AP Top Stories October 14 A
Subscribe for more Breaking News: http://smarturl.it/AssociatedPress Here #39;s the latest news for Tuesday, Oct. 14th: Health care workers monitored in Dallas; Dozens arrested in police shooting...
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Health Care in Liberia, in the Time of Ebola
Soon there will be 700 beds for treating Ebola patients in Monrovia. But medical staff are among the first victims, and in the Liberian capital, half of the health centers are shut and just...
By: Doctors Without Borders / MSF-USA
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What is PEPlus?
With a grant given by the Sequoia Health Care District, Redwood City Parks, Recreation Community Service Department (PRCS) is partnering with the Peninsula Community Center (PCC) to provide.
By: Redwood City Parks, Recreation Community Services
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Health care professionals plan for Ebola
Local medical professionals met at the Western Michigan University Homer Stryker M.D. School of Medicine Tuesday morning to discuss preparedness for Ebola. (Oct. 14, 2014)
By: WOOD TV8
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Improving the Patient Experience with Advanced Illness through Research on Technology
Arif Kamal, MD Assistant Professor of Medicine Division of Medical Oncology and Duke Palliative Care Duke University Medical Center Physician Director of Quality and Outcomes Duke Cancer Institute ...
By: Duke Clinical Research Institute
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Improving the Patient Experience with Advanced Illness through Research on Technology - Video
The Ebola outbreak shows that being on the front lines of disease can be particularly dangerous business for health-care workers. More than 230 workers have died overseas trying to battle the deadly virus, and the infection of a Dallas nurse treating the first U.S. patient diagnosed with Ebola is a reminder that health-care workers put themselves at risk to treat the sick.
When it comes to treating Ebola patients, it's hard to understate how careful health-care workers must be. As this graphic explains, there's about 30 distinct steps workers have to take to avoid a risk of infection. After the infection of the Dallas nurse, the CDC is rethinking protocols for care and that's after the country's largest nurse's union has warned that its members haven't been adequately trained on Ebola.
Of course, Ebola is a special case, but health-care workers face significant risks on the job. In fact, working in health care is about the unhealthiest profession you could choose.
Health-care and social assistance workers reported 653,900 injury and illness cases in 2010, far more than any other private industry sector, according to the Occupational Safety and Health Administration. That's significantly more than manufacturing and construction, which used to be much more dangerous industries by comparison. The following chart showing injury and illness rates over a 20-year period indicates that health-care's modest safety improvements have been far outpaced by other sectors.
(Bureau of Labor Statistics)
So, what makes health care work so dangerous? Here's OSHA's explanation:
Healthcare workers face a number of serious safety and health hazards. They include bloodborne pathogens and biological hazards, potential chemical and drug exposures, waste anesthetic gas exposures, respiratory hazards, ergonomic hazards from lifting and repetitive tasks, laser hazards, workplace violence, hazards associated with laboratories, and radioactive material and x-ray hazards. Some of the potential chemical exposures include formaldehyde, used for preservation of specimens for pathology; ethylene oxide, glutaraldehyde, and paracetic acid used for sterilization; and numerous other chemicals used in healthcare laboratories.
Not for the faint of heart, basically. Fortunately, the U.S. health-care industry in the past 20 years has significantly reduced the risk of contracting pretty terrible diseases. Between 2003 and 2011, hospitals reported 37 cases of work-related fatalities from exposure to harmful substances about 14 percent of all workplace deaths reported for hospitals during that time, according to OSHA. And in 2011, exposure to substances accounted for just about 4 percent of all hospital worker injuries resulting in days off.
There's also been a huge drop in the reported cases of occupational transmissions of hepatitis B since federal regulators issued guidelines nearly 25 years ago to stem the epidemic of infections among health-care workers. Cases of contracting hepatitis B on the job decreased from 17,000 cases in 1983 to 400 in 1995, and there were only 10 reported cases in 2010, according to a Public Citizen report.
The health-care industry has been even better at preventing HIV transmissions. There's been just 57 cases of documented transmissions and 143 possible transmissions of HIV to U.S. health-care workers on the job, according to the Centers for Disease Control and Prevention. And it's been about 15 years since a reported case, though the CDC said it's possible this could be because of underreporting. Again, the improvements are the result of better federal guidelines for limiting transmission risks on the job, as well as treatments when possible exposures occur.
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Wonkblog: Its not just Ebola. Health care is pretty dangerous work.
