Pandemic Influenza Plan - Questar III

Section 4: Infection Control
should be addressed when developing a facility-specific cohorting plan for the LTCF
setting:
• Assess units that can easily be physically segregated from the rest of the facility,
if possible. Private resident rooms are preferred for an ill or exposed cohort, if
feasible.
• Assess how residents would be able to perform activities of daily living in a
cohort (e.g., eating in rooms, bathing in only cohorted facilities, therapies to be
provided in rooms or in a cohort).
• Assess the numbers of direct patient care and essential ancillary staff that would
need to be available to staff the cohort.
G. Cohorting for LTCFs during a local pandemic
• Cohorting can be a considered control measure for a local pandemic, with
cohorts (symptomatic and asymptomatic) established for all new admissions
into the facility for the duration of incubation period, or illness, if symptomatic.
These cohorts should be established very early in the local pandemic.
• Personnel (clinical and non-clinical) assigned to the cohorts for influenza should
not float to other resident care areas.
• Limit the number of personnel assigned to the pandemic influenza cohort.
Facilities should have the capacity to obtain resident care assignments of the
cohorts for any designated time period for the purpose of an epidemiological
investigation.
• Reinforce adherence to infection control practices (i.e., hand hygiene, standard
precautions) to prevent the transmission of healthcare associated infections
within the cohort.
• Laboratory testing for confirmation is likely to be limited and/or not timely
during a local pandemic, in which case cohorting should be based on having
symptoms consistent with pandemic influenza.
• Personnel who have recovered from pandemic influenza should be prioritized for
the cohort of residents with active known or suspect pandemic influenza.
• If staffing crisis necessitates that HCWs work while ill, they should be placed on
antiviral medication and assigned to the ill cohort of residents (see parts III.C and
D of this section).
H. Nosocomial outbreak management for all influenza pandemic periods
Nosocomial outbreaks of influenza most often occur in residential facilities, and are
rarely reported in acute care facilities. The risk of an outbreak of influenza would
increase if pandemic influenza affected a local community for the following reasons:
• Staff may become exposed in the community or in the facility, and may transmit
infection while incubating or ill;
• During a pandemic, a severe staffing crisis may necessitate ill workers to work
while ill.
February 7, 2006 4-19