{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:07:04Z","timestamp":1763017624925},"reference-count":25,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2016,3,4]],"date-time":"2016-03-04T00:00:00Z","timestamp":1457049600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1935789316000021_abs1\" sec-type=\"general\"><jats:title>Objective<\/jats:title><jats:p>The 2014 Ebola virus disease (EVD) outbreak in West Africa remains the most deadly in history. Emergency departments (EDs) are more likely to come into contact with potential EVD patients. It is important for EDs to be prepared to care for suspected EVD patients. Our objective was to understand the perceived challenges experienced by Washington State ED medical directors in EVD preparedness.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789316000021_abs2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>An anonymous, electronic survey was sent to a convenience sample of ED medical directors across Washington State between November and February of 2014\u20132015. The perceived challenges of and attitudes toward EVD preparations were assessed and reported as stratified proportions.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789316000021_abs3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Of 85 medical directors contacted, 59 responses (69%) were received. This included EDs with annual patient volumes of &lt;20,000 (20 hospitals, 34%), 20,000 to 40,000 (21 hospitals, 36%), 41,000 to 60,000 (4 hospitals, 6.8%), and &gt;60,000 (12 hospitals, 20%). Among the perceived challenges in EVD preparations were spatial modifications (eg, building an anteroom for donning and doffing of personal protective equipment) and waste management planning. Ninety-five percent of respondents moderately or strongly agreed that it is important to have a predesignated hospital to care for EVD patients.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789316000021_abs4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Washington State ED medical directors have faced significant challenges in ensuring their EDs are prepared to safely care for suspected EVD patients. Attitudes toward EVD preparations are mixed. Varying levels of perceived importance may represent an additional barrier to statewide EVD preparedness. (<jats:italic>Disaster Med Public Health Preparedness<\/jats:italic>. 2016;10:662\u2013668)<\/jats:p><\/jats:sec>","DOI":"10.1017\/dmp.2016.2","type":"journal-article","created":{"date-parts":[[2016,3,4]],"date-time":"2016-03-04T10:24:51Z","timestamp":1457087091000},"page":"662-668","source":"Crossref","is-referenced-by-count":10,"title":["Survey of Ebola Preparedness in Washington State Emergency Departments"],"prefix":"10.1017","volume":"10","author":[{"given":"C. Hayes","family":"Wong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Stern","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven H.","family":"Mitchell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2016,3,4]]},"reference":[{"key":"S1935789316000021_ref21","unstructured":"Ebola Preparedness Continues in Washington Hospitals. Washington State Department of Health website. http:\/\/www.doh.wa.gov\/Newsroom\/2014NewsReleases\/14170WashingtonEbolaPreparednessContinues. Published November 17, 2014. Accessed April 15, 2015."},{"key":"S1935789316000021_ref16","first-page":"95","article-title":"Pandemic influenza and major disease outbreak preparedness in US emergency departments: a selected survey of emergency health professionals","volume":"6","author":"Morton","year":"2011","journal-title":"Am J Disaster Med"},{"key":"S1935789316000021_ref5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g6200"},{"key":"S1935789316000021_ref24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe1411471"},{"key":"S1935789316000021_ref19","unstructured":"Interim Guidance for U.S. Hospital Preparedness for Patients Under Investigation (PUIs) or With Confirmed Ebola Virus Disease (EVD): A Framework for a Tiered Approach. Centers for Disease Control and Prevention website. http:\/\/www.cdc.gov\/vhf\/ebola\/healthcare-us\/preparing\/hospitals.html. Last updated August 28, 2015. Accessed March 11, 2015."},{"key":"S1935789316000021_ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1409858"},{"key":"S1935789316000021_ref11","unstructured":"Nurses\u2019 union: Dallas hospital lacked Ebola protocols. CBS\/AP. http:\/\/www.cbsnews.com\/news\/nurses-union-dallas-hospital-lacked-ebola-protocols\/. Published October 14, 2014. Accessed February 15, 2016."},{"key":"S1935789316000021_ref8","unstructured":"Rural Health: Designated Critical Access Hospitals. Washington State Department of Health website. http:\/\/www.doh.wa.gov\/ForPublicHealthandHealthcareProviders\/RuralHealth\/HealthcareFacilityResources\/CriticalAccessHospitals\/DesignatedCriticalAccessHospitals. Accessed June 7, 2015."},{"key":"S1935789316000021_ref7","unstructured":"Hospitals by County, Washington State Hospital Association website. http:\/\/www.wsha.org\/. Accessed June 7, 2015."},{"key":"S1935789316000021_ref18","first-page":"A15","article-title":"Channeling, high-level biocontainment and research","volume":"65","author":"Millard","journal-title":"Ann Emerg Med"},{"key":"S1935789316000021_ref23","unstructured":"Code of Ethics for Emergency Physicians. American College of Emergency Physicians website. https:\/\/www.acep.org\/Clinical---Practice-Management\/Code-of-Ethics-for-Emergency-Physicians\/. Revised June 2008. Accessed May 10, 2015."},{"key":"S1935789316000021_ref10","unstructured":"Doughton S . Survey: state\u2019s nurses uneasy about Ebola preparedness. Seattle Times. http:\/\/www.seattletimes.com\/seattle-news\/survey-statersquos-nurses-uneasy-about-ebola-preparedness\/. Published October 13, 2014. Accessed May 9, 2015."},{"key":"S1935789316000021_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"S1935789316000021_ref25","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2014.9.24011"},{"key":"S1935789316000021_ref15","first-page":"A15","article-title":"Ebola preparedness: on avoiding making a scary virus scarier","volume":"65","author":"Millard","year":"2015","journal-title":"Ann Emerg Med"},{"key":"S1935789316000021_ref12","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12661"},{"key":"S1935789316000021_ref1","unstructured":"Ebola Situation Report - 15 April 2015. World Health Organization website. http:\/\/apps.who.int\/ebola\/current-situation\/ebola-situation-report-15-april-2015. Published April 15, 2015. Accessed April 15, 2015."},{"key":"S1935789316000021_ref13","unstructured":"Fox J , Bornstein B , Grant S . Emory Healthcare Ebola Preparedness Protocols. Emory Healthcare. http:\/\/www.emoryhealthcare.org\/ebola-protocol\/ehc-message.html. Accessed May 5, 2015."},{"key":"S1935789316000021_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2014.10.009"},{"key":"S1935789316000021_ref20","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES2014.19.48.20980"},{"key":"S1935789316000021_ref2","unstructured":"Statement on the 1st meeting of the IHR Emergency Committee on the 2014 Ebola outbreak in West Africa. World Health Organization website. http:\/\/www.who.int\/mediacentre\/news\/statements\/2014\/ebola-20140808\/en\/. Published August 8, 2014. Accessed April 14, 2015."},{"key":"S1935789316000021_ref22","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12642"},{"key":"S1935789316000021_ref9","unstructured":"Guidance on Personal Protective Equipment (PPE) To Be Used by Healthcare Workers during Management of Patients with Confirmed Ebola or Persons under Investigation (PUIs) for Ebola who are Clinically Unstable or Have Bleeding, Vomiting, or Diarrhea in U.S. Hospitals, Including Procedures for Donning and Doffing PPE. Centers for Disease Control and Prevention website. http:\/\/www.cdc.gov\/vhf\/ebola\/healthcare-us\/ppe\/guidance.html. Version current August 27, 2015. Accessed April 15, 2015."},{"key":"S1935789316000021_ref14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409838"},{"key":"S1935789316000021_ref17","unstructured":"McCabe C , Weaver C . Ebola still weighs on Texas Hospital. Presbyterian sees patient visits decline even as no new cases have emerged. Wall Street Journal. http:\/\/www.wsj.com\/articles\/ebola-still-weighs-on-texas-hospital-1414009789. Published October 22, 2014. 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