ethical presentation: ebola

8/17/2019 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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8 9%:; 8 9% <

3H-=$ RE$P->$%.%%56 %$ %5 5- PR-%DE 5HE

PR-PER PPE, 5R)%>%>G, )>D ED9:)5%->?

)" >9R$E$

." HE)5H :)RE '):%%56:" $E:->D GR)DE $:H-- 5E):HER

D" P)5%E>5


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8 9%:; 8 9% <

% 3-9D :)RE '-R ) P)5%E>5 5H)5 H)D E.-)

%' % D%D >-5 H)E 5HE PR-PER PPE, 5R)%>%>G

-R ED9:)5%->?

)"5R9E."')$E


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ethical presentation: ebola

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