Pandemic Influenza Plan - Questar III

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Section 4: Infection Control o Assess compliance with daily and discharge cleaning by identifying a person(s) in the facility to perform daily rounds to inspect cleanliness. o Assuring the product used for daily routine and discharge cleaning of patient areas is an Environmental Protection Agency (EPA) registered low- or intermediate-level disinfectant and it is used as per the manufacturer’s instructions. o See CDC Guideline for Environmental Control in Health-Care Facilities, 2003 (http://cdc.gov/ncidod/hip/enviro/guide.htm) for specific guidance for maintaining a safe environment for patients. B. Management of infectious/potentially infectious patients Respiratory hygiene/cough etiquette detailed below should be utilized at all times, yearround, in all healthcare settings and points of entry into the healthcare delivery system (e.g., emergency departments, admissions department, outpatient clinics, physician offices). Key points for successful implementation of respiratory hygiene/cough etiquette include: • Early detection of patients with respiratory symptoms can take place at triage areas, reception areas or during the scheduling of appointments. • Health care providers and non-licensed personnel will play an important role in early identification and should all be familiar with and incorporate respiratory hygiene/cough etiquette into their practice. Respiratory Hygiene/Cough Etiquette • Provide surgical masks to all patients with symptoms of a respiratory illness. Provide instructions on the proper use and disposal of masks. • For patients who cannot wear a surgical mask, provide tissues and instructions on when to use them (i.e., when coughing, sneezing, or controlling nasal secretions), how and where to dispose of them, and the importance of hand hygiene after handling this material. • Provide hand hygiene materials in waiting room and common areas, and encourage patients with respiratory symptoms to perform hand hygiene. • Designate an area in waiting rooms where patients with respiratory symptoms can be segregated (ideally by at least 3 feet) from other patients. • Place patients with respiratory symptoms in a private room or cubicle as soon as possible for further evaluation. • Implement use of surgical or procedure masks and gloves by healthcare personnel during the evaluation of patients with respiratory symptoms. • Consider the installation of plexiglass barriers at the point of triage or registration to protect healthcare personnel from contact with respiratory droplets. • If no barriers are present, instruct registration and triage staff to remain at least 3 feet from unmasked patients and perform frequent hand hygiene. February 7, 2006 4-6
Section 4: Infection Control Droplet precautions and patient placement Patients with known or suspected pandemic influenza should be placed on droplet precautions for the duration of their illness, and a minimum of 5 days from the onset of symptoms (note: the infectious period is under discussion with the CDC). Refer to the following CDC Website for a detailed explanation of droplet precautions: (http://www.cdc.gov/ncidod/dhqp/gl_isolation_droplet.html), which include: • Donning a surgical or procedural mask upon room entry. The practice of donning a mask upon room entry (as opposed to within 3 feet) may increase compliance and prevent unnecessary exposures. • Discard the mask after leaving the patient room. If the healthcare worker is attending multiple patients in the same room (e.g., in a cohort situation), the same mask may be utilized until the healthcare worker leaves the room. • Hand hygiene must be performed after each patient encounter (see CDC Hand Hygiene Guidelines: http://www.cdc.gov/ncidod/dhqp/gl_handhygiene.html ). • Place patient in a private room, if feasible. Patients may be cohorted if necessary. As patients may be infected with different strains of influenza virus or other infectious agents, care must be taken to prevent transmission within the cohort (i.e., spatial separation of at least 3 feet). See settingspecific cohorting sections of this document for recommendations on establishing and implementing cohorts in the hospital and long-term care settings. Aerosol-generating procedures for patients with pandemic influenza Aerosol-generating procedures (e.g., endotracheal intubation/extubation, suctioning, nebulizer treatments, and bronchoscopy) may increase the potential for dissemination of droplet nuclei in the immediate vicinity of the patient. Therefore, healthcare workers should wear the following personal protective equipment (PPE) when performing aerosol-generating procedures on patients with suspected, or known to be infected with, pandemic influenza: • Gloves • Gown • Face/eye protection • N95 respirator or other appropriate particulate respirator o Respirators should be used within the context of a respiratory protection program that includes fit-testing, medical clearance, and training. Additional work practice controls may further reduce transmission during an aerosolgenerating procedure, and should be implemented for patients with suspected or confirmed pandemic influenza: • Limit the numbers of HCWs present during the procedure to essential staff only. • Utilize closed systems for suctioning to prevent splattering/spraying of potentially infectious secretions. February 7, 2006 4-7
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February206 Pandemic Plan NewYorkSt
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Introduction Pandemic influenza occ
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example, at this time, it is realis
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Acronyms (cont.) IND IHANS IRB ISHS
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Section 1: Command and Control I. O
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Section 1: Command and Control pers
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February 7, 2006 Appendix 1-A
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Appendix 1-B The Public Health Law
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Appendix 1-B communicable diseases
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Appendix 1-C Management Office or t
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Appendix 1-E Suspension of Public M
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Appendix 1-G A Guide to New York St
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Appendix 1-G health commissioner. P
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Appendix 1-G 8. State Institutions
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Appendix 1-G b. Governor May Invoke
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Appendix 1-G may direct, pursuant t
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Appendix 1-G c. Commissioner of Gen
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Appendix 1-G Designation of emergen
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Appendix 1-G physician’s assistan
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Appendix 1-H Summary of Public Offi
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Section 2: Surveillance and Laborat
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Appendix 2-A • Surveillance Crite
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Appendix 2-A • In New York City,
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NYSDOH Novel Influenza Case Report
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Appendix 2-C to health care provide
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Virus Detection History NYS Lab Num
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Section 3: Healthcare Planning and
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Appendix 5-D handling soiled laundr
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DRAFT Appendix 5-E Footnotes to App
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Appendix 5-F February 7, 2006 1
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Appendix 5-F 7. Guidance on the eva
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Appendix 5-H Source: U.S. Departmen
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February 7, 2006 2 Appendix 5-I
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Appendix 5-J Clinical Presentation
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Appendix 5-J diabetes mellitus), re
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Appendix 5-J resistant S. aureus (M
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Appendix 5-K eight patients—all o
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Appendix 5-L Guidelines for Managem
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Appendix 5-L testing should be perf
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Appendix 5-L February 7, 2006 5
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Section 6: Vaccine Procurement, Dis
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Appendix 6-A Vaccine Priority Group
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Appendix 6-B Mass Clinic Planning O
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Appendix 6-C Vaccine and Antiviral
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Appendix 6-C 1. Request Phase The r
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Appendix 6-C 3. Receipt and Sign-of
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Appendix 6-C • Work with local he
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Section 7: Antiviral Medication Pro
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Appendix 7-A Characteristics of Ant
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Appendix 7-B a The drug package ins
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Appendix 7-C 7 HCWs in emergency de
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Section 8: Travel-Related Disease C
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Appendix 8-A Home or Community-Base
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Appendix 8-B Contact Identification
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Appendix 8-B • Determine the time
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Appendix 8-C Administrative Data: S
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Appendix 8-D CONTACT DAILY TEMPERAT
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Appendix 8-F Definitions: Intervent
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Appendix 8-F facility. No specific
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Appendix 8-F • Resources Required
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Appendix 8-G Business Pandemic Infl
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Appendix 8-G 4. Allocate resources
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Appendix 8-H CDC guidelines suggest
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Appendix 8-H If I am not masked I
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Appendix 8-H NYSDOH Model Influenza
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Appendix 8-H I understand that if
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Section 9: Communications I. Overvi
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Section 9: Communications and commu
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Section 9: Communications web pages
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Section 9: Communications Local Hea
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Section 9: Communications • A JIC
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Section 9: Communications backup to
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Section 9: Communications • In th
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Appendix 9-A Public Health Risk Com
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Appendix 9-C New York State Departm
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Appendix 9-C PRE-EVENT MESSAGE MAP:
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Appendix 9-C PROTECTIVE MESSAGE MAP
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Appendix 9-C TREATMENT MESSAGE MAP:
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Appendix 9-C BUSINESS CONTINUITY PR
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Section 10: Training and Education
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Appendix 10-A NYSDOH STAFF PRIVATE
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FACILITY- BASED RNs FACILITY- BASED
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Section 11: Workforce Support I. Ov
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Section 11: Workforce Support Pande
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Section 12: Highly Pathogenic H5N1
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Section 12: H5N1 in Non-Human Anima
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Section 13: Public Health Preparedn
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Appendix 13-A NYSDOH Roles Notified
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Appendix 13-B Notifications sent by
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Appendix 13-B HAN posting is used a
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Appendix 13-B notification system t
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Appendix 13-C Overview of the Healt
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Appendix 13-C • Ongoing surveilla
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Table 1. Summary of HERDS Use To da
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Appendix 13-D Commerce Access and A
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Appendix 13-D Table 3. Organization
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Pandemic Influenza Plan - Questar III

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