Information from Texas Health Presbyterian Hospital Dallas regarding treating the Ebola virus and hospital conditions.
Texas Health Presbyterian Hospital Dallas is committed to working together with its employees to provide a safe, healthy and satisfying workplace.
In the pursuit of open feedback, Texas Health Dallas has a strict nonretaliation policy. Employees are encouraged to raise issues and concerns via the chain of command. This process is a core tenet of our culture and values. It is documented in our Code of Business Ethics.
In addition, Texas Health Dallas employees have two mechanisms available to anonymously raise issues about safety concerns or related matters. It is important to note that no Texas Health Dallas employee did so concerning their care of Mr. Duncan or our two co-workers.
Third parties who don’t know our hospital, our employees and who were not present when the events occurred are seeking to exploit a national crisis by inserting themselves into an already challenging situation. Based on our strong track record of having excellent relationships with our employees, we do not believe it is necessary or helpful for outside parties to intervene in this relationship. Everyone should be focused on supporting each other in our pursuit of learning and continuous improvement that can be applied to hospitals throughout the nation. We are dedicated to providing a wide range of opportunities for employees to give input and influence decision making. From Magnet® designation to multiple Employer of Choice awards, this has long been a recognized strength of our organization.
Many of the comments we have seen or heard in the media are only loosely based on fact, but are often out-of-context and sensationalized. Others are completely inaccurate. We would like to address some of those that have surfaced over the last 24 hours:
- We have conducted interviews with well over 100 caregivers involved in Mr. Duncan’s care, some multiple times. The consistent and universal theme we have heard is that all caregivers reported being consistently compliant with utilizing the appropriate PPE in accordance with guidelines from the CDC. The CDC guidelines changed frequently, and those changes were frustrating to them and to management. Nonetheless, they endeavored to remain compliant with what was communicated as the most recent and appropriate guideline.
- When Mr. Duncan returned to the Emergency Department (ED), he arrived via EMS. He was moved directly to a private room with a negative air pressure and placed in isolation. There were no other patients in that room. Again, THD staff wore the appropriate PPE as recommended by CDC at the time.
- The Infection Prevention coordinator was properly notified in a timely manner of the initial diagnosis and followed Dallas County Health and Human Services process of notification, which includes notification of the CDC.
- Mr. Duncan’s initial ED specimens were handled in accordance with normal protocol, bagged and sent in a sealed container through the tube delivery system. There was no spillage of Mr. Duncan’s specimens.
- Mr. Duncan’s later specimens in the ED were triple-bagged, placed in a transport container and hand-carried to the lab utilizing the buddy system.
- Mr. Duncan’s specimens in the Medical ICU were hand-carried and sealed per protocol. Routine labs were done in his room via wireless equipment.
- Nurses who interacted with Mr. Duncan wore PPE consistent with CDC guidelines. Staff had shoe covers, face shields were required, and N-95 mask was optional – again, consistent with CDC guidelines at the time. When CDC issued updates, as they did with leg covers, we followed their guidelines.
- When CDC recommended that nurses wear isolation suits, the nurses raised questions and concerns about the fact that the skin on their neck was exposed. Two onsite CDC members approved and recommended that they pinch and tape the necks of the gown. Because our nurses continued to be concerned, particularly about removing the tape, we ordered medical shrouds.
- The CDC classified risk/exposure levels. Nurses who were classified as “no known exposure” or “no risk” were allowed to treat other patients per CDC guidance.
- Patients who may have been exposed were always housed or isolated per CDC guidance.
- Waste was contained in accordance with CDC standards, and waste was located in safe and containable locations. It is a gross exaggeration to say that trash was stacked up to the ceiling.
- When we received Tyvek suits, some were too large. We have since received smaller sizes, but it is possible that nurses used tape to cinch the suits for a better fit.
It is incorrect and disturbing to many of our staff to hear media exaggerations about their commitment to the organization they love. They are understandably worried and concerned in the eye of this storm, but they are steadfastly supporting their patients, each other, and the hospital they love.
Texas Health Dallas was the first hospital in the United States to receive a patient with undiagnosed Ebola. We have acknowledged that we made mistakes and that we are deeply sorry. Our amazing caregiving team did not hesitate to rise to the challenge despite being in an unprecedented situation.
Texas Health Dallas remains a safe place for employees and patients. We support the tireless and selfless dedication of our nurses and physicians, and we hope these facts clarify inaccuracies recently reported in the media.