ethical presentation: ebola
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Ebola: To trea t or no t to
trea t
Analeissa Gu tierrez, K ana
ni Ho, Chris tine
Rombawa
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E th ical D ilemma
Treating patients with Ebola presents an ethical dilemma for health care
workers. They want to help, but place themselves and their families at risk by
doing so.
The 2014 Ebola Epiemi! is the lar"est in histor# a!!orin" to
the C$C% &t has two importe !ases in!luin" one eath antwo lo!all# a!'uire !ases in health!are wor(ers that ha)ebeen reporte in the *nite +tates% Health proessionals a!e amoral ilemma when as(e to help in an outbrea( su!h as theone o!!urrin"% A nurse !arin" or patients with Ebola, (nows
that the# ma#, with one slip o a "lo)e, "et it, an now the#ha)e !ompromise themsel)es an !ompromise theiramilies is an e-tremel# i.!ult ethi!al e!ision that we asnurses will a!e on a ail# basis when we are as(e to !are orthose who ha)e an ine!tious isease%
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Go t PPE ? ? ? ?
The C$C has re)ise //E "uielinesan there is a tremenous awareness othe Ebola )irus, #et it is improbable that
e)er# hospital, ambulator# !are !lini!,an ph#si!ian pra!ti!e in the *nites+tates has been traine to a le)el oautomati! !ompeten!#, obtaine the
!orre!t //E resour!es, an establishethe proper proto!ols or nursin" sta,!ustoial sta, super)isors, an
health!are mana"ers%
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Respons ib il i t y
es, it is the nurses ob anresponsibilit# to !are or patients,
but it3s also the nurses ob anresponsibilit# to !are orthemsel)es, b# a!!eptin" or
ree!tin" an assi"nment that the#are not e'uippe or traine oran the nees o the patient are
be#on the 'uali!ations an
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hemorrhagic
fever5Severe disease with high case fatality
5 Absence of specific treatment or
vaccine5Transmitted by direct contact
5Bodily fluids (Blood, saliva,mucus,vomit, urine, feces, sweat)
5Standard, Contact, Dropletprecautions
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How long does Ebola live outside the
body?
Ebola on dry surfaces, such as doorknobs and
countertops, can survive for several hours
irus in body fluids !such as blood" cansurvive up to several days at room
temperature#
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$igns and $ymptoms
%nitial& 'ever, chills, myalgias, malaise,
anore(ia )fter * days& G% symptoms+ nausea,
vomiting, watery diarrhea, abdominal pain
Headache, conunctivitis, hiccups, rash,chest pain, $-., confusion, sei/ures
Hemorrhagic symptoms
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Pro tocol
!atient placement
!roper"Ade#uate
$acilities!atient Care
%#uipment
!!%
Ade#uate Training
&and &ygiene
%nvironmental
'nfection ControlSafe 'nection
practices
onitoring,anagement, and
Training of *isitors
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Gu idance for PPE
0# Prior to working with Ebola patients, all healthcare workers involved in
the care of Ebola patients must have received repeated training
and have demonstrated competency in performing all Ebola+
related infection control practices and procedures, and
specifically in donning1doffing proper PPE#2# 3hile working in PPE, healthcare workers caring for Ebola patients
should have no skin e(posed#4# 5he overall safe care of Ebola patients in a facility must be overseen by
an onsite manager at all times, and each step of every PPEdonning1doffing procedure must be supervised by a trained observer to
ensure proper completion of established PPE protocols#
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PPE& Donn ing
Donning +- .espirator/0 %ngage Trained
1bserver
20 .emove !ersonal
Clothing and 'tems30 'nspect !!% !rior to
Donning
40 !erform &and &ygiene
-0 !ut on 'nner 5loves
60 !ut on Boot or Shoe
Covers
70 !ut on 5own or Coverall
80 !ut on +- .espirator 0 !ut on Surgical &ood
/90!ut on 1uter Apron
//0!ut on 1uter 5loves
/20!ut on $ace Shield
/30*erify
/40Disinfect 1uter 5loves
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PPE& Do f f ing
Doffing +- .espirator
/0 %ngage Trained 1bserver
20 'nspect !!%
30 Disinfect 1uter 5loves
40 .emove Apron
-0 'nspect Apron
60 Disinfect 1uter 5loves70 .emoved Boot or Shoe
Covers
80 Disinfect and .emove 1uter
5loves
0 'nspect and Disinfect 'nner5loves
/90.emove $ace Shield
//0Disinfect 'nner 5loves
/20 .emoved Surgical &ood
/30Disinfect 'nner 5loves/40.emove 5own or Coverall
/-0Disinfect and Change 'nner
5loves
/60.emove +- .espirator
/70Disinfect 'nner 5loves/80Disinfect :ashable Shoes
/0Disinfect and .emove 'nner
5loves
290!erform &and &ygiene
2/0'nspect
220Scrubs
230Shower
240!rotocol %valuation"edical
Assessment
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6ene 4!en!e
Protect
oursel
our amil# The patient
;nowledge may not re#uire refusal
of the assignment but rather an agreement to ensure patientsafety0 'f no accommodation for limitations is considered, the nurse
has an obligation to refuse an assignment for which she or he
lac>s education or e=perience0? @American +urses Association
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E th ical %ssue
7 Reusal to ta(e !are o patient
7 &nae'uate sta
7 8)erwor(e9Tire nurses
7 Responsibilit#
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Coe o Ethi!s
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Responsibilit# or nursin" u"ment an a!tion 4%;<
Responsibilit# reers to the spe!i! a!!ountabilit# orliabilit# asso!iate with the perorman!e o uties oa parti!ular role%
=urses a!!ept or ree!t spe!i! role emans baseupon their eu!ation, (nowle"e, !ompeten!e, an
e-tent o e-perien!e% &ni)iual nurses are responsible or assessin" their
own !ompeten!e% >hen the nees o the patient arebe#on the 'uali!ations an !ompeten!e o thenurse, !onsultation an !ollaboration must be sou"ht
rom 'ualie nurses, other health proessionals, orother appropriate sour!es% Eu!ational resour!es shoul be sou"ht b# nurses
an pro)ie b# institutions to maintain an a)an!ethe !ompeten!e o nurses%
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http:99#outu%be9'G6?$@&zR*
http://youtu.be/qGB6DJIz5RUhttp://youtu.be/qGB6DJIz5RU
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6our cho ice7###
=urses ha)e the ri"ht to reuse to
!are or the patient%%%& the hospitalor !lini! oes not pro)ie the
proper //E, trainin", an
eu!ation%
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3H-=$ RE$P->$%.%%56 %$ %5 5- PR-%DE 5HE
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