Attachment_21_Chg_1 _POI_List_Three.pdf

Course Number Course Title

PER‐321 Barrier Protections and Controls for Highly Infectious Diseases (HID)

PER‐313

Intermediate Hands‐On Training for CBRNE Incidents: Law Enforcement (HOT‐

LE)

PER‐262 Hands‐On Training for CBRNE Incidents (HOT)

PER‐900 Intermediate Hands‐On Training for CBRNE Incidents (HOT‐I)

PER‐261 Hazardous Materials Technician for CBRNE Technician (HT) Located in Attachment 48

MGT‐360

Incident Command: Capabilities, Planning and Response Actions for All

Hazards (IC)

ICE Integrated Capstone Event (HCL/HERT/EMO)

PER‐268 Incident Complexities ‐ Responder Actions for CBRNE Incidents (ICR)

POI List Three

Training Delivery Services

Attachment 21, Chg 1

HID POI 1.0 1

SECTION I

COURSE DESCRIPTION

Course Number: PER-321

Course Title: Barrier Precautions and Controls for Highly Infectious Disease

Version Control Number: 1.0

Effective Date: TBD

Course Purpose. The purpose of this course is to provide emergency medical service, healthcare, and public health professionals with knowledge and practical experience in the barrier precautions and infection control guidelines and procedures for triaging, transporting, transferring, treating, and managing risk of transmission in persons with highly infectious diseases.

Course Goals

a. To provide realistic practical application in the handling and treatment of persons with a highly infectious disease.

b. To develop critical thinking ability with regard to the decisions that must be effectively made to prevent providers, other patients, and visitor infections when handling and treating persons with a highly infectious disease.

c. To provide knowledge and experience that aids in assessing the risk and reducing the potential for infection of responders, healthcare providers, and other patients.

Course Scope. This course provides the student with the best practice knowledge and skill for triaging, transporting, transferring, treating, and managing persons with highly infectious diseases. Students participate in a guided discussion of best practices for managing and treating persons with a highly infectious disease from identification or presentation through conclusion and final outcome of treatment. Students receive demonstrations and practical experience in the proper donning and doffing of personal protective equipment (PPE) required to prevent provider and other patient contamination. Lastly, students conduct a series of patient management and treatment exercises in a realistic healthcare setting to include presentation at an emergency room and treatment in a hospital isolation ward using best practice barrier precautions and infection control procedures.

Terminal Course Objectives

a. Determine infection control barrier precautions and guidelines

b. Manage risk of transmission in a patient with a highly infectious disease

c. Don personal protective equipment

d. Doff personal protective equipment

e. Process infectious human remains

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f. Handle infectious and/or hazardous waste

g. Disinfect patient treatment area and equipment

Course Length: 3 Days

Course Academic Hours: 24 Hours

Class Size

a. Minimum: 16

b. Optimal: 24

c. Maximum: 32

Class Iterations per Year: 6

Optimum Annual Student Throughput: 144

Course Delivery Means

a. Resident. This course is delivered in residence at the Center for Domestic Preparedness (CDP) in Anniston, Alabama.

b. Non-resident. Not applicable

c. Indirect. Not applicable

Target Audience. The target audience for this course is emergency medical services, healthcare, and public health professionals with a requirement to triage, transport, and treat persons with a highly infectious disease.

Course Prerequisites. To be eligible to attend the course, a student must meet the following requirements.

a. Possess training and/or education in basic barrier precautions and infection control requirements and procedures.

b. Possess training and/or education in medical triage and treatment protocols.

c. Be physically capable of assisting in the transfer and movement of a patient role player or mannequin weighing up to 200 pounds.

d. Be physically and mentally capable of wearing personal protective equipment that conforms tightly to the face or encapsulates the head and face.

Exceptions to any of the above prerequisites may be granted on a case-by-case basis at the discretion of the Center for Domestic Preparedness Registrar.

Job/Function Tasks Trained

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Task Number Task Title Proficiency Level1

HC-0001

Determine Infection Control Barrier Precautions and Guidelines

Proficiency

HC-0005

Manage Risk of Transmission in a Patient with a Highly Infectious Disease

Part-Task

HC-0015 Don Personal Protective Equipment Proficiency HC-0020 Doff Personal Protective Equipment Proficiency HC-0025 Process Infectious Human Remains Part-Task HC-0030 Handle Infectious and/or Hazardous Waste Part-Task HC-0035 Disinfect Patient Treatment Area and Equipment Part-Task

1Proficiency Level = Familiarization, Part Task, Proficiency, or Reinforced

Continuing Education Units or Academic Equivalency

a. As an International Association for Continuing Education and Training (IACET) Authorized Provider, the Center for Domestic Preparedness awards 2.4 continuing education units for this program under the American National Standards Institute (ANSI)/IACET Standard.

b. The Alabama Board of Nursing, in partnership with the CDP, awards 24 contact hours toward continuing education credit for the successful completion of this course.

Instructor Qualifications. All instructors delivering curriculum for the Center for Domestic Preparedness must meet the basic instructor qualifications outlined in the performance work statement. Exceptions to these instructor qualifications may be granted on a case-by-case basis via request through the contracting officer’s representative.

Regulations, National Goals, Doctrine, Standards, and Capability Gaps Supported by the Course

a. Regulations. Pandemic and All-Hazards Preparedness Reauthorization Act of 2013. The course supports the 2013 Pandemic and All-Hazards Preparedness Reauthorization Act by improving state and local public health security and enhancing hospital preparedness and situational awareness through practical instruction and experience in the safe and proper management and treatment of persons with highly infectious disease.

b. National Preparedness Goal. This course supports the response mission area of the

National Preparedness Goal by providing knowledge and practical experience in the procedures, guidelines and best practices for preventing the spread of highly infectious diseases to responders, healthcare providers, and other patients. This course specifically supports the following FEMA Core Capabilities.

