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Nurses say Ebola protocol, procedures lacking at hospital

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(Bloomberg) — Texas Health Presbyterian Hospital in Dallas, where two health care workers contracted Ebola after treating a patient with the deadly illness, lacked protocols for dealing with the virus and resisted employee calls for stricter isolation and sanitation measures, a nurses union said.

National Nurses United said there was inadequate protective equipment for the nurses who initially cared for Thomas Eric Duncan, the Ebola patient from Liberia who died in Dallas last week. The union said the allegations came from nurses who were reluctant to be identified for fear of retaliation.

The hospital left Duncan for hours in an area with other patients, supplied safety suits whose exposed necklines forced nurses to use medical tape to cover their skin, played down the need for more face masks and handled Duncan’s lab specimens without special seals, the group said.

The protective gear used by the health care workers when officials from U.S. Centers for Disease Control and Prevention arrived “did allow exposure of some parts of the skin,” said director Thomas Frieden in a call with reporters today.

Some workers were using three or four layers of gear, which becomes harder to remove and the risk of contamination “gets much higher,” Frieden said.

“Patient and employee safety is our greatest priority and we take compliance very seriously,” Wendell Watson, a hospital spokesman, said in an e-mailed statement. “We will continue to review and respond to any concerns raised by our nurses and all employees.”

Sent home

The nurses’ assertions raised new questions about the performance of Texas Presbyterian in dealing with the Ebola outbreak. National Nurses said there is no union representation in Dallas hospitals.

“I have no reason to not believe what those nurses are saying at all,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases said in a CNN interview. “If that’s true, that’s clearly not acceptable.”

Duncan was sent home after his first hospital visit last month, and on his second he was left for several hours with other patients present, according to the nurses’ statement. Hospital officials resisted a nursing supervisor’s demand that he be moved to an isolation unit, the group said.

“Were protocols breached? The nurses say there were no protocols,” the group said in the statement. The union isn’t identifying the health workers “for their protection.”

Tube system

Duncan’s lab specimens, which were transported in a hospital tube system for moving samples, were sent in a way that could potentially contaminate all such specimens, the union said. Nurses who interacted with Duncan without wearing the proper protective equipment continued caring for other patients, the group said.

The hospital didn’t do any preparatory work for an Ebola case, and even after Duncan tested positive, its procedures didn’t include having every nurse practice putting on and removing protective equipment such as gloves and masks, the group said.

Nurses witnessed CDC members violate principles of infection control, according to the statement.

“The nurses strongly feel unsupported, unprepared, lied to, and deserted to handle the situation on their own,” the group said.