Originally published October 14, 2014 at 6:27 PM | Page modified October 14, 2014 at 7:30 PM
Officials of a union that represents 26,000 health-care workers in the state say its members particularly those who clean hospital rooms are not being properly equipped, trained or supported to deal with potential Ebola cases.
Its a big concern and our people are on the front lines, said Chris Barton, secretary-treasurer of Service Employees International Union Healthcare 1199NW, and a nurse herself.
Several medical workers and union staffers met with the media outside Swedish Medical Center/First Hill campus Tuesday.
Im very worried, said Carmencita Smith, a longtime environmental-services worker who cleans rooms at Swedish. We need better equipment.
Shes worried that by the time a patient is confirmed to have Ebola, hospital workers may have already been exposed.
Smith said in 25 years of cleaning up messes most people wouldnt want to talk about, shes had minor ailments that may have been caused or aggravated by what she comes in contact with at work. Thats why shes frightened to be around a virus as deadly as Ebola.
But Smith said that when she mentioned her fear to her supervisor this week, she was told not to worry because Swedish wont get any Ebola cases.
She remains concerned the hospital wont know when patients arrive whether they have the deadly virus.
The U.S. Centers for Disease Control and Prevention has said all hospitals should be prepared to recognize, isolate and treat potential Ebola patients.
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Health-care union says its members unprepared for Ebola cases
STORY HIGHLIGHTS
(CNN) -- In a matter of days, they transformed from caretakers into patients.
The two women live thousands of miles apart, but the first known Ebola cases contracted outside Africa during this outbreak have one striking similarity: Both were health care workers, caring for someone infected with the deadly virus.
As a nurse in Dallas and a nurse's assistant in Madrid fight for their lives, a key question looms: Are people who are putting themselves in harm's way to care for Ebola victims receiving the training and equipment they need?
No, says Zenei Cortez, vice president of National Nurses United.
"It's really a disaster waiting to happen," she told CNN's "The Lead with Jake Tapper" on Thursday.
The union is pushing for more equipment, training and education for nurses, Cortez said. A survey of 1,900 nurses by the union found that 76% said their hospital had not communicated any policy for the potential admission of patients infected by Ebola.
It's a "startling statistic," CNN Chief Medical Correspondent Dr. Sanjay Gupta said, particularly since the Centers for Disease Control and Prevention said in May that it was distributing guidelines to hospitals around the country.
"Infectious disease protocols, universal precautions should be the same, really, in hospitals all over the country. They should apply here with regard to Ebola as well," Gupta said. "But obviously, that's not happening. These nurses who are a part of that survey just don't feel comfortable as things stand now."
CDC chief blames protocol breach
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14-Oct-2014
Contact: Annmarie Christensen Annmarie.Christensen@dartmouth.edu 603-653-0897 The Geisel School of Medicine at Dartmouth
LEBANON, NH The foundation of evidence-based research has eroded and the trend must be reversed so patients and clinicians can make wise shared decisions about their health, say Dartmouth researchers in the journal Circulation: Cardiovascular Quality and Outcomes.
Drs. Glyn Elwyn and Elliott Fisher of The Dartmouth Institute for Health Policy & Clinical Practice are authors of the report in which they highlight five major problems set against a backdrop of "obvious corruption." There is a dearth of transparent research and a low quality of evidence synthesis. The difficulty of obtaining research funding for comparative effectiveness studies is directly related to the prominence of industry-supported trials: "finance dictates the activity."
The pharmaceutical industry has influenced medical research in its favor by selective reporting, targeted educational efforts, and incentivizing prescriber behavior that influences how medicine is practiced, the researchers say. The pharmaceutical industry has also spent billions of dollars in direct-to-consumer advertising and has created new disease labels, so-called disease-mongering, and by promoting the use of drugs to address spurious predictions.
Another problem with such studies is publication bias, where results of trials that fail to demonstrate an effect remain unpublished, but trials where the results are demonstrated are quickly published and promoted.
"We do not know when healthcare decisions are guided by sound interpretations of the evidence and whether patients are engaged in the process," say Elwyn and Fisher. "Rather we observe that in the United States, one of the most highly developed healthcare systems, consumer demand for healthcare is manufactured and manipulated, driving up cost, waste and harm."
And even if the synthesis is competent, they say, more evidence remains inaccessible and presented in a way that is difficult to translate into effective communication about harms and benefits.
