Tuesday, August 18, 2009
Preparing for Flu
The hospitals I work in are gearing up for the flu season. The H1N1 (Swine) flu is on everyone's radar and we just don't know if we will be slammed with patients. Preparedness is the name of the game and nurses, doctors, infection control experts and risk managers are coming together to make sure policies and protocols are in place before we are hit with emergencies.
Here is what we know now. H1N1 flu is still present across the globe and in the United States, 477 deaths have been reported. This is not unlike regular flu. We do know that this strain is especially virulent in pregnant women and hospitals are particularly concerned about protecting them from infection.
The instant screening tests (rapid influenza diagnostic tests) are not able to distinguish novel H1N1 flu from other seasonal flu, nor can they provide information about sensitivity to drugs. The tests for confirming H1N1 flu take weeks and are not readily available in clinics or hospitals.
Hospital employees who are in contact with patients who have flu are expected to wear a special "fit mask" and if they have unprotected close contact with a patient suspected of H1N1 flu, that employee is to take prophylactic medication (Tamiflu) or be off work for 7 days.
We are trying to decide if all visitors to patients hospitalized with flu should be limited. I believe our first duty is to the patient and to keeping other patients and employees safe. For that reason, if a person is sick enough to be in the hospital with flu, I believe all visitors should be screened and limited. That policy has not yet been codified.
If a flu epidemic does manifest this fall, we will likely set up triage areas to keep suspected sick people away from the emergency department and other areas of the hospital. If there is a surge, how should screening of asymptomatic visitors at hospital entry be handled? If a large percentage of employees cannot come to work, how will the hospitals function?
We are still meeting to decide the answers and provide the best patient safety and care for influenza.
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