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CCHC Ebola Readiness Plan

The CCHC Ebola Readiness Plan covers both hospitals as well as the Urgent Care Centers at Stoneman Outpatient Center in Sandwich and Fontaine Outpatient Center in Harwich, as well as more than 250 CCHC and community physician offices.

CCHC training teams have met with physicians, nurses, technicians and others in the Emergency Centers and other departments at Cape Cod Hospital and Falmouth Hospital, to relay the latest protocol and to instruct in up-to-date procedures for putting on and taking off Personal Protective Equipment (PPE), which is worn by anyone treating an Ebola patient.

CCHC CEO Michael Lauf, along with CCHC Infection Prevention Director Georgia Dash, RN, MS, CIC; Chief Medical Officer Donald A. Guadagnoli, MD; Cape Cod Hospital Emergency Center Chief Craig Cornwall, MD; and Falmouth Hospital Emergency Center Chief Robert Davis, MD, met in town hall-style meetings with staff recently at CCH and FH to outline the Readiness Plan and respond to any concerns or questions.

CCHC Screening/Communication/Isolation Procedure:

  • Patient presents to Emergency Center (EC) at Cape Cod Hospital or Falmouth Hospital OR a CCHC Urgent Care Center with Ebola symptoms.
  • Triage nurse asks the patient if he/she has traveled to or been a resident of one of the Ebola-affected countries AND had direct contact with blood/bodily fluids.
  • If the answer is YES, the triage nurse removes the patient from the patient waiting room to a separate area and notifies the EC Chief, Nurse Manager and Charge Nurse.
  • EC Chief notifies a CCHC Infectious Disease physician for an immediate consult.
  • If Infectious Disease physician deems the case suspect, the EC Chief notifies the Chief Medical Officer (CMO) and CMO notifies the CEO.
  • The Infectious Disease physician notifies Director of Infection Prevention and Massachusetts Department of Public Health and Centers for Disease Control and Prevention for consultation on transfer to a tertiary treatment facility.

Isolation Procedures

  • The patient is isolated in the “Purple Zone” of the Cape Cod Hospital EC – a separate area of the EC.
  • Patients who present to the Falmouth Hospital Emergency Department will be triaged to ED Room 28 for Isolation and assessment for signs and symptoms and a travel history consistent with Ebola Virus Disease. If the Emergency Department Physician in concert with the Infectious Disease Physician believe that the patient is a possible suspect Ebola case, the patient will be transferred to Cape Cod Hospital Emergency Purple Zone for further assessment and care. 
  • The Nurse Manager/Charge Nurse brings Special Pathogens Precautions Cart to the Isolation Treatment area in the EC. She/he notifies triage nurse when ready and notifies the Vice President of Patient Services and Shift Supervisor.
  • Special red infectious waste container is placed inside the Isolation Room.
  • Second staff member is stationed outside the Isolation Room and keeps a log of everyone who enters.
  • Staff who have treated the patient and wish to isolate at the hospital, have access to a special staff dormitory at the hospital.
  • An ambulance decontamination location and supply cache located at a separate building on the Cape Cod Hospital campus.

Outpatient Facility Guidelines

  • If a patient meets the screening criteria for a suspect Ebola case, the physician in charge will consult with a CCHC Infectious Disease physician and the Medical Chief at Cape Cod Hospital to arrange for transport to the hospital.
  • The patient is given a mask and asked to self-apply, and immediately escorted to an examination room. No examination is done or specimens obtained.
  • Cape and Islands EMS called to transport the patient to Cape Cod Hospital EC.
  • EMT and outpatient personnel assisting in the patient transfer by ambulance will wear designated PPE.
  • If the patient refuses to go the EC by ambulance and insists on using a private vehicle, Cape Cod Hospital EC and hospital Security will be notified to anticipate the patient’s arrival.
  • If the patient refuses to go to the hospital and states that they will go home against medical advice, the Cape Cod Hospital EC physician in charge will be notified, and the state Department of Public Health will be notified to begin appropriate follow-up.
  • The room where the patient was assessed is cleaned and disinfected, and waste removed, according to strict CDC and CCHC policies

Physician Offices Guidelines

  • See above guidelines for Outpatient Facilities.
  • Cape and Islands EMS will only transport suspect Ebola cases to Cape Cod Hospital.
  • If a patient arrives at a physician’s office close to Falmouth Hospital and insists on going there, the physician notifies the physician in charge at Falmouth Hospital Emergency Center. Hospital Security is notified and awaits the patient’s arrival by private vehicle.
  • CCHC sends trained staff for proper office cleaning, disinfection and waste removal.

Waste Disposal

  • All infectious waste is disposed of in special red infectious waste containers in the Isolation Room.
  • The waste bag is wiped with a special bleach cloth and placed into a second bag. The outer surface of the second bag is also wiped with a bleach cloth.
  • The bag is placed in a 55-gallon special drum directly outside the Isolation Room, and the drum is taken by the waste disposal service for incineration.

Additional Resources for Employees

  • A dedicated internal web site on Ebola has been established to ensure that our staff is educated and trained in the screening, detection and treatment of Ebola. The site is updated regularly with resources and guidance on assessing patients and protecting our caregivers.
  • An educational video has been developed to walk employees through Ebola procedures, including the proper use of PPE.

CCHC Protocol
putting on &
taking off PPE

putting on and taking off Ebola PPE