"The problems of greatest concern to patients are often left uninvestigated, with emphasis given to research that expands market share," say Elwyn and Fisher.
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Standard Poor #39;s U.S. Consumer, Retail, And Health Care Weekly Review (Oct. 5)
In this segment of Standard Poor #39;s U.S. Consumer, Retail, and Health Care Weekly Review, Standard Poor #39;s Associate Director Jacqui Hui highlights sector ...
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Bergen County Community College Pres.: Health Care Program Is Expanding To Meet Demand
Bergen Community College President Kaye Walter says that the school #39;s health care program is expanding in order to meet the demand. For more New Jersey news,...
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DALLAS --
Tests confirmed the first known case of Ebola transmitted in the nation, raising questions about assurances by health officials here that the disease will be contained and any American hospital should be able to treat it.
Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, said Sunday there had been a breach of protocol that led the worker to become infected while treating patient Thomas Eric Duncan, but officials are not sure what occurred. Duncan, who traveled from Liberia to visit family, did not get sick until he arrived in the U.S. He died Wednesday.
The worker, who has not been identified, has not been able to point to how the breach might have occurred.
President Barack Obama asked the CDC to quickly investigate the incident, the White House said.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases was asked on ABC's "Good Morning America" if federal health authorities should consider requiring that Ebola patients be sent only to highly specialized "containment" hospitals.
"That is something that should be seriously considered," Fauci said.
Dallas police barred entry to the health care worker's apartment complex Sunday. Officers also knocked on doors, made automated phone calls and passed out fliers to notify people within a four-block radius about the situation, although Dallas authorities assured residents the risk was confined to those who have had close contact with the two Ebola patients.
The worker wore a gown, gloves, mask and shield while she cared for Duncan during his second visit to Texas Health Presbyterian Hospital, said Dr. Daniel Varga of Texas Health Resources, which runs the hospital.
Duncan, who arrived in the U.S. from Liberia Sept. 20, first sought medical care for fever and abdominal pain Sept. 25. He told a nurse he had traveled from Africa, but he was sent home. He returned Sept. 28 and was placed in isolation because of suspected Ebola.
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DALLAS Federal health officials on Monday urged the nation's hospitals to "think Ebola" and launched a review of procedures for treating infected patients, while the World Health Organization called the outbreak "the most severe, acute health emergency seen in modern times."
Public-health authorities also intensified their monitoring of Dallas hospital workers who cared for a man who died of Ebola. Their stepped-up efforts came a day after a nurse was tested positive for the virus.
The nurse, who was wearing protective gear when she took care of Thomas Eric Duncan, became the first person to contract the disease within the United States.
Centers for Disease Control and Prevention Director Tom Frieden said he would not be surprised if another hospital worker who cared for Duncan becomes ill because Ebola patients become more contagious as the disease progresses. The CDC now is monitoring all hospital workers who treated Duncan and planned to "double down" on training and outreach on how to safely treat Ebola patients, Frieden said.
When asked how many health care workers are being checked, Frieden said officials "don't have a number."
Health officials have relied on a 'self-monitoring' system when it comes to U.S. health care workers who care for isolated Ebola patients and wear recommended protective equipment. They expect workers to report any potential exposures to the virus and watch themselves for symptoms.
Besides the workers, health officials continue to track 48 people who were in contact before Duncan was admitted to the hospital and placed in isolation. They are monitoring one person the nurse was in contact with while she was in an infectious state.
None has exhibited symptoms, Frieden said.
The case involving the infected nurse raised questions about assurances by American health officials that the disease will be contained and that any U.S. hospital should be able to treat it.
Frieden has said a breach of protocol led to the nurse's infection, but officials are not sure what went wrong. The nurse, who has not been identified, has not been able to point to any specific breach.
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A Texas Health Presbyterian Hospital health care worker in Dallas who had extensive contact with the first Ebola patient to die in the United States has contracted the disease.
The Centers for Disease Control and Prevention in Atlanta confirmed the news Sunday afternoon after an official test.
The infected person detected a fever Friday night and drove herself to the Presbyterian emergency room, where she was placed in isolation 90 minutes later. A blood sample sent to the state health lab in Austin confirmed Saturday night that she had Ebola the first person to contract the disease in the United States.
The director for the Centers for Disease Control and Prevention said Sunday that the infection in the health care worker, who was not on the organizations watch list for people who had contact with Ebola patient Thomas Eric Duncan, resulted from a breach in protocol.
