FAST Previsit Preparedness Checklist
DRAFT
Rev.3
Facility Support Team Pre-visit Considerations for U.S. Hospitals
Introduction
The Centers for Disease Control and Prevention’s (CDC's) Rapid Ebola Preparedness Team (REP) is a
preparedness team dedicated to assessing the needs of U.S. hospitals for managing a suspected or
known Ebola Virus Disease (EVD) patient. The goal of the assessment is to help a healthcare facility
move from the planning and exercising of plans to the functional capability and capacity to safely and
efficiently care for a Person Under Investigation (PUI) for Ebola. The checklist below highlights key
preparedness components U.S. hospitals should review and complete prior to a REP assessment.
1.
Review key plans and protocols – Ensure your hospital has
 An emergency operations plan (EOP) that includes (1) coordination mechanisms between the
facility, public health, healthcare coalitions, emergency medical services (EMS), and emergency
management and (2) an appendix for Ebola and other category A agents.
 Plans to provide safe clinical care for a patient with Ebola to include adequate respiratory
support, safe administration of medication, sharps procedures, reinforcement of proper
biohazard containment and disposal precautions, testing procedures, and palliative care.
 Identified a Principal Investigator who is authorized to use investigational therapies and an
Institutional Review Board designated to conduct an expedited review of these therapies.
 Reviewed with the Ethics Committee the use of extraordinary care (i.e., intubation, dialysis,
Extracorporeal Membrane Oxygenation) for a patient with Ebola.
2.
Engage EMS in planning for transport to and inside hospital – Ensure your hospital has conducted
training for
 Pre-notification of hospital of patient under investigation for or confirmed Ebola.
 Pre-determined route of entry into isolation room in Emergency Department or to assigned
inpatient isolation room.
 Designated area for doffing PPE from EMS personnel.
 A designated area where EMS personnel can decontaminate their vehicle and dispose of
contaminated PPE and medical waste.
3.
Ensure triage procedures and protocols are in place to detect persons exposed to or ill with EVD
– Ensure your hospital has
 Procedures in place to rapidly identify a PUI for Ebola (includes triage screening and lab
procedures).
October 27, 2014
DRAFT
Page 1 of 4
FAST Previsit Preparedness Checklist
4.
DRAFT
Rev.3
Ensure isolation procedures and protocols are in place to reduce the risk of exposure to Ebola –
Ensure your hospital has
 Isolation rooms and protocols for placing any suspected or known EVD patient in a private
room or isolated area for evaluation.
 When available in your facility, Airborne Infection Isolation Rooms (AIIRs) that are functioning
correctly and appropriately monitored for airflow.
 Portable equipment available to create negative pressure in an isolation room in the event no
negative pressure rooms exist.
 Trained engineering department staff necessary to maintain the negative pressure records and
portable equipment and comply with associated requirements.
5.
Review infection control procedures and protocols to ensure they fully protect healthcare
personnel and patients from exposure to Ebola – Ensure your hospital has
 Designated individuals as site managers responsible for overseeing the implementation of
precautions for healthcare workers and patient safety.
 Enough personal protective equipment (PPE) available to care for suspected or known patients
with Ebola and an increase in resupply to support the increased demand.
 Designated separate areas for donning (clean area) and doffing (dirty area) of PPE.
 Personnel trained in donning and doffing procedures and proper disposal of PPE and other
medical waste.
 A buddy system protocol in place in which donning and doffing of PPE are directly observed by
a trained observer.
 Procedures for disinfecting reusable equipment based on manufacturer guidelines for proper
disinfection prior to reusing it (e.g., powered air purifying respirators [PAPRs]).
 A procedure for disinfecting isolation rooms and readying them for another patient.
 A strategy to coordinate communication between (1) healthcare providers and the patient and
(2) the patient and family members without the risk of exposure to Ebola.
 A designated area and procedures for the disposal of Category A PPE and other medical waste.
6.
Review security procedures and protocols to ensure access control to potentially contaminated
areas – Ensure your hospital has
 A protocol to ensure that only authorized persons have access to the room of a suspected or
known EVD patient or any other potentially contaminated area.
October 27, 2014
DRAFT
Page 2 of 4
FAST Previsit Preparedness Checklist
7.
DRAFT
Rev.3
Determine whether waste management procedures and protocols comply with applicable laws
and regulations – Ensure your hospital has
 Personnel who have coordinated with the local health department to identify applicable local
regulations with regard to Category A waste transportation.
 Ensure both hospital and waste carrier have filed applicable waivers for the possible
transportation of Ebola waste.
 Trained staff on the proper procedures to package and dispose of Category A waste.
8.
Review staffing procedures and protocols to ensure they reduce the risk of staff exposure to
Ebola – Ensure your hospital has
 A staffing schedule for case treatment that includes adjusted shifts (due to increased time for
donning and doffing and use of PPE for prolonged periods), more staff than usual for an
isolation patient, no ancillary services, and a care from a multidisciplinary team that may
include nephrology, anesthesia, critical care, infectious disease, hospitalists, etc.
 Policies and procedures in place for screening exposed or ill healthcare personnel and
implementing predetermined work restriction of these exposed or ill workers.
 A designated team to prepare risk communication messages for all internal staff.
 A buddy system protocol and mechanism (window or monitor) to observe care of a suspected
or known EVD patient and tracking of all personnel who enter patient room the patient
zone/isolation unit.
9.
Review laboratory testing procedures and protocols to ensure they reduce the risk of exposure
to Ebola and to identify which testing can be done in house and which testing requires use of an
external laboratory – Ensure your hospital has
 Trained healthcare personnel to properly handle a specimen for Ebola testing.
 Prepared for bedside diagnostic testing, if the hospital will use this method.
 Set aside an area in the lab for testing specimens from the patient with Ebola, if the hospital
chooses this method.
10. Review exercising and testing records to determine that key elements of the hospital EOP
appendix for highly infectious disease have been exercised or tested with first-contact
personnel, clinical providers, and ancillary staff – Key elements to be exercised or tested include
 The plan or protocol for receiving from EMS and transporting a suspected or known EVD patient
to isolation room.
 Infectious disease procedures and protocols, including PPE donning and doffing.
October 27, 2014
DRAFT
Page 3 of 4
FAST Previsit Preparedness Checklist
DRAFT
Rev.3
 Triage protocols and Ebola screening questions.
 Disease identification, testing, specimen collection, and specimen transport procedures.
 Isolation and security procedures.
 Communications and reporting procedures.
 Cleaning and disinfection procedures.
 The ability to share lessons learned between key stakeholders, coalition partners, public health,
emergency management, and others without violating patient privacy rights.
October 27, 2014
DRAFT
Page 4 of 4