(1) Public Health and Medical Services. This course supports the capability by enhancing hospital preparedness through practical instruction and experience in the safe and proper management and treatment of persons with highly infectious disease.

(2) Situational Assessment. This course supports the capability by training responders and healthcare professionals in the procedures for notifying federal, state, local, and tribal agencies of persons with infectious diseases and their treatment status.

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c. Doctrine

(1) National Response Framework Emergency Support Function 8. The course supports Emergency Support Function 8 by increasing healthcare professionals’ awareness of health surveillance reporting requirements and through increased preparedness to safely deliver patient care for persons with highly infectious disease.

(2) National Response Framework Worker Health and Safety Annex. This course supports worker health and safety by providing state, local, and tribal responders and healthcare providers with training in the barrier precautions and infection control procedures to safely manage and treat persons with highly infectious disease.

d. Standards. The course is consistent with guidelines for infection control and the management and treatment of persons with highly infectious disease published by U.S.

Department of Health and Human Services, and Centers for Disease Control and Prevention.

e. Capability Gaps. This course supports the capability gap identified through the number of secondary infections of healthcare workers during the 2014 Ebola outbreaks in Africa and the United States. The course focuses on the safe management and treatment of persons with highly infectious disease through the use of barrier precautions and best practice infection control procedures in an effort to support reduction of secondary infections of responders, healthcare professionals, and others.

Version Control Number Change History

Version Control Number

New, Minor or

Major Concise Description of Change(s)

Effective Date of Change

1.0 New

This is a new course developed based upon the outcomes of a needs assessment.

Additional Remarks: None

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SECTION II

COURSE SUMMARY AND RECOMMENDED SCHEDULE

Course Executive Summary. The following is a concise overview for each learning activity within the program. Each activity is presented in the sequence in which it is recommended to be executed.

Activity Number

Activity Title Activity Description Total Time

Med 1 Medical Screening Medical evaluation in accordance with CDP policy.

30 minutes

Admin 1 Tablet Orientation

An orientation to the operations of the tablet and the procedures for using it to access, annotate, and distribute electronic student materials.

30 minutes

Module 1

Introduction to the Barrier Precautions and Controls for Highly Infectious Disease Course

Provides an introduction to the CDP;

a review of the course and associated graduation criteria; an overview of key policies, expectations, and the facilities; and introductions to the staff and fellow students.

1 hour

Module 2 Barrier Precautions and Controls

To provide knowledge of barrier precautions and controls to protect from infectious agent transmission.

2 hours

ELA 1

Noble Training Facility and Infection Control Plan

To orient the class to the Noble Hospital Infection Control Policy and the layout and capabilities of Noble Hospital; particularly the Emergency Department and the Isolation Ward.

1 hour

Module 3 Infectious Disease Patient Management

To discuss infectious disease patient management processes for effectively managing patients with highly infectious diseases.

2 hours and 30 minutes

ELA 2

Exercise 1: Infectious Disease Patient Management

A practical exercise that requires the triage, initial treatment, and safe transfer to an isolation ward room for a patient with a highly infectious disease that requires airborne barrier precautions and infection control procedures.

1 hour and 30 minutes

Med 2 Vitals Screening Vitals screening in accordance with CDP policy.

15 minutes

Med 3 Vitals Screening Vitals screening in accordance with CDP policy

15 minutes

ELA 3

Barrier Precaution Demonstrations

A demonstration of the procedures for performing fit testing of an N95 respirator and donning and doffing of maximum barrier precautions PPE.

1 hour

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Activity Title Activity Description Total Time

ELA 4

Maximum Barrier Precaution PPE Donning and Doffing Practical Application

Practical application in the procedures for donning and doffing maximum barrier PPE and for performing the trained observer role.

2 hours

ELA 5

Exercise 2: Managing Infectious Disease Patients I

A practical exercise that requires the triage, transfer, and treatment of patients with a highly infectious disease that requires droplet barrier precautions and infection control procedures.

2 hours and 30 minutes

ELA 6

Maximum Barrier Precautions Skills Exercise

A practical exercise that provides students with experience donning maximum barrier PPE, performing select clinical procedures, doffing PPE, and serving as a trained observer for the donning and doffing procedure.

2 hours and 30 minutes

Med 4 Vitals Screening Vitals screening in accordance with CDP policy.

15 minutes

Med 5 Vitals Screening Vitals screening in accordance with CDP policy.

15 minutes

ELA 7

Maximum Barrier Ambulance Preparation and Disinfection Demonstration

To provide students with a demonstration of the procedures for preparing an ambulance for transport of a highly infectious disease patient and the procedures for disinfecting the ambulance following transport.

1 hour

ELA 8

Exercise 3: Managing Infectious Disease Patients II

A practical exercise that requires students to manage and treat a patient with a highly infectious disease that requires maximum barrier precautions and infection control procedures.

4 hours and 45 minutes

ELA 9

Ebola Virus Disease and Viral Hemorrhagic Fever Human Remains Handling Practical Exercise

To provide students with practical experience in the handling of infectious human remains in accordance with current CDC guidelines.

1 hour and 15 minutes

Med 6 Vitals Screening Vitals screening in accordance with CDP policy.

15 minutes

Module 4 Course Review and Open Forum

A review of the entire course and an open forum for students to address questions or receive clarification on best practice barrier precautions and infection control procedures from the instructional staff.