"We have spoken with the health care worker," who cannot "identify the specific breach" that allowed the infection to spread, said CDC director Dr. Tom Frieden. The CDC has sent additional staff members to Dallas to assist with the response, he said.
Frieden said exposure can result from a single inadvertent slip. He cautioned: "Unfortunately it is possible in the coming days we will see additional cases of Ebola" in health care workers.
Texas health commissioner David Lakey said the health care worker had "extensive contact" with Duncan. The nurse, who missed two days of work before going to the emergency room, is believed to have had contact with one person while symptomatic. Ebola, which is spread through direct contact with bodily fluids of a sick person, can only be transmitted from infected people showing symptoms.
"We have been preparing for an event like this, Lakey said.
Presbyterian chief clinical officer Daniel Varga said the exposure occurred during Duncans second visit to the hospital. Duncan, the first person to die of Ebola in the United States, went to the Presbyterian emergency room Sept. 25 and was sent home with antibiotics only to return to the hospital on Sept. 28. He was diagnosed with Ebola and died Oct. 8.
It is not clear how the health care provider contracted Ebola. According to Duncan's patient records released by the family to The Associated Press, this is what happened at Presbyterian:
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Health care worker at Presbyterian Hospital in Dallas tests positive for Ebola
DALLAS --
Public-health authorities also intensified their monitoring of Dallas hospital workers who cared for a Liberian man who died of Ebola. Their stepped-up efforts came a day after a 26-year-old nurse tested positive for the virus.
The nurse, identified as Nina Pham, was wearing protective gear when she took care of Thomas Eric Duncan, but became the first person to contract the disease within the United States. Nina Pham's family told WFAA-TV in Dallas that she was the health care worker with Ebola. A rector at her family's church told The Associated Press that Pham's mother told him Pham has the virus.
Pham, a graduate of Texas Christian University's nursing school, was monitoring her own temperature and went to the hospital Friday night as soon as she found out she was running a low fever. She is in isolation and in stable condition, health officials said.
Signs and symptoms of Ebola virus
Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days
When asked how many health care workers are being checked, Frieden said officials "don't have a number."
Health officials have relied on a 'self-monitoring' system when it comes to U.S. health care workers who care for isolated Ebola patients and wear recommended protective equipment. They expect workers to report any potential exposures to the virus and watch themselves for symptoms.
Besides the workers, health officials continue to track 48 people who were in contact before Duncan was admitted to the hospital and placed in isolation. They are monitoring one person the nurse was in contact with while she was in an infectious state.
None has exhibited symptoms, Frieden said.
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October 13, 2014, 11:01 AM Last updated: Monday, October 13, 2014, 11:02 AM
DALLAS (AP) Health officials are intensifying the monitoring of hospital workers who provided care to the first person to be diagnosed with Ebola in the U.S. after one of them was infected with the virus despite wearing protective gear.
Tests confirmed the first known case of Ebola transmitted in the nation, raising questions about assurances by health officials here that the disease will be contained and any American hospital should be able to treat it.
Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, said Sunday there had been a breach of protocol that led the worker to become infected while treating patient Thomas Eric Duncan, but officials are not sure what occurred. Duncan, who traveled from Liberia to visit family, did not get sick until he arrived in the U.S. He died Wednesday.
The worker, who has not been identified, has not been able to point to how the breach might have occurred.
President Barack Obama asked the CDC to quickly investigate the incident, the White House said.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases was asked on ABC's "Good Morning America" if federal health authorities should consider requiring that Ebola patients be sent only to highly specialized "containment" hospitals.
"That is something that should be seriously considered," Fauci said.
Dallas police barred entry to the health care worker's apartment complex Sunday. Officers also knocked on doors, made automated phone calls and passed out fliers to notify people within a four-block radius about the situation, although Dallas authorities assured residents the risk was confined to those who have had close contact with the two Ebola patients.
The worker wore a gown, gloves, mask and shield while she cared for Duncan during his second visit to Texas Health Presbyterian Hospital, said Dr. Daniel Varga of Texas Health Resources, which runs the hospital.
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A day after a nurse who treated an Ebola-stricken patient in Dallas was diagnosed with the virus,public health officials are still trying to figure out how many health-care workers may have had similar exposure.
