The World Health Organization (WHO) has recently updated its infection prevention and control (IPC) guideline for Ebola and Marburg disease in an effort to tackle “inappropriate practices” in managing these outbreaks. This includes revisiting existing recommendations based on past experiences with outbreaks of these deadly diseases. According to a summary of the recommendations by Victoria Willet, RN, and colleagues in The BMJ, there have been instances where the use of personal protective equipment (PPE) was either excessive or inappropriate, leading to adverse effects for healthcare workers and the environment.
Challenging Misconceptions
One of the misconceptions that the updated guidelines aim to address is the belief that more PPE is always better. This flawed notion has resulted in the unnecessary use of PPE, causing negative impacts on healthcare workers and the environment. Additionally, the routine spraying of chlorine for disinfection during Ebola and Marburg virus outbreaks has been a common practice, despite previous WHO recommendations against it. This practice has led to adverse ocular, respiratory, and skin reactions among workers and the environment. Instead, the WHO now recommends wiping potentially contaminated surfaces with disinfectant as a safer alternative.
Confusion surrounding the use of PPE, specifically double gloving, has also been highlighted in the updated guidelines. Some facilities have inconsistent approaches to changing gloves between patients and glove disinfection, leading to risks for healthcare workers. The new guidelines provide clarity on when double or single gloving should be used, how to disinfect gloves properly, and when to change gloves between patients. By outlining these procedures, the updated guidelines aim to standardize practices and reduce the risks associated with PPE usage.
While the appropriate use of PPE remains a crucial control measure, the updated guidelines emphasize the importance of isolating infected individuals from healthcare workers. This includes implementing engineering controls and administrative controls, such as changing work practices to create a barrier between infected patients and healthcare workers. The guidelines stress the need for collaboration among different agencies and stakeholders to effectively implement these control measures.
The guideline also introduces the concept of the IPC “ring” approach, which involves rapid mobilization of teams in geographical at-risk areas with infected individuals. This approach aims to limit exposure of healthcare workers by screening, triaging, providing patient care, environmental cleaning, and ensuring safe burial practices. By focusing on early intervention and containment strategies, the IPC “ring” approach can help prevent further spread of Ebola and Marburg diseases.
The updated infection prevention and control guidelines for Ebola and Marburg disease by the WHO are crucial in improving the management of outbreaks and reducing risks for healthcare workers. By addressing inappropriate practices, clarifying PPE usage, emphasizing engineering and administrative controls, and integrating the IPC “ring” approach, these guidelines provide a comprehensive framework for effective response to deadly disease outbreaks. Collaboration among different stakeholders and agencies is key to successfully implementing these guidelines and protecting the health and safety of individuals in at-risk areas.
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