Key components of a bioterror curriculum
Key components of a bioterror curriculum
Host of issues must be addressed
Some examples of key areas to be included in a curriculum in bioterrorism for health care workers are summarized as follows from "Bioterrorism: A Guide for Hospital Preparedness."1
• Understanding the Role of the Hospital and the Health Care Worker in a Biological Attack: General orientation regarding the likely role that the hospital would play in the event of a biological attack should be provided to all employees. All hospital-based health care workers should be instructed on the general procedures that might be undertaken in such an event (e.g., lockdown, emergency call-in of off-duty workers, etc.).
In a larger sense, all hospital workers must understand the special role that they and their institution would play in a bioterrorist attack. Similar to the way they are held to high standards in areas such as patient confidentiality, personal hygiene, and sense of service and responsibility, much would be expected of hospital workers in the event of an attack. As was witnessed in the very limited anthrax attacks of 2001, the public would expect the hospital and its workers to remain available and accessible not only to treat victims but to provide reliable information and a safe sanctuary when necessary. It is important that all hospital workers understand that these expectations would impact their work lives in many ways. The hospital must take responsibility for preparing its workers for such an environment.
• Clinical Recognition of Syndromes Associated with Biological Attack Scenarios: The ability to diagnose and effectively manage infections caused by biological terrorism includes an understanding of natural history, physical findings, laboratory patterns, isolation procedures (when applicable), and the approach to diagnosis and therapy.
Embodied in this knowledge base is an understanding of the role of personal protective equipment and the proper means of obtaining and processing laboratory specimens, as well as an understanding of the methods for evaluating contacts and potential contacts of victims.
• Medical Management of Likely Diseases To be Encountered: This similar but slightly reoriented knowledge base would include the ability to manage complications of diseases of biological attack that might not be manifest on initial presentation.
• Understanding the Role of Decontamination and Isolation of Victims and Contacts: This knowledge element requires an understanding of the uses of decontamination in biological attack. Because most agents of biological terror would not require extensive decontamination, the employees needing this education should also understand why unnecessary mass decontamination procedures may represent an impediment to the response to biological attack.
Specific topics include the following: the means of deploying decontamination equipment and effectively staffing decontamination areas within the hospital; the use of personal protective equipment; and the means of identifying those patients and staff members who require decontamination.
• Understanding Uses of Personal Protective Equipment: This component of the curriculum would focus on the proper uses of personal protective equipment (PPE), including indications for the various levels of PPE, as well as the means of locating and deploying equipment in the event of an attack.
• Understanding How Clinical Specimens Should Be Handled: The proper means of collecting, packing, and transporting clinical specimens would be covered in this component of the curriculum. Included would be the specific use of PPE by the clinical, transport, and laboratory staff involved in handling and processing such specimens.
• Understanding Hospital Plans for Establishing Surge Capacity: The management of patient flow such that the emergency department and other clinical areas do not become overwhelmed with patients not needing acute care would be addressed in this component of the curriculum.
A knowledge of space limitations and availability within the hospital or at predesignated locations outside the hospital would be emphasized. Strategies for holding potentially exposed individuals not requiring evaluation by public health authorities or medical care would be addressed. Other appropriate topics would include the means of obtaining additional equipment and supplies, the processes for rapidly discharging or transferring hospital patients, and limiting access of individuals seeking elective care.
• Understanding Likely Security Concerns: Issues to be addressed include the procedures for strictly enforcing existing security procedures and, if appropriate, limiting access to public areas of the hospital. In addition, the potential interactions and means of communication between hospital security staff and law enforcement agencies should be discussed.
• Understanding Communication Issues with News Media: A pre-event procedure for effective communication with print and broadcast news media should be established. All hospital staff should be aware of the general procedures for responding to inquiries from the press. Such inquires are best handled through a coordinated effort directed by the hospital’s senior leadership and, if available, public affairs staff.
• Recognizing and Understanding the Psychological Impact of a Terrorist Attack on Health Care Workers: The emotional impact of a terrorist attack on the hospital’s staff should not be underestimated.
The stress and fear associated with the dual roles of hospital employee and member of the general public in a community under attack should be anticipated and provisions for addressing the emotional needs of the staff developed.
• Familiarity with Regulations Governing Quarantine: The need for quarantine (confinement of individuals who may have been exposed to a contagious agent) would presumably be determined by public health authorities. Hospital staff, however, would be required to assist in enforcing quarantine procedures when necessary. All clinical, administrative, and security personnel would require a basic understanding of quarantine procedures set forth by local departments of health and their individual roles in putting these procedures into practice.
Reference
- Masci JR, Bass E. "Bioterrorism: A Guide for Hospital Preparedness." Boca Raton, FL, CRC Press: 2005
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