Inside an Ebola Treatment Unit: A Nurse Shares Her Experiences in Liberia

By Sylvia Foley, AJN senior editor

“It is extraordinarily difficult to establish an IV line in a dehydrated patient by generator-powered light while double gloved, with one’s goggles fogging.”—Deborah Wilson

Author Deborah Wilson at the Foya ETU cemetery. Photograph by Marcos Leitão.In one of this month’s CE features, “Inside an Ebola Treatment Unit: A Nurse’s Report,” author Deborah Wilson offers readers a rare look from the frontlines of the 2014 Ebola epidemic. Her stories about her patients and colleagues are as compelling as they are informative. Here’s a short overview of the article:

In December 2013, the first cases of the most recent outbreak of Ebola virus disease (EVD; formerly known as Ebola hemorrhagic fever) emerged in the West African nation of Guinea. Within months the disease had spread to the neighboring countries of Liberia and Sierra Leone. The international humanitarian aid organization Médecins Sans Frontières (MSF; known in English as Doctors Without Borders) soon responded by sending staff to set up treatment centers and outreach triage teams in all three countries. In August 2014, the World Health Organization declared the outbreak an international public health emergency.

In September 2014, the author was sent by MSF to work as a nurse in an Ebola treatment unit in Foya, Liberia for five weeks. This article describes her experiences […]

AJN in December: Inside an Ebola Unit, Acupressure, Early Mobility, EHRs, More

AJN1215.Cover.OnlineOn this month’s cover, nurse Elie Kasindi Kabululu cares for a patient at Centre Médical Evangélique in Nyankunde, Beni, Democratic Republic of Congo. Originally, this location served a population of 150,000 and also housed a nursing school; but in 2002, during war in the region, the facility was attacked. About 1,000 people were killed—including patients and staff—and the center was looted and destroyed.

Providing medical assistance in the world’s war-torn and neediest areas is commonplace for health care providers like Kabululu, just as it is for humanitarian organizations such as Médecins Sans Frontières (MSF), which works in 70 countries worldwide—nearly half of these in Africa. Shortly after the recent outbreak of Ebola in West Africa, MSF sent close to 300 international workers to help combat this public health emergency. To read one nurse’s experience traveling to Liberia for MSF to work in a treatment center, see “Inside an Ebola Treatment Unit: A Nurse’s Report.”

Some other articles of note in the December issue:

Original Research: Implementation of an Early Mobility Program in an ICU.” This article, from our Cultivating Quality column, recounts how the effects of an early mobilization program delivered to critically ill patients at a community hospital by an independent ICU mobility team contributed to fewer delirium days and improvements in patient outcomes, sedation levels, and functional status.

CE Feature: Incorporating Acupressure into Nursing Practice.” The effects of acupressure can’t always be explained in terms of Western anatomical […]

Ebola, One Year Later: What We Learned for the Next Big Epidemic

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Scanning electron micrograph of filamentous Ebola virus particles budding from an infected VERO E6 cell (35,000x magnification). Credit: NIAID Scanning electron micrograph of filamentous Ebola virus particles budding from an infected VERO E6 cell (35,000x magnification). Credit: NIAID

U.S. hospitals have not seen a case of Ebola virus disease since November 11, 2014, when Dr. Craig Spencer was discharged from Bellevue Hospital Center in New York City. While the number of new infections has declined dramatically in the West African countries where the 2014–2015 epidemic began, it is virtually certain that the disease will continue to resurface.

This epidemic was by far the largest and most geographically widespread Ebola epidemic to date, with approximately 28,000 cases (suspected, probable, or confirmed) and more than 11,000 deaths in Liberia, Guinea, and Sierra Leone, the three hardest-hit countries. The seven other countries affected account for a combined total of 34 confirmed (and two probable) cases and 15 deaths.

According to a recent WHO report, these numbers include (through March of this year) 815 confirmed or probable cases among health care workers, more than half of whom were nurses or nurses’ aides. (Doctors and medical students made up about 12% of total […]

An Unending Series of Challenges: APIC Highlights the ‘New Normal’ in Infection Control

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Panelists to the Opening Plenary, Mary Lou Manning, Michael Bell, CDC, Russell Olmsted, Trinity Health, Phillip W. Smith, Nebraska Biocontainment Unit discuss various topics pertaining to infection control. APIC panelists (APIC president Mary Lou Manning; Michael Bell, CDC; Russell Olmsted, Trinity Health; Phillip W. Smith, Nebraska Biocontainment Unit) discuss various topics pertaining to infection control.

At the 42nd annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC), held in late June in Nashville, experts from around the world shared information and insights aimed at infection preventionists but of interest to nurses in many practice settings.

APIC president Mary Lou Manning, PhD, CRNP, CIC, FAAN, opened the first plenary with the observation that to be presented with an unending series of challenges is the “new normal” in infection control and prevention. Collaboration is more important than ever in health care, she said, and “there is strength in our combined efforts.”

Cathryn Murphy, PhD, […]

A Nurse Epidemiologist’s Notes on Issues Raised by a Recent Death from Lassa Fever

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Lassa fever is most often diagnosed by using enzyme-linked immunosorbent serologic assays (ELISA), which detect IgM and IgG antibodies as well as Lassa antigen. Reverse transcription-polymerase chain reaction (RT-PCR) can be used in the early stage of disease. The virus itself may be cultured in 7 to 10 days, but this procedure should only be done in a high containment laboratory with good laboratory practices. Immunohistochemistry, performed on formalin-fixed tissue specimens, can be used to make a post-mortem diagnosis.

Some aspects of last month’s case of Lassa fever in New Jersey seemed to parallel the story of Thomas Duncan, who died last October in Dallas after contracting Ebola virus disease in Liberia.

A man arrived in the U.S. from Western Africa. He was screened for Ebola at the airport and instructed to monitor his temperature […]

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