45 minutes

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Activity Title Activity Description Total Time

Admin 2 Graduation and End-of- Course Evaluation

To recognize successful student performance by providing them with a certificate of completion and collect student end-of-course evaluation forms, as required.

15 minutes

Recommended Academic Course Schedule. This schedule illustrates the recommended sequencing by day for the administrative and academic learning activities. Every attempt will be made to maintain this sequencing of the academic learning activities in order to ensure maximum transfer of knowledge is achieved.

Activity Number Activity Title Hours

DAY 1

Med 1 Medical Screening 30 minutes Admin 1 Tablet Orientation 30 minutes Module 1 Introduction to the Barrier Precautions and Controls for

Highly Infectious Disease Course 1 hour

Module 2 Barrier Precautions and Controls 2 hours ELA 1 Noble Training Facility and Infection Control Plan 1 hour

Lunch 45 minutes Module 3

Infectious Disease Patient Management 2 hours and 30 minutes

ELA 2 Exercise 1: Infectious Disease Patient Management 1 hours and 30 minutes Med 2 Vitals Screening 15 minutes

Day 1 Total 8 hours

DAY 2

Med 3 Vitals Screening 15 minutes ELA 3 Barrier Precaution Demonstrations 1 hour

ELA 4

Maximum Barrier Precaution PPE Donning and Doffing Practical Application

2 hours

Lunch 45 minutes

ELA 5 Exercise 2: Managing Infectious Disease Patients I 2 hours and 30 minutes

ELA 6 Maximum Barrier Precautions Skills Exercise 2 hours and 30 minutes Med 4 Vitals Screening 15 minutes

Day 2 Total 8 hours

DAY 3

Med 5 Vitals Screening 15 minutes

ELA 7

Maximum Barrier Ambulance Preparation and Disinfection Demonstration

1 hour

ELA 8

Exercise 3: Managing Infectious Disease Patients II

2 hours and 45 minutes

Lunch 45 minutes ELA 8 Exercise 3: Managing Infectious Disease Patients II

(continued) 2 hours

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ELA 9

Ebola Virus Disease and Viral Hemorrhagic Fever Human Remains Handling Practical Exercise

1 hour and 15 minutes

Med 6 Vitals Screening 15 minutes Module 4 Course Review and Open Forum 45 minutes Admin 2 Graduation and End-of-Course Evaluation 15 minutes

Day 3 Total 8 hours

Total Academic Hours 24

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SECTION III

LEARNING ACTIVITY DESCRIPTIONS

Number: Administrative 1

Title: Tablet Orientation

Time: 30 minutes

Instructional Methods

Method Time Instructor to Student Ratio Demonstration 25 minutes 1:24 Facilitation 5 minutes 1:24

Media/Technology: Actual equipment

Purpose: An orientation to the operations of the tablet and the procedures for using it to access, annotate, and distribute electronic student materials. Main ideas for this module include an explanation and demonstration of the

a. basic operations of the tablet,

b. procedures for opening student materials using the reader application,

c. procedures for highlighting text in the reader application,

d. procedures for taking and saving notes within the student materials using the reader application, and

e. procedures for emailing annotated student materials.

Learning Objectives

a. Terminal Learning Objectives. Not applicable

b. Enabling Learning Objectives. Not applicable

Downgrade Justification: Not applicable

Concept of Instruction

a. Demonstration. A demonstration for each of the main ideas listed above is conducted using an actual tablet preloaded with student materials.

b. Facilitation. The instructor facilitates a brief review and questions and answers session upon completion of the demonstration.

Required Instructional Materials: Instructor guide and tablet reference guide

Risk Assessment: Low

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Reference:

Center for Domestic Preparedness. (2013). Student handbook. Anniston, AL: Author.

Training Facilities Facility Title Facility Description Quantity Classroom Capable of accommodating the enrolled class size 1

Instructor and Training Support Personnel Description Special Qualifications Quantity Instructor None 1

Equipment

Item Quantity Unit of

Measure Unit of Issue

None

Consumables

Item Quantity Unit of

Measure Unit of Issue

None

Agent

Description Quantity Unit of

Measure Unit of Issue

None

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Number: Module 1

Title: Introduction to the Barrier Precautions and Controls for Highly Infectious Disease Course

Total Time: 1 hour

Instructional Methods

Method Time Instructor to Student Ratio Lecture 20 minutes 1:24 Facilitation 40 minutes 1:24

Media/Technology: Multimedia presentation

Purpose. To provide an introduction to the CDP; to review the course and associated graduation criteria; to provide an overview of key policies, expectations, and the facilities; and to conduct staff and student introductions. The main ideas for this module include the following items:

a. recent infectious disease cases,

b. an overview of the course,

c. graduation criteria for the course,

d. an overview of the facilities and key student expectations,

e. sources of additional information regarding Center for Domestic Preparedness (CDP) courses, and

f. the facilitation of instructor and class member introductions.

a. Terminal Learning Objectives. Not applicable

b. Enabling Learning Objectives. Not applicable

Downgrade Justification. Not applicable

Concept for Instruction

a. Lecture. A lecture supplemented by a multimedia presentation is presented for main ideas a. through d. above.

b. Facilitation. Introductions are facilitated for the instructional staff and each class member.

Required Instructional Materials: Instructor guide and multimedia presentation

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Reference(s): Center for Domestic Preparedness. (2013). Student handbook. Anniston, AL:

Author.

