Worldwide implications of Ebola

Ebola: An International Crisis Ebola Virus * Medical condition * Transmission * Treatment Health Care Workers and Caring for the Infected * Health care in West Africa- Guinea, Liberia, and Sierra Leonne * Nursing * Challenges Global Effects of the Ebola Virus * East Africa * United States The recent (2014) Ebola crisis was “the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined” (World Health Organization, 2015). *Over 27,000 cases have been identified since March of 2014 with close to a 50% mortality rate. Opener

Objectives 1. To identify the origin, signs and symptoms, modes of transmission, and medical treatment of the Ebola virus 2. To understand the challenges of West African that contributed to the 2014 Ebola virus crisis 3. To understand the role of nursing in an Ebola virus outbreak 4. To understand the worldwide inferences, implications, and consequences of the Ebola virus 5. To understand global and national perspectives in facing future Ebola virus outbreaks

West Africa faces the Ebola Crisis West Africa- Guinea, Liberia and Sierra Leone Challenges in the region * Civil war * Poverty * Limited resources * Poor health-care infrastructure “Long before the crisis, access to health services and to safe drinking water and sanitation in West Africa were inadequate. There were marked inequalities between regions, socioeconomic groups and gender” (OXFAM, 2015). West African culture * First Ebola outbreak in this region * International assistance * Rituals of the deceased

International Response the Ebola Outbreak in West Africa The World Health Care Organization (WHO) * Responsibilities * Barriers * Initial response * Declared a “Global Emergency” in August 2014 “In August, the United Nations health agency declared an "international public health emergency", saying that a coordinated response was essential to halt the spread of the virus” (BBC News, 2016). The United States join the Effort * October 2014- 3,000 military members to deploy to West Africa * Non-profit organizations * Two American health care workers diagnosed with Ebola virus * Ebola virus in the United States Response by other Countries * Great Britain, China, and Cuba * Canada and Japan Explain the need for service: Often shelters do little more than provide overnight shelter away from the elements. Most often they will also provide a meal or two. It is also not uncommon for individuals to have to check in and check out every day and night at these shelters. Therefore, a first come first serve relationship with the shelters has been established. More help is needed here in these counties!!! Longer term shelter, basic healthcare, job placement assistance, mental health assistance, and job training are just some of the needs of these counties. **********WE NEED REFERENCE FOR THIS INFORMATION*******

Nursing Implications Nursing Challenges when caring for the Contagious * Fear * Isolation * Quarantines * The American Nurses Association Caring for the Infected in West Africa * Basic nursing care * Skilled nursing care * Limited resources * Unfamiliar environment “Health care workers are undoubtedly at a higher rate of exposure, than those not in contact with an infected patient, owing to the inevitable exposure to a patients’ bodily fluids by patient contact. (Lupton, p. 178, 2015). Prevention * Personal protective equipment * Required skills * Standards of infection prevention and control * Personal health

Root Causes Analysis Factors Contributing to the Largest Ebola Virus Outbreak in History * Regional Influences * Late Identification * Slow Response from WHO * Poor Containment * Limited Resources * No Vaccine or Drug to Treat Ebola Virus

Consequences, Inferences, and Implications to the West African Ebola Outbreak Mortality * Over 27,000 cases diagnosed with close to 50% mortality * Change in family structure * Orphans Social and Economic * Community dynamics * Loss of trust in government and health care agencies * Financial burden * Decrease in local and international trade Mobility * Limited local, national, and international travel * Airport screening * Border screening and closure

Consequences, Inferences, and Implications Continued Stigma of the Ebola Virus Health care * Loss of lives * Loss of trust * Strain on health care structure * Future need of health care providers Nursing * Psychological effects * Frustration * Grief * Guilt and shame * Isolation

Other Perspectives of the Ebola Virus Financial * The financial cost of an Ebola virus outbreak Research * pharmaceuticals Political * Collaborative efforts between countries and international agencies Ethical * Human life

Facing Future Ebola Virus Outbreaks Global Perspective * Education * Health care challenges * Emergency preparedness * Building relationships * Containment Strategies National Perspective * Treatment and vaccines * Evidenced based policy and procedure * Support health care workers

Strategies to Prevent the Spread of the Ebola Virus The CDC recommends: Appropriate and prompt triage protocols to identify and categorize high risk patients Training Healthcare organization to effectively deal with Ebola infected patients. Isolation precautions Trained monitor

Conclusion The devastating effects of an Ebola virus epidemic in any region can be felt worldwide The 2014 West African Ebola epidemic demonstrated challenges that must be addressed to prevent future occurrences Nurses play a critical role in caring for individuals affected by this disease Globally we must share resources to support regions that are affected by the Ebola virus Emergency preparedness and medical research to find a vaccine and treatment for the Ebola virus must be a global priority

References Blackley, D.J., Lindblade, K.A., Kateh, F., Broyles, L.N., Westercamp, M., Neatherlin, J.C., ….Nyenswah., T. (2014). Morbidity and Mortality Weekly Report. Rapid Intervention to Reduce Ebola Transmission in a Remote Village-Gbarpolu County, Liberia, 64, 175-178. Boulton, J. (2015). Ebola revisited: Lessons learned in managing global epidemics. British Journal of Nursing. 24(13). 665-669. Centers for Disease Control and Prevention. (2014). Infection Prevention and Control Recommendations for Hospitalized Patients Under Investigation (PUIs) for Ebola Virus Disease (EVD) in U.S. Hospitals. Retrieved from: http://www.cdc.gov/vhf/ebola /healthcare-us/hospitals/infection-control.html Grim, G. & Nichols, L., M. (May, 2015). Ebola crisis of 2014: Are current strategies enough to meet the long-run challenges ahead? American Journal of Public Health. 105(5) 8-9. Lee-Kwan, S., H., DeLuca, N., Adams, M., Dalling, M., Drevlow, E., Gassma, G., & Davies, T. (December 19, 2014). Support services for survivors of the ebola virus disease- Sierra Leone, 2014. Morbidity and Mortality Weekly Report. 63(50). 1205-1206. Lupton, K (2015). Preparing nurses to work in Ebola treatment centres in Sierra Leone. British Journal of Nursing. 24(3) 168-172.

References McGillis-Hall, L., & Kashin, J. (2016). Public understanding of the role of nurses during ebola. Journal of Nursing Scholarship. 48(1). 91-97. OXFAM International. (2015). Never Again Building resilient health systems and learning from the Ebola crisis. Retrieved from: www.oxfam.org Questions and Answers: 2014 Ebola Outbreak. Retrieved from: http://www.cdc.gov/vhf/ebola/outbreaks/2014-west- africa/qa.html Sunshine, G. Pepin, D., & Penn, M. (October 16, 2015). State and territorial ebola screening, monitoring, and movement policy statements- United States, August 31, 2015. 64(40).1145-1146. Troncoso, A. (2015). Ebola outbreak in West Africa: a neglected tropical disease. Asia Pacific Journal of Tropical Biomedicine, 5(4), 255-259. Retrieved from: www.elsevier.com/ Locate/apjtb World Health Organization. Ebola Virus Disease. (2015). Retrieved from: http://www.who.int/medicacenter/factsheets/fs103/en/