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High Consequence Infectious Disease: What Nurses Need to Know
HIGH CONSEQUENCE INFECTIOUS DISEASE:
WHAT NURSES NEED TO KNOW
By Toby Hatton, MA, RN, BSN, BS, CHSP and Ellen Martin, PhD, RN, CPHQ
NURSES AT THE SHARP END of healthcare are at increased risk during an infectious disease outbreak. As we learned during the Ebola outbreak three years ago, the stakes are highest when the infectious disease is lethal. High consequence infectious diseases (HCID) are defined by the Centers for Disease Control and Prevention (CDC) as those diseases that have epidemic or pandemic potential, have the potential to spread rapidly through a population, or have a high mortality rate.
The Texas Department of State Health Services (DSHS) defines HCID as diseases that: “presents an immediate threat, poses a high risk of death or serious long-term disability to a large number of people; and creates a substantial risk of public exposure because of the disease’s high level of contagion or the method by which the disease is transmitted.” This definition is closely tied to the Texas Health and Safety Code definition of a public health disaster.
HCID PREPAREDNESS
The potential severity of HCID makes preparedness and response planning a vital public health priority with significant policy implications at the federal, state, health system, and facility level.
The federal priority is mitigating the effects of HCID through training, preparedness, response, investigation, monitoring, and controlling so that a constant state of readiness exists within both public health and healthcare delivery systems. In response to the Ebola outbreak in 2014, Texas received $13.3 M in new state funds and $15.5 M in one-time federal funding to support high consequence infectious disease projects.
The Texas Department of State Health Services and the Health and Human Services Commission address HCID in their strategic plans. The two main priorities are to develop and sustain an HCID response system and build an infrastructure within the existing healthcare delivery system of hospitals and Emergency Medical Services (EMS) to ensure facilities and healthcare providers are prepared to safely transport and treat patients with HCID.
Hospital priorities include development of internal processes and procedures so that staff can safely receive and treat patients with HCID. Nurses will provide direct care to the patient with a HCID until they can be safely transferred to a CDCapproved HCID Treatment Center.
From a public health perspective, collaboration is the priority as all entities work together to build a stronger and better prepared community. This includes providing education, monitoring, and supporting the HCID response. The CDC and Center for Health Security at the Johns Hopkins Bloomberg School of Public Health have developed resources including a health sector resilience checklist to help support public health preparedness and response efforts.
HCID RESPONSE
In Texas, we have a system of disaster responders known as the Emergency Medical Task Force (EMTF). The EMTF is broken into eight regions that encompass the entirety of Texas. These EMTF teams are further broken down in to unique and specialized disaster response components such as Mobile Medical Units, Nurse Strike Teams, Ambulance Strike Teams, Mass Casualty Ambulance Buses, and more.
Additionally, Texas is pioneering a highly specialized and highly trained Infectious Disease Response Unit (IDRU) within the EMTF. This IDRU consists of two components, hospital augmentation teams and pre-hospital/inter-facility transport teams. The Hospital augmentation teams will consist of specially trained nurses who will provide direct patient care to HCID patients in the hospital setting. The nurses serving on this elite team will receive in-depth training and would be paid through the hospital or agency they normally work for, and that agency, in turn, is reimbursed by the State of Texas for personnel costs.
WANT TO GET INVOLVED?
Nurses are now being recruited for the Infectious Disease Response Unit. If you are interested in trying out for this unique team, or want to learn more about the criteria, please visit the IDRU website at www.txidru.org.
In exchange for their participation, selected nurses will receive specialized training at no cost that will allow them to help their community and be part of the Emergency Medical Task Force in Texas. i
Toby Hatton is the regional emergency management officer for MedxcelFM, a subsidiary of Ascension Health, responsible for emergency management in more than 13 hospitals and countless clinics and doctor’s offices. He has extensive experience and content knowledge in disaster nursing and chairs the Hospital Committee of the Texas Infectious Disease Response Unit.
