Pandemic Influenza Plan - Questar III

Section 3: Healthcare Planning and Emergency Response
from hospitals; retaining their residents rather than transferring them to the hospital; and
surging beyond their licensed capacity.
Each of these actions, together with a possible significant increase in resident
mortality, could contribute to staff grief and exhaustion. Staff should be
monitored closely for stress and psycho-social intervention should be made available
where indicated.
The following concepts should be reviewed and reinforced with staff:
• information on disease prevention strategies
• infection control techniques
• identification of symptoms to promote early detection and minimize the spread of
disease should be reviewed with staff at all levels.
The nursing home should make arrangements to provide or arrange for immunization of
their patients and staff.
All residents of LTCFs should have Health Care Proxies or End-of-Life decisions
clarified or confirmed as appropriate.
The ultimate impact of a pandemic flu on the nursing home bed supply is uncertain. It
may leave a great number of patients who need either short-term or long-term
rehabilitation and many who may need nursing home care. However, if the influenza
mortality rate is high, the post-pandemic bed need may be less than the number of
available beds.
B. Adult Care Facilities (ACFs)
During a pandemic outbreak all levels of health and residential care facilities will be
affected. Hospitals will be adversely affected due to surging admissions, and capacity
will likely be at a maximum, and staff may be overwhelmed. As a result, nursing homes
will suffer a sizeable ripple effect, necessitating a State level decision to alter standards of
care. This decision to alter standards of care will then affect ACFs.
ACFs will need to generate plans for a pandemic to enhance their ability to retain, and
possibly admit, sicker residents. ACFs will be unable to transfer acutely ill residents to
hospitals or nursing homes, and in addition they may be faced with admitting residents
that they would not care for under standard circumstances.
These conditions, coupled with the real potential for heightened resident mortality, may
intensify staff grief and fatigue. Therefore, staff should be closely monitored for fatigue
and stress, and physical rest, nutrition and hydration should be made available. In
addition, psycho-social intervention should be offered as appropriate and indicated.
ACF staff education should be reviewed and enhanced at all levels to include:
• Information on disease prevention
• Infection control methodology
February 7, 2006 3-16