Training Facilities Facility Type Facility Description Quantity

Lead Instructor None 1

Item Name Quantity Unit of

Measure Unit of Issue

None

Consumables

Item Quantity Unit of

Measure Unit of Issue

Agent

Unit of

Measure Unit of Issue

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Number: Module 2

Title: Barrier Precautions and Controls

Total Time: 2 hours

Lecture 1 hour and 40 minutes 1:24 Guided Discussion 20 minutes 1:24

Purpose. To provide knowledge of barrier precautions and controls to protect from infectious agent transmission.

Learning Objectives

a. Terminal Learning Objective. Given a patient history and symptoms and/or diagnosis, determine infection control barriers and guidelines in accordance with Centers for Disease Control and Prevention and Occupational Safety and Health Administration.

(HC-0001)

b. Enabling Learning Objectives

(1) Define key infectious disease terms in accordance with the Centers for Disease Control and Prevention. (HC-0001a)

(2) Given an infectious disease, identify the mode of infectious agent transmission in accordance with the Centers for Disease Control and Prevention. (HC-0001b)

(3) Identify standard barrier precautions and associated procedures in accordance with the Centers for Disease Control and Prevention. (HC-0001c)

(4) Identify airborne barrier precautions and associated procedures in accordance with the Centers for Disease Control and Prevention. (HC-0001d)

(5) Identify contact barrier precautions and associated procedures in accordance with the Centers for Disease Control and Prevention. (HC-0001e)

(6) Identify droplet barrier precautions and associated procedures in accordance with the Centers for Disease Control and Prevention. (HC-0001f)

(7) Given a viral hemorrhagic fever or Ebola virus disease situation, identify barrier precautions and associated procedures in accordance with the Centers for Disease Control and Prevention. (HC-0001g)

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a. Lecture. The instructor presents a lecture for each enabling learning objective supplemented by a multimedia presentation.

b. Guided Discussion. The instructor presents questions to allow students to consider trends of recent events. The instructor solicits questions and provides responses to student questions that reinforce the learning objectives.

Required Instructional Materials: Instructor guide, student guide, and multimedia presentation

References

Center for Disease Control and Prevention (2003a). Guidelines for environmental infection control in health-care facilities. Retrieved from http://www.cdc.gov/MMWR/preview/MMWRhtml/rr5210a1.htm

Center for Disease Control and Prevention. (2007). Guidelines for isolation precautions:

Preventing transmission of infectious agents in healthcare settings. Retrieved from http://www.cdc.gov/hicpac/pdf/isolation/Isolation2007.pdf

Center for Disease Control and Prevention. (2005b). Guidelines for preventing the transmission of M. tuberculosis in health-care settings. Retrieved from http://www.cdc.gov/tb/publications/slidesets/infectionguidelines/default.htm

Centers for Disease Control and Prevention. (2015i). Quarantine and isolation. Retrieved from http://www.cdc.gov/quarantine/index.html

Training Facilities

Unit of

Measure Unit of Issue

None

Consumables

Item Quantity Unit of

Measure Unit of

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Description Quantity Unit of

Measure Unit of Issue

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Number: Experiential Learning Activity 1

Title: Noble Training Facility Infection Control Plan Orientation

Total Time: 1 hour

Instructional Methods

Method Time Instructor to Student Ratio Demonstration 45 minutes 3:24 Guided Discussion 15 minutes 3:24

Media/Technology: Actual equipment and facilities

Purpose. To orient the class to the Noble Hospital Infection Control Policy and the layout and capabilities of Noble Hospital; particularly the Emergency Department and the Isolation Ward.

a. Terminal Learning Objective. Given a patient with an infectious disease, manage the risk of transmission in a patient with an infectious disease by ensuring conformance with infection control barriers and guidelines and preventing contamination of others. (HC- 0005)

b. Enabling Learning Objective. Given a highly infectious disease patient scenario, determine patient flow for minimizing risk of exposure and transmission of infectious agents in accordance with the Centers for Disease Control and Prevention. (HC-0005a)

a. Demonstration. Instructors review the Noble Hospital Infection Control Plan and introduce students to the Noble Training Facility. Instructors use the Infection Control Plan to orient students to the proper entry ways, elevators, and areas for moving highly infectious disease patients throughout the hospital.

b. Guided Discussion. At the conclusion of the demonstration, the lead instructor conducts a brief review and solicits and responds to student questions.

Required Instructional Materials: Experiential learning guide

References

Center for Domestic Preparedness. (2015). Noble hospital infectious disease policy. Anniston, AL: Author.

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Noble Training Facility Training hospital 1 Hospital isolation ward Entire isolation ward 1

Instructor None 3

Unit of

Measure Unit of Issue

None

Consumables

Item Quantity Unit of

Measure Unit of Issue

None

Agent

Description Quantity Unit of

Measure Unit of Issue

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Number: Module 3

Title: Infectious Disease Patient Management

Total Time: 2 hours and 30 minutes

Lecture 2 hours and 30 minutes 1:24

Purpose. To discuss infectious disease patient management processes for effectively managing patients with highly infectious diseases.

a. Terminal Learning Objectives

(1) Given a patient history and symptoms and/or diagnosis, determine infection control barriers and guidelines in accordance with Center for Disease Control and Prevention and Occupational Safety and Health Administration. (HC-0001)

(2) Given a patient with an infectious disease, manage a patient with an infectious disease by ensuring conformance with infection control barriers and guidelines and preventing contamination of others. (HC-0005)

(3) Given a fatality with an infectious disease and appropriate equipment and materials, process infectious human remains in accordance with Center for Disease Control and Prevention. (HC-0025)

(4) Given appropriate handling and waste disposal equipment and materials, handle infectious and/or hazardous waste in accordance with Center for Disease Control and Prevention and Occupational Safety and Health Administration. (HC-0030)

