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Background: In October 2014, two U.S. nurses became infected with Ebola while caring for a patient who had traveled from West Africa. That same week, a survey from the Association for Professionals in Infection Control and Epidemiology found that more than half of responding infection preventionists indicated that “Personal Protective Equipment (PPE) donning/doffing protocols” were needed to improve healthcare worker preparedness. CDC issued updated PPE guidance on October 20 and began conducting assessments of hospitals using Rapid Ebola Preparedness Teams. On December 2, CDC issued a tiered approach to Ebola preparedness and identified 35 Ebola treatment centers that were ready to safely manage patients with Ebola. CDC needed to rapidly train healthcare workers in these facilities, as well as Ebola assessment hospitals.
Program background: CDC set out to communicate changes in the PPE guidance and what emergency departments needed to know to prepare for a possible patient with Ebola. The training tools included:
Web-based video training: Effectively donning and doffing PPE is one of the most complex aspects for healthcare workers in caring for a patient with Ebola.
On October 31, within 11 days of releasing updated PPE guidance, CDC and Johns Hopkins Armstrong Institute for Patient Safety used human factors engineering tools and methods to developing and launch an interactive web-based video learning program that included more than 160 video segments detailing procedures for four PPE combinations. The videos were made accessible via YouTube and iTunesU.
Additionally, to assist in facility preparedness, CDC and Johns Hopkins Medicine developed four web-based video training modules for emergency department personnel in Ebola treatment centers and Ebola assessment hospitals to detail how to safely manage patients with Ebola or other infectious diseases.
Training via mobile device: CDC initiated a public-private partnership with 22ottersTM to develop a mobile device application that provides speech-enabled, animated directions for donning and doffing PPE.
Evaluation Methods and Results: As of mid-April 2015, the PPE video modules were viewed 476,647 times, with an estimated 388,154 minutes (6,470 hours) watched. The average percentage viewed for the set of PPE videos is 87%. The emergency department training modules were viewed a total of 4,436 times, with an estimated 23,699 minutes (395 hours) watched. The mobile training app will be released in the summer of 2015 and will provide a distinct method for healthcare worker training.
Conclusions: Training of healthcare workers in Ebola treatment centers and Ebola assessment hospitals on proper use of PPE and safe management of patients who potentially have Ebola was imperative to protecting healthcare workers, patients, and other staff. With easily accessible training, healthcare workers can confidently prepare to identify and isolate patients, as well as don and doff PPE properly.
Implications for research and/or practice: Healthcare workers need proper training to protect themselves and their patients. The methods CDC and its strategic partners used to rapidly disseminate training materials to a large number of healthcare workers who needed the information were key to the success of this program.