In response to a publication by National Nurses United on their website yesterday, Statement by RN’s at Texas Health Presbyterian Hospital as provided to National Nurses United, where a number of allegations were made concerning policies and protocols during the treatment of Thomas Eric Duncan, and the subsequent infections of Nina Pham, hospital officials released the following statement:
Correcting the Record: Facts about Protocols and Equipment at Texas Health Presbyterian Hospital Dallas
National Nurses United recently made allegations regarding the protocols and equipment in place during Thomas Eric Duncan’s treatment at Texas Health Presbyterian Hospital Dallas.
The assertions do not reflect actual facts learned from the medical record and interactions with clinical caregivers. Our hospital followed the Centers for Disease Control (CDC) guidelines and sought additional guidance and clarity.
The following are facts about procedures and protocols in place during Mr. Duncan’s treatment:
- When Mr. Duncan returned to the Emergency Department (ED), he arrived via EMS. He was moved directly to a private room and placed in isolation. THD staff wore the appropriate personal protective equipment (PPE) as recommended by the CDC at the time.
- Regarding the ED tube delivery system utilized during Mr. Duncan’s initial visit, all specimens were placed into closed specimens bags and placed inside a plastic carrier that travel through a pneumatic system. At no time did Mr. Duncan’s specimens leak or spill — either from their bag or their carrier — into the tube system.
- During Mr. Duncan’s second visit, the tube system was not used at all. His specimens were triple-bagged, placed in a container, and placed into a closed transport container and hand-carried to the lab utilizing the buddy system. Additionally, while Mr. Duncan was in the MICU, all lab specimens were hand-carried and sealed per protocol. Routine labs were done in his room via wireless equipment.
- Nurses who interacted with Mr. Duncan wore PPE consistent with the CDC guidelines. Staff had shoe covers, face shields were required, and an N-95 mask was optional — again, consistent with the CDC guidelines at the time.
- When the CDC issued updates, as they did with leg covers, we followed their guidelines.
- When the CDC recommended that nurses wear isolation suits, the nurses raised questions and concerns about the fact that the skin on their neck was exposed. The CDC recommended that they pinch and tape the necks of the gown. Because our nurses continued to be concerned, particularly about removing the tape, we ordered hoods.
- Protective gear followed governing CDC guidelines at the time.
- The CDC classified risk/exposure levels. Nurses who were classified as “no known exposure” or “no risk” were allowed to treat other patients per the CDC guidance.
- Per the CDC guidelines, patients who may have been exposed were always housed or isolated per the CDC guidance.
- Regarding hazardous waste, the hospital went above and beyond the CDC recommendations. Waste was well-contained in accordance with standards, and it was located in safe and containable locations.
- Admittedly, when we received Tyvek suits, some were too large. We have since received smaller sizes, but it is possible that nurses used tape to cinch the suits for a better fit.
According to an employee satisfaction survey by Press Ganey, Texas Health Dallas is in the top one percent in the country when it comes to employee engagement and partnership. We support the tireless and selfless dedication of our nurses and physicians, and we hope these facts clarify inaccuracies recently reported in the media.