(5) Given appropriate disinfection equipment and materials, disinfect patient treatment areas and equipment in accordance with Center for Disease Control and Prevention and Occupational Safety and Health Administration. (HC-0035)

b. Enabling Learning Objectives

(1) Define key infectious disease terms in accordance with the Centers for Disease Control and Prevention. (HC-0001a)

(2) Given an infectious disease, identify the mode of infectious agent transmission in accordance with the Centers for Disease Control and Prevention. (HC-0001b)

(3) Identify the requirement and procedures for preparing a medical transport vehicle for a highly infectious disease patient in accordance with the Centers for Disease Control and Prevention. (HC-0001h)

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(4) Identify the requirement and procedures for disinfecting a medical transport vehicle in accordance with the Centers for Disease Control and Prevention. (HC-0035a)

(5) Given a highly infectious disease patient scenario, determine patient flow for minimizing risk of exposure and transmission of infectious agents in accordance with the Centers for Disease Control and Prevention. (HC-0005a)

(6) Given a highly infectious disease patient scenario, determine the requirement and procedures for disinfecting patient treatment areas and associated equipment in accordance with the Centers for Disease Control and Prevention. (HC-0035b)

(7) Given a patient scenario requiring infectious disease reporting, determine infectious disease reporting requirements in accordance with typical state and local public health department procedures and the Centers for Disease Control and Prevention.

(HC-0005b)

(8) Identify the requirement and procedures for preparing infectious human remains in accordance with the Centers for Disease Control and Prevention and the World Health Organization. (HC-0025a)

(9) Identify the requirement and procedures for handling and preparing infectious waste in accordance with the Centers for Disease Control and Prevention and U.S.

Department of Transportation Hazardous Materials Regulations. (HC-0030a)

(10) Given a highly infectious disease patient scenario, determine airborne infection isolation requirements and procedures in accordance with the Centers for Disease Control and Prevention Guidelines for Environmental Infection Control in Health- Care Facilities. (HC-0005c)

a. Lecture. The instructor presents a lecture for each enabling learning objective supplemented by a multimedia presentation.

Required Instructional Materials: Instructor guide, student guide, and multimedia presentation

References

American Medical Response (AMR). (2014). Ebola patient preparation for transport, patient movement & decontamination procedures. Retrieved from http://www.amr.net/Ebola/Ebola- Patient-Information.aspx

APIC (n.d.). Infectious disease disasters: Bioterrorism, emerging infections, and pandemics.

Retrieved from http://apic.org/Resource_/TinyMceFileManager/Topic-specific/47901_CH120_R1.pdf

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Centers for Disease Control and Prevention. (2014a). Case definition for Ebola virus disease (EVD). Retrieved from http://www.cdc.gov/vhf/ebola/healthcare-us/evaluating-patients/case-definition.html

Centers for Disease Control and Prevention. (2014b). CDC Health Advisory: Guidelines for evaluation of US patients suspected of having Ebola virus disease. Retrieved from http://emergency.cdc.gov/HAN/han00364.asp

Centers for Disease Control and Prevention. (2014c). Checklist for patients being evaluated for

Ebola virus disease (EVD) in the United States. Retrieved from http://stacks.cdc.gov/view/cdc/25856

Centers for Disease Control and Prevention. (2014f). Ebola: Personal protective equipment

(PPE) donning and doffing procedures training. Retrieved from http://www.cdc.gov/vhf/ebola/hcp/ppe-training/index.html

Centers for Disease Control and Prevention. (2014g). Ebola virus disease (EVD): Algorithm for evaluation of the returned traveler. Retrieved from http://www.cdc.gov/vhf/ebola/pdf/ebola-algorithm.pdf

Centers for Disease Control and Prevention. (2014i). Guidance on air medical transport for

Middle East Respiratory Syndrome (MERS) patients. Retrieved from http://www.cdc.gov/coronavirus/MERS/hcp/air-transport.html

Centers for Disease Control and Prevention. (2015a). Guidance for collection, transport and submission of specimens for Ebola virus testing. Retrieved from http://www.cdc.gov/vhf/ebola/healthcare-us/laboratories/specimens.html

Centers for Disease Control and Prevention. (2015b). Guidance for safe handling of human remains of Ebola patients in U.S. hospitals and mortuaries. Retrieved from http://www.cdc.gov/vhf/ebola/healthcare-us/hospitals/handling-human-remains.html

Centers for Disease Control and Prevention. (2015c). Guidance for safe handling of human remains of Ebola patients in U.S. hospitals and mortuaries: Mortuary guidance job aid.

Retrieved from http://www.cdc.gov/vhf/ebola/pdf/postmortom-preparation.pdf

Centers for Disease Control and Prevention. (2014h). Guidance for the selection and use of personal protective equipment (PPE) in healthcare settings (PowerPoint presentation).

Retrieved from http://www.cdc.gov/HAI/pdfs/ppe/PPEslides6-29-04.pdf

Centers for Disease Control and Prevention. (2015d). Guidance for U.S. laboratories for managing and testing routine clinical specimens when there is a concern about Ebola virus disease. Retrieved from http://www.cdc.gov/vhf/ebola/healthcare-us/laboratories/safe-specimen-management.html

Centers for Disease Control and Prevention. (2014j). Guidance on personal protective equipment to be used by healthcare workers during management of patients with Ebola virus disease in U.S. hospitals, including procedures for putting on (donning) and removing (doffing). Retrieved from http://www.cdc.gov/vhf/ebola/healthcare-us/ppe/guidance.html

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Centers for Disease Control and Prevention. (2008). Guideline for disinfection and sterilization in healthcare facilities. Retrieved from http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf

Centers for Disease Control and Prevention. (2003a). Guidelines for environmental infection control in healthcare facilities. Retrieved from

Centers for Disease Control and Prevention. (2007). Guidelines for isolation precautions:

Centers for Disease Control and Prevention. (2005b). Guidelines for preventing the transmission of M. tuberculosis in health-care settings. Retrieved from

Centers for Disease Control and Prevention. (2015e). Infection prevention and control recommendations for hospitalized patients with known or suspected Ebola virus disease in U.S. hospitals. Retrieved from http://www.cdc.gov/vhf/ebola/healthcare-us/hospitals/infection-control.html

Centers for Disease Control and Prevention. (2015f). Interim guidance for emergency medical services (EMS) systems and 9-1-1 public safety answering points (PSAPs) for management of patients with known or suspected Ebola virus disease in the United States. Retrieved from http://www.cdc.gov/vhf/ebola/healthcare-us/emergency-services/ems-systems.html

Centers for Disease Control and Prevention. (2015g). Interim guidance for environmental infection control in hospitals for Ebola virus. Retrieved from http://www.cdc.gov/vhf/ebola/healthcare-us/cleaning/hospitals.html

Centers for Disease Control and Prevention. (2014k). Interim guidance for monitoring and movement of persons with Ebola virus disease exposure. Retrieved from http://www.cdc.gov/vhf/ebola/exposure/monitoring-and-movement-of-persons-with-exposure.html

Centers for Disease Control and Prevention. (2014l). Interim guidelines for collecting, handling, and testing clinical specimens from patients under investigation (PUIs) for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) – version 2.1 Retrieved from http://www.cdc.gov/coronavirus/mers/guidelines-clinical-specimens.html

Centers for Disease Control and Prevention. (2015h). Interim infection prevention and control recommendations for hospitalized patients with Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Retrieved from http://www.cdc.gov/coronavirus/mers/infection-prevention-control.html

Center for Disease Control and Prevention. (2012). Menu of suggested provisions for state tuberculosis prevention and control laws. Retrieved from http://www.cdc.gov/tb/programs/laws/menu/definitions.htm

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Centers for Disease Control and Prevention. (2014m). MERS interim guidance for health professionals. Retrieved from http://www.cdc.gov/coronavirus/mers/interim-guidance.html

Centers for Disease Control and Prevention. (1992a). MMWR management of persons exposed to multidrug-resistant tuberculosis. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/00031296.htm

Centers for Disease Control and Prevention. (1992b). MMWR national action plan to combat multidrug-resistant tuberculosis. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/00031159.htm

Centers for Disease Control and Prevention. (2003b). MMWR treatment of tuberculosis.

Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htm

Centers for Disease Control and Prevention. (2014n). National Notifiable Diseases Surveillance

System (NNDSS). Retrieved from http://www.cdc.gov/nndss/

Center for Disease Control and Prevention. (2015i). Quarantine and isolation. Retrieved from http://www.cdc.gov/quarantine/index.html

Centers for Disease Control and Prevention. (2014o). Recommended guidance for extended use and limited reuse of N95 filtering facepiece respirators in healthcare settings. Retrieved from http://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html

Centers for Disease Control and Prevention. (1998). Special Article: Guideline for infection control in health care personnel. Retrieved from http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf

Emory Healthcare. (2014). Emory Healthcare Ebola preparedness protocols (draft). Retrieved from http://www.emoryhealthcare.org/ebola-protocol/resources.html

Kansas Department of Health. (n.d.). Fit testing procedures for N95 respirators using 3M FT-30, Bitter Fit test equipment. Retrieved from http://www.kdheks.gov/cphp/download/Fit_Test_Pro_for_N95_R.pdf

Kortepeter, M.G., Bausch, D.G., and Bra, M. (2011). Basic clinical and laboratory features of filoviral hemorrhagic fever. The Journal of Infectious Diseases: Oxford University Press

Manitoba Health. (2012). Routine practices and additional precautions for preventing the transmission of infection in health care. Retrieved from http://www.gov.mb.ca/health/publichealth/cdc/docs/ipc/rpap.pdf

National Ambulance Resilience Unit, United Kingdom. (n.d.). Exercise BG (video)

National Institute for Occupational Safety and Health: National Personal Protective Technology

Laboratory. (2014). Considerations for selecting protective clothing used in healthcare for protection against microorganisms in blood and body fluids. Retrieved from http://www.cdc.gov/niosh/npptl/topics/protectiveclothing/

Occupational Safety and Health Administration. 29 Code of Federal Regulations 1910.134

Appendix A, OSHA fit testing procedures (mandatory). Retrieved from

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https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=

Occupational Safety and Health Administration. (2014). OSHA Fact Sheet - Cleaning and decontamination of Ebola on surfaces: Guidance for workers and employers in non-healthcare/non-laboratory settings. Retrieved from https://www.osha.gov/Publications/OSHA_FS-3756.pdf

U.S. Army Institute of Public Health, Environmental Health Engineering Portfolio (2014). Ebola virus disease waste management in the medical treatment facility. Retrieved from http://phc.amedd.army.mil/PHC%20Resource%20Library/EVDWasteManagementonMTFSO P.docx

U.S. Department of Health and Human Services. (2014). Detailed emergency medical services

(EMS) checklist for Ebola preparedness. Retrieved from http://www.cdc.gov/vhf/ebola/pdf/ems-checklist-ebola-preparedness.pdf

U.S. Department of Health and Human Services, National Institutes of Health (2009).

Antimicrobial (Drug) resistance. Retrieved from http://www.niaid.nih.gov/topics/antimicrobialresistance/understanding/pages/drugresistance definition.aspx

U.S. Department of Transportation. (2014). Guidance for transporting Ebola-contaminated items, a category A infectious substance. Retrieved from http://phmsa.dot.gov/hazmat/phmsa-provides-guidance-for-transporting-ebola-contaminated-items

U.S. Department of Transportation, (n.d.). Procedural guidance on the proper packaging of

Ebola suspected waste. Retrieved from http://www.phmsa.dot.gov/pv_obj_cache/pv_obj_id_31B33CF36D39B2AD26122A6F536258 AADEB90100/filename/suspected_ebola_patient_packaging_guidance_final.pdf

U.S. National Library of Medicine. National Institutes of Health. (January 12, 2015). Reportable diseases. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/001929.htm

World Health Organization. (2014). Infection prevention and control of epidemic- and pandemic-prone acute respiratory infections in health care. Retrieved from http://apps.who.int/iris/bitstream/10665/112656/1/9789241507134_eng.pdf?ua=1

World Health Organization, Infection Prevention and Control (2014). Interim infection prevention and control guidance for care of patients with suspected or confirmed filovirus hemorrhagic fever in health-care settings, with focus on Ebola. Retrieved from http://apps.who.int/iris/bitstream/10665/130596/1/WHO_HIS_SDS_2014.4_eng.pdf

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Unit of

Measure Unit of Issue

None

Consumables

Item Quantity Unit of

Measure Unit of Issue

None

Agent

Description Quantity Unit of

Measure Unit of Issue

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Number: Experiential Learning Activity 2

Title: Exercise 1: Infectious Disease Patient Management

Total Time: 1 hour and 30 minutes

Instructional Methods

Method Time Instructor to Student Ratio Practical Application 1 hour 3:24 Guided Discussion 30 minutes 3:24

Purpose. A practical exercise that requires the triage, initial treatment, and safe transfer to an isolation ward room for a patient with a highly infectious disease that requires airborne barrier precautions and infection control procedures.

barriers and guidelines in accordance with Centers for Disease Control and Prevention and Occupational Safety and Health Administration. (HC-0001)

(2) Given a patient with an infectious disease, manage a patient with an infectious disease by ensuring conformance with infection control barriers and guidelines and preventing contamination of others. (HC-0005)

(3) Given access to personal protective equipment and a patient history and symptoms and/or diagnosis, select and don personal protective equipment required to protect against infection in accordance with Centers for Disease Control and Prevention and Occupational Safety and Health Administration. (HC-0015)

(4) After interaction with a person with an infectious disease and while wearing personal protective equipment, doff personal protective equipment in accordance with Centers for Disease Control and Prevention and Occupational Safety and Health Administration. (HC-0020)

(5) Given appropriate handling and waste disposal equipment and materials, handle infectious and/or hazardous waste in accordance with Centers for Disease Control and Prevention and Occupational Safety and Health Administration. (HC-0030)

(6) Given appropriate disinfection equipment and materials, disinfect patient treatment area and equipment in accordance with Centers for Disease Control and Prevention and Occupational Safety and Health Administration. (HC-0035)

b. Enabling Learning Objectives

(1) Given an infectious disease, identify the mode of infectious agent transmission in

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(2) Identify standard barrier precautions and associated procedures in accordance with the Centers for Disease Control and Prevention. (HC-0001c)

(3) Identify airborne barrier precautions and associated procedures in accordance with the Centers for Disease Control and Prevention. (HC-0001d)

(4) Given an N95 respirator, identify the requirement for an N95 respirator in accordance with the Centers for Disease Control and the Occupational Safety and Health Administration. (HC-0015a)

(5) Given an N95 respirator, don and doff an N95 respirator in accordance with the

Centers for Disease Control and the Occupational Safety and Health Administration.

(HC-0015b)

(6) Given a highly infectious disease patient scenario, determine airborne infection

Control and Prevention Guidelines for Environmental Infection Control in Health-Care Facilities. (HC-0005c)

(7) Given a highly infectious disease patient scenario, determine patient flow for

(8) Given a patient scenario requiring infectious disease reporting, determine infectious

(9) Given a situation, identify the requirement and procedures for handling and preparing infectious waste in accordance with the Centers for Disease Control and Prevention and U.S. Department of Transportation Hazardous Materials Regulations. (HC- 0030a)

(10) Given a highly infectious disease patient scenario, determine the requirement and

a. Practical Application. The instructional staff divides the class into three groups based upon their assessment of student backgrounds and skills. Each group is assigned to an instructor. The assigned instructor introduces the group to the situation and allows the group to determine required barrier precaution and infection control procedures given the patients symptoms and history. The group must receive the patient, conduct triage, provide initial treatment as necessary, transfer the patient to the isolation ward, and establish the patient in an isolation ward room for observation and treatment while observing all barrier precautions and infection control procedures and best practices. The assigned instructor provides students guidance, as appropriate, to ensure completion of

HID POI 1.0 27

essential procedures within the designated timeframe and records group performance on the appropriate performance checklists.

b. Guided Discussion. At the conclusion of practical application, the assigned instructor conducts a review of group performance using the observations recorded in the performance checklists. Once all groups have completed their review, the instructional staff conducts a comprehensive review of group performance with the class to reinforce key considerations and best practice procedures.

Risk Assessment: Moderate

Centers for Disease Control and Prevention. (2005a). Additional frequently asked questions

(FAQ) for clarification of recommendations in the “Guidelines for preventing the transmission of mycobacterium tuberculosis in health-care settings, 2005.” Retrieved from http://www.cdc.gov/tb/publications/guidelines/pdf/additionalfaqs.pdf http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf

Centers for Disease Control and Prevention. (2003a). Guidelines for environmental infection

Centers for Disease Control and Prevention. (2005b). Guidelines for preventing the transmission of M. tuberculosis in health-care settings. Retrieved from

Centers for Disease Control and Prevention. (1992a). MMWR management of persons exposed to multidrug-resistant tuberculosis. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/00031296.htm

Centers for Disease Control and Prevention. (1992b). MMWR national action plan to combat multidrug-resistant tuberculosis. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/00031159.htm

Centers for Disease Control and Prevention. (2003b). MMWR treatment of tuberculosis.

Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htm

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Centers for Disease Control and Prevention. (2014n). National Notifiable Diseases Surveillance System (NNDSS). Retrieved from http://www.cdc.gov/nndss/

Laboratory. (2014). Considerations for selecting protective clothing used in healthcare for

U.S. National Library of Medicine. National Institutes of Health. (2015, January 12). Reportable

World Health Organization. (2014). Infection prevention and control of epidemic- and pandemic-prone acute respiratory infections in health care. Retrieved from http://apps.who.int/iris/bitstream/10665/112656/1/9789241507134_eng.pdf?ua=1

Hospital emergency room Emergency room entrance and designated treatment areas

Hospital isolation ward Entire isolation ward 1

Instructor and Training Support Personnel Description Special Qualifications Quantity

Role player None 3

Unit of

Measure Unit of Issue

Gurney 3 Each Class Gurney linen 3 Sets Class

Consumables

Unit of

Measure Unit of Issue

Boot covers, fluid resistant or impermeable, single use 1 Pair Student Central line, triple lumen 3 Each Class Face shield, single use or reusable 1 Each Student Gloves, vinyl or nitrile 1 Pair Student Gown, fluid resistant or impermeable, single use 1 Each Student Hair cover, fluid resistant or impermeable, single use 1 Each Student IV bag 6 Each Class IV sets 6 Each Class Mask, surgical 3 Each Class N95 respirator 1 Each Student N95 respirator 3 Each Class

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Unit of

Measure Unit of Issue

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Number: Experiential Learning Activity 3

Title: Barrier Precaution Demonstrations

Total Time: 1 hour

Instructional Methods

Method Time Instructor to Student Ratio Demonstration 45 minutes 3:24

Purpose. A demonstration of the procedures for performing fit testing of an N95 respirator and donning and doffing of Ebola Virus Disease/viral Hemorrhagic Fever PPE.

(1) Given access to personal protective equipment and a patient history and symptoms

(2) After interaction with a person with an infectious disease and while wearing personal

(1) Identify the requirement for an N95 respirator in accordance with the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration. (HC-0015a)

(2) Don and doff an N95 respirator in accordance with the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration. (HC-0015b)

(3) Identify the procedures for qualitative fit testing for an N95 respirator in accordance with the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration. (HC-0015c)

(4) Identify required materials, equipment, and procedures for donning personal protective equipment for care of an Ebola Virus Disease or Viral Hemorrhagic Fever patient in accordance with Centers for Disease Control and Prevention. (HC-0015d)

(5) Identify required materials, equipment, and procedures for doffing personal protective equipment for care of an Ebola Virus Disease or Viral Hemorrhagic Fever patient in accordance with Centers for Disease Control and Prevention. (HC-0020a)

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Concept for Instruction. The instructional staff performs each of the following activities:

Activity Title (In order of execution) Time Activity 1: N95 Fit Testing Demonstration 20 minutes Activity 2: Maximum Barrier Precautions PPE Donning and Doffing Demonstration 40 minutes

a. Demonstration

(1) Activity 1: N95 Fit Testing Demonstration. One instructor narrates the procedure for the class and directs the actions of the demonstrators in accordance with the experiential learning guide. The other two instructors demonstrate the fit testing procedure by serve as the fit tester and the person being fitted.

(2) Activity 2: Maximum Barrier Precautions PPE Donning and Doffing Demonstration.

One instructor narrates the procedures for the class and serves as the trained observer; one instructor dons and doffs the PPE in accordance with the instructions from the trained observer; and the third instructor servers as the assistant during the demonstration of the doffing procedures. The assistant aids the person doffing in the disinfection and removal of PPE items as required. The trained observer and assistant must be in the appropriate PPE during demonstration of doffing procedures.

b. Guided Discussion. At the conclusion of each activity, the lead instructor conducts a brief review and solicits and responds to student questions.

Centers for Disease Control and Prevention. (2014f). Ebola: Personal protective equipment

Centers for Disease Control and Prevention. (2014o). Recommended guidance for extended use and limited reuse of N95 filtering facepiece respirators in healthcare settings. Retrieved from http://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html

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Kansas Department of Health. (n.d.). Fit testing procedures for N95 respirators using 3M FT-30, Bitter Fit test equipment. Retrieved from http://www.kdheks.gov/cphp/download/Fit_Test_Pro_for_N95_R.pdf

Indoor training area Space to accommodate the enrolled class size and the demonstration of N95 fit testing and donning and doffing of maximum barrier precautions PPE

Unit of

Measure Unit of Issue

Chair, plastic, capable of being disinfected 2 Each Class Clipboard 1 Each Class Container with lid, hard plastic, large enough to store powered air purifying respirator unit with hose

1 Each Class

Hand sanitizer, automatic dispenser 1 Each Class N95 respirator qualitative fit testing kit 1 Each Class Powered air purifying respirator, biological 1 Each Class Table, plastic top, capable of being disinfected 1 Each Class Trash receptacle, bio-hazard 1 Each Class

Unit of

Measure Unit of Issue

Apron, fluid…