s powerful and what’s possible when you bring diverse groups of people together from the government, the private sector and the public sector who can work together to solve these really big problems that our country and the world face.”

The CDC has also contracted the Armstrong Institute to produce three additional modules geared toward emergency department staff. These modules will train emergency health care workers on proper identification, isolation and treatment procedures for interacting with patients who may be at high risk for developing Ebola.

—Lisa Rademakers

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As seen in the 2016 Biennial Report. Learn more.

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