For General Healthcare Settings in West Africa: Four Keys to Infection Control

Key Points

• A greater awareness and adherence to recommended infection control practices must occur in general healthcare settings to protect healthcare workers and uninfected patients from Ebola.
• Preventing transmission of the Ebola virus requires a well-considered plan that prioritizes 1) identifying and isolating suspect Ebola cases, 2) protecting patients and healthcare workers, 3) cleaning up safely, and 4) managing PUIs safely and compassionately.
• To be effective, each component of an infection control plan must be rigorously and meticulously followed.

Preventing transmission of a germ such as the Ebola virus requires much more than pulling on a pair of gloves and a gown. It requires a well-considered plan of defense that prioritizes 1) identifying and isolating PUIs, 2) protecting patients and healthcare workers, 3) cleaning up safely after patient care for PUIs and patients with confirmed EVD, and 4) managing PUIs safely and compassionately.

This site provides guidance for general healthcare settings¹, which are healthcare settings not officially dedicated to providing care and treatment for Ebola patients. General healthcare settings include

• Peripheral health units
• Health posts
• Clinics
• Outpatient departments
• Inpatient units in hospitals

These general healthcare settings are on the front lines of providing care to patients with numerous medical problems. Unlike at an Ebola treatment unit (ETU) where patients are known to have EVD, the challenge at these facilities is that patients present with a variety of conditions, and it is not known whether they have EVD or other transmissible pathogens. A greater awareness and adherence to recommended infection control practices must occur in these settings to protect healthcare workers and uninfected patients from the Ebola virus. Infection control guidance for these settings should be able to prevent transmission of a variety of pathogens, including the Ebola virus, and be based on well-established infection prevention and control practices.

There are four keys to infection prevention and control in general healthcare settings:

1. Identifying and isolating PUIs
   • Screening patients at initial contact with the healthcare system
   • Using case definitions to evaluate patients
   • Setting up the healthcare facility and patient flow
   • Implementing other administrative controls
2. Protecting patients and healthcare workers
   • Practicing hand hygiene regularly
   • Practicing safe injection and sharps injury prevention
   • Implementing proper phlebotomy (blood drawing) technique
   • Using appropriate personal protective equipment (PPE)
3. Cleaning up safely
   • Making cleaning solutions
   • Cleaning and disinfecting the patient care environment
   • Managing waste safely
4. Manage PUIs safely and compassionately
   • Following protocols for notifying authorities about people with EVD and coordinating care
   • Managing PUIs safely prior to transfer to ETU
   • Communicating with PUIs to effectively and compassionately educate them about EVD and what to expect during their treatment process

The information on this site is constantly being updated to create a step-by-step framework through which all of the above principles can be achieved. For an infection control plan to be effective, each component of the plan must be rigorously and meticulously followed at all times. It is crucial that workers in international healthcare facilities are well trained in all aspects of infection control and that infection control procedures are consistently followed. This practice will save lives and help stop the spread of Ebola.

References

1. Guidance on this site is aimed at general healthcare settings and not intended for Ebola treatment units (ETUs) and Ebola care centers (ECCs), sometimes referred to as Ebola community care centers (ECCCs).