It is still unclear how, exactly, the nurse at Texas Health Presbyterian Hospital Dallas became the first person to contract the virus in the United States, said Thomas Frieden, director of the Centers for Disease Control and Prevention.
But ifone health-care workerwas infected,it is possible other people could have been infected as well, Frieden said during a briefing with reporters on Monday.
This infection substantially changes how public health authorities will respond to the virus in the United States, he said.
We have to rethink the way we address Ebola infection control, becauseeven a single infection is unacceptable, Frieden said.
Thomas Frieden, director of the Centers for Disease Control and Prevention, provided an update Monday to the investigation into the spread of the Ebola virus to a nurse at a Dallas hospital. Frieden also apologized for his initial remarks about the nurses infection, which seemed to blame the nurse or other health care workers for the infection. (AP)
The nurse remains in stable condition at the same hospital that treated Thomas Eric Duncan, a Liberian man who was diagnosed with the virusand died last week. Shehad one and only one contact during the period when she may have been infectious, a person who is being monitored and has exhibited no symptoms of Ebola.In addition, the 48 people who are known to have had possible contact with Duncan before his hospitalization continue to show no symptoms, Frieden said.
Still, the uncertainty about how the nurse was infected and the fact that she was infected while Duncan was isolated at a hospital raises more questions about how prepared hospitals and health-care workers are to deal with the additional Ebola cases that authorities say are likely to occur.
We need to consider the possibility that there could be additional cases, particularly among the health-care workers that cared for [Duncan] when he was so ill, Frieden said. We would not be surprised if we did see additional cases in the health-care workers who also provided care to [Duncan].
Figuring out exactly what protocols need to be strengthened and who else may have been exposed is particularly difficult because it is not known how the nurse was infected. TheCDC is looking at every aspect of patient treatment, rangingfrom what types of equipment can beused to how protective gear is placed on and off, to try and determine if the current guidelines are strong enough.
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A Dallas health care worker who has been diagnosed with Ebola got sick because safety protocols for treating a man who later died from the disease were not followed, health officials said Sunday.
The unidentified health care worker at Texas Health Presbyterian Hospital who tested positive for Ebola wore full protective gear while she cared for Thomas Eric Duncan, a Liberian man who died from Ebola on October 8.
But just wearing the gear isn't enough to avoid danger, according to health officials who suggested that contamination could have occurred while the health care worker was putting on or taking off the protective gear, which consists of a gown, a mask, gloves, a face shield, and booties.
"We don't know what occurred in the care of the patient in Dallas, but at some point there was a breach in protocol," said Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC).
The Dallas health care worker's illness is a reminder of the risks medical personnel have faced during the Ebola outbreak that began in West Africa, and of how U.S. health officials have been scrambling to try to ensure the safety of medical personnel who may come in contact with Ebola patients.
At least 416 health care workers have been infected with Ebola in West Africa this year and 233 have died, greatly limiting the care options there, and the willingness of others to provide that care. In total, more than 8,300 people have been infected by Ebola this year and about 4,000 have died.
Health care workers in the West typically are better protected from contagious diseases than those in Africa, because Western workers and hospitals have the knowledge and equipment to shut down the spread of infections.
But the outbreak of Ebolawhich is spread through close contact with symptomatic person's bodily fluids such as blood, vomit, feces, or semenis raising questions about just how prepared U.S. health care workers and hospitals really are.
Ashish Jha, professor of health policy at the Harvard School of Public Health, said medical protocols have to be followed meticulously to protect health care workers from Ebola.
It's not yet clear specifically how the Dallas health care worker became infected, but Jha said it likely occurred when she was taking off her protective equipment, which he said has to be done very carefully to avoid contamination. At the most well-run Ebola treatment units in Africa, a staff member is responsible for watching other workers, particularly when they take off their gear, to make sure no one comes in contact with the outside of the gear.
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Ebola Health Care Worker Sick Because Safety Rules Werent Followed, O
In Buffalo, A.G. Schneiderman Highlights Office #39;s Health Care Helpline
Joined by Erie County Executive Mark Poloncarz, State Senator Tim Kennedy and Assemblymember Crystal Peoples-Stokes in Buffalo, Attorney General Schneiderman...
By: Eric T. Schneiderman
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In Buffalo, A.G. Schneiderman Highlights Office's Health Care Helpline - Video
Advocate Health Care Drive Better Patient Outcomes with IBM InfoSphere Master Data Management
http://www.ibm.com/software/data/master-data-management/
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