Pandemic Influenza Plan - Questar III

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Section 3: Healthcare Planning and Emergency Response E. Emergency Medical Services Pandemic influenza will increase the need for EMS activity. EMS activity will be impacted by an increased number of persons requesting care, expansion in triage activity and especially the opening of alternative treatment centers and inter-facility patient transfer. As a healthcare sector that provides direct patient care, effective infection control will be critical to preserving EMS capacity and slowing the spread of influenza in the community. Therefore, EMS agencies must reinforce infection control practices including promoting annual influenza vaccination and the proper use of PPE. They must also develop plans to rapidly immunize direct care workers and key ancillary staff and distribute antivirals should they be made available. Communication will also be a key factor both in preparation for and in response during a pandemic. Agencies must ensure that they have strong communication links with the county EMS Coordinator who will be working closely with the LHD, County OEM and the NYSDOH. F. Non-Traditional Triage and Alternative Care Sites If an influenza pandemic causes severe illness in large numbers of people, hospital and clinic capacity might be overwhelmed. In that case, non-traditional alternative sites for triage/ patient care may need to be established (e.g., school gymnasiums, armories, church halls). While it may not be desirable to provide care and treatment of influenza patients in a site not normally used for providing medical care, it may be necessary during a pandemic. Establishing triage/treatment facilities in non-traditional sites is a significant task requiring resolution of numerous issues including who specifically will have legal responsibility for operating the site and how will it be supervised, staffed, supplied and equipped. It is likely that hospitals will be fully occupied with keeping sufficient healthy staff, equipment and supplies and maintaining their own facilities to meet the demands of the patients within their own institution. Local communities (LHDs, Emergency Managers, EMS) should plan for possible rapid development of alternative care sites using healthcare personnel willing to volunteer but not currently working in a hospital. Advance planning for and staff training on triage/treatment protocols, patient separation, patient flow and infection control procedures must occur. The site selected for a treatment facility must accommodate the following infection control and patient care needs: • Bed capacity and spatial separation of patients • Facilities and supplies for hand hygiene • Lavatory and shower capacity for large numbers of patients • Food services (refrigeration, food handling, and preparation) • Medical services • Staffing for patient care and support services February 7, 2006 3-19
Section 3: Healthcare Planning and Emergency Response • PPE supplies • Cleaning/disinfection supplies • Environmental services (linen, laundry, waste) • Safety and security. The success of even the best planned non-traditional triage and/or treatment site will hinge on the effective use of public service announcements that clearly explain the rationale for and the advantages of using the site to the community. V. General Considerations A. Infection Control Adherence to basic infection control principles is paramount to containing the spread of influenza within facilities to healthcare workers and other patients. It may be assumed that there will be a limited supply, if any, of vaccine and antivirals. Therefore, infection control becomes even more important. These infection control principles include the early identification of potentially infectious patients and the immediate implementation of control measures for containment. Respiratory hygiene/cough etiquette should be utilized at all times, in all health care settings and points of entry into the healthcare system. Section 4, Infection Control, is provided to assist healthcare facilities in planning for pandemic influenza and enhancement of infection control precautions according to the current global and local epidemiology of influenza. Infection control guidelines, including standard and droplet precautions, respiratory hygiene/cough etiquette, and hand hygiene are provided for all types of health care facilities and providers. The guidelines are specified for patients, employees, and visitors. Specific strategies for hospital triage and admission that minimize the risk of transmission are described. Patients with known or suspected pandemic influenza should be placed on Standard and Droplet Precautions (use of surgical mask for the patient, spatial separation of 3 feet, private room or cohort) for the duration of their illness. Patient transport and movement should be limited to