Pandemic Influenza Plan - Questar III

Section 4: Infection Control
C. Infection control measures for hospitalized patients with known or suspected
pandemic influenza for all periods
Patient admission:
• Limit admission of influenza patients to those with severe complications of
influenza who cannot be cared for outside of the hospital setting.
• Place patients with known or suspected pandemic influenza on droplet
precautions for the duration of illness (for a minimum of 5 days after onset), or
until etiology confirmed as not communicable (note: the infectious period is
under discussion with the CDC).
• Admit patients to a single patient room. If numbers of cases exceeds private
room availability, attempt to cohort patients (see cohorting section below).
• Consider an AIIR for patients requiring frequent aerosol-generating procedures
(e.g., frequent deep tracheal suctioning).
D. Cohorting in the hospital setting during all pandemic periods
Cohorting in the hospital setting is indicated when the numbers of patients admitted with
influenza-like illness exceeds the facility’s capacity to isolate patients given their routine
means (i.e., lack of sufficient private rooms), or if there was an uncontrolled nosocomial
outbreak (rare in acute care settings). Utilize the following measures to operationalize
cohorting in a hospital setting:
• Identify an area that the facility could utilize for cohorting patients with pandemic
influenza. Ideally, this area should be comprised of single patient rooms. If this
is not feasible, identify an area that provides the best spatial separation for
patients. Respiratory viruses (e.g., non-pandemic influenza, respiratory syncytial
virus, parainfluenza) or other infectious agents may be circulating concurrently in
the community. Therefore, cohorting of patients should be prioritized as follows:
o Patients with laboratory-confirmed pandemic influenza.
o Suspect pandemic influenza patients with a well established
epidemiological link to a known case (e.g., household member of a case).
o Patients with influenza-like illness (ILI) without a well-established
epidemiological link to a known pandemic influenza case.
• Asymptomatic contacts (i.e., roommates of a pandemic influenza case) should be
monitored closely, and if possible, maintained in a private room for the entire
incubation period and placed on droplet precautions.
• Reinforce adherence to infection control practices (i.e., hand hygiene, standard
precautions) to prevent the transmission of influenza and other healthcare
associated infections within the cohort.
• Personnel (clinical and non-clinical) assigned to cohort unit for pandemic
influenza patients should not float to other patient care areas.
• Limit the number of personnel assigned to the pandemic influenza cohort.
• Facilities should have the capacity to obtain patient care assignments of the
cohorts for any designated time period for the purpose of an epidemiological
investigation.
February 7, 2006 4-12