5 ways formulary managers can brace for Ebola

In recent months, the CDC has cautioned that individuals with Ebola virus disease (EVD) in West Africa may travel to the United States, exhibit signs and symptoms of EVD, and present to US facilities.^1,2 Now, the first case of a patient presenting with EVD to a US hospital has been reported and some others identified as being in contact with this patient are at risk.³

So, what measures can US hospital-based formulary managers take in helping to cope with the arrival of an EVD patient in their medical facility? Here is a brief overview of important aspects to consider in the face of this potentially serious healthcare concern.

Educate

Formulary managers can play an essential role in educating healthcare personnel about EVD, its symptoms, and the risk of transmission in the hospital setting.

Symptoms of EVD include fever, severe headache, joint/muscle aches, weakness, diarrhea, vomiting, abdominal pain, and unexplained hemorrhage (bleeding, bruising). These may appear 8 to 10 days after exposure to EVD, but can also show up as early as a few days and as late as 21 days after that exposure.^2,4

Healthcare providers treating an EVD patient can be exposed to the virus by:  

• Direct contact with the blood or body fluids of an infected person

• Exposure to objects such as needles and syringes contaminated with the virus⁴

This bad outcome can occur when staff do not wear personal protective equipment including gowns, goggles/face shields, facemasks, and gloves.²

Help prevent

Formulary managers can also help get the word out on prevention. Healthcare providers caring for an EVD patient need to be instructed to put on personal protective equipment before entering the patient’s room.² In general, healthcare personnel should be told to use appropriate infection control measures. Disinfecting surfaces is essential, as is frequent hand washing with soap and water to kill the virus.⁵

Proper cleaning and disposal of instruments (eg, needles, syringes) is another necessity. Healthcare staff must sterilize any instruments being used more than once, so as to guard against further transmission and help contain a current outbreak.⁵

Coordinate

Formulary managers in concert with physicians and other healthcare professionals can help devise work practices that can detect persons possibly infected with EVD or other infectious agents. Such work practices can aid in preventing the spread of the virus throughout the community, as well as diminish the impact of an infection with an Ebola virus strain on the hospital, its staff, and its patients.^1,4 Infection control policies and procedures should be reviewed with physicians and other healthcare personnel.

Communicate

Formulary managers can underscore the importance of gathering and sharing information about a patient among all hospital staff. Plans for administrative, environmental, and communication measures have to be in place before any potential EVD case occurs.¹

Keep up to date

Finally, formulary managers need to keep up to date on the latest developments concerning Ebola and help make this information available to their hospital colleagues. Be sure to check in with CDC updates on line at www.cdc.gov/vhf/ebola/. For consultation, the CDC’s Emergency Operations Center can be contacted 27/7: phone, (770) 488-7100; email: eocreport@cdc.gov.¹

Ms Schwenker is a freelance medical writer and editor from Princeton, New Jersey.

Disclosure information: The author reports no financial disclosures as related to products discussed in this article.

References

1. Centers for Disease Control and Prevention; Office of the Assistant Secretary for Preparedness and Response. Checklist for healthcare coalitions for Ebola preparedness. http://www.cdc.gov/vhf/ebola/pdf/coalition-checklist-ebola-preparedness.pdf. Accessed October 2, 2014.

2. Centers for Disease Control and Prevention. Checklist for patients being evaluated for Ebola virus disease (EVD) in the United States. http://www.cdc.gov/vhf/ebola/pdf/checklist-patients-evaluated-us-evd.pdf. Accessed October 2, 2014.

3. Sack K, Santora M. Texas says that up to 100 are at risk of Ebola exposure. New York Times. October 2, 2014.

4. Centers for Disease Control and Prevention. Ebola (Ebola virus disease). http://www.cdc.gov/vhf/ebola/index.html. Accessed October 2, 2014.

5. Goodyer L. Ebola: the essential facts. Pharmaceutical Journal. 2014;293(7826). http://www.pharmaceutical-journal.com/learning/learning-article/ebola-what-pharmacists-need-to-know/20066261.article. Accessed October 2, 2014.

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