Health workers handed Ebola checklist

Auckland Hospital staff are being trained in how to carefully protect themselves when dealing with infectious diseases like Ebola. Photo / Michael Craig

Auckland Hospital has devised a 91-point checklist for Ebola safety.

As the disease continues to threaten to spread from West Africa, where it is estimated to have killed nearly 5000 people, New Zealand's health authorities are taking the threat of an outbreak here seriously.

The 91-point checklist for health workers has precise instructions on how and when to put on gloves, when to clean hands and at what stage to don hoods and safety goggles.

The protective outfit consists of socks, shoe covers, a chemical protection suit, a mask, eye glasses, a full face shield and a box of gloves.

Unlike the equipment used by most healthcare workers in West Africa, everything except rubber clogs is disposable, removing the risk associated with cleaning.

Three people are involved with the process: a healthcare worker who will enter the isolation area, an assistant who helps to put on and take off the outfit, and a team leader who reads through the checklist to ensure nothing has been left out.

The assistant must also wear a protective outfit in case the healthcare worker's suit becomes contaminated.

The process begins with the team leader asking whether anyone wants to go to the toilet - it could be a long time until they get to use it again. The exhaustive process then continues. "Perform hand hygiene. Put socks on and tuck scrubs into socks. Put on shoe covers. Bring ties to the front and tie with a loose bow. DO NOT double knot." And so on.

Once the process has been completed and the assistant has also put on his or her protective gear, the risky business of taking off the outfit commences.

"That's when the gear will have become potentially contaminated and it could be any part of the outside so that's why we need another person," Auckland District Health Board intensive care specialist Dr Colin McArthur said.

"We have concluded it's not possible to take it off yourself without potentially contaminating yourself and that's where we suspect many of the healthcare workers overseas have got into trouble."

The cost of one set of personal protective equipment was $21.56, he said. However, a new set was required each time someone entered the room so it was expected the daily cost per patient would be between $250 and $350 to cover the different staff involved and the need for breaks and staff changes.

Auckland Hospital's infection control staff aim to train about 80 doctors and nurses in the process as well as a further 30 to 40 trainers.

McArthur said even if it was never used for Ebola patients, it could prove invaluable in treating patients with other infectious diseases.

Since August 10 about 60 people entering New Zealand have been screened for the virus.