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Ebola: new hospital guidelines

November 2014

Published in the November 2014 issue of Today’s Hospitalist

Ebola: guidelines to protect hospital personnel

WITH TWO NURSES HAVING CONTRACTED EBOLA from an index patient in a Texas hospital, the CDC last month issued much more stringent guidelines for personal protective equipment for clinicians treating ebola.

According to the New York Times, the CDC admitted that its previous recommendations were too lax. The revised guidelines now reflect those of Doctors Without Borders, whose volunteers have been treating ebola in West Africa. The new guidelines recommend using full-body suits, rubber aprons, face shields and boots; two sets of gloves for doctors and nurses; working in pairs; and having strict supervision as protective clothing is removed, among other provisions.

The CDC also announced that it will send a rapid response team to any hospital with an ebola diagnosis. And the agency released a PowerPoint with presentations from clinicians at Emory Healthcare and Nebraska Medical Center.

Lessons learned from treating ebola in those hospitals include not only strategies to protect clinicians, but the need for bedside lab testing, how specimens need to be shipped, and how waste and trash need to be disposed.

Payment data: “Dollars for Dudes”

THE LAUNCH THIS FALL of the CMS’ Open Payments Web site revealed that physicians and teaching hospitals were paid $3.5 billion in the last five months of 2013 by pharmaceutical and device manufacturers for consulting, research, travel expenses and royalties. According to HealthLeaders Media, those payments went out to more than 500,000 doctors and more than 1,300 teaching hospitals.

However, a ProPublica analysis of the Open Payments database found that more than 90% of the top 300 physicians with the highest payments were male. That was despite the fact that men made up only two-thirds (68%) of active physicians in 2012.

The analysis noted that 91 internists made the top 300 list; only 12% of those were women. As for the reasons behind that disparity, ProPublica noted that male physicians may be more willing to accept payments, that pharma and device manufacturers may reach out more often to male physicians, or male doctors may have more senior positions that attract industry attention.

The analysis also pointed out that one-third of the payments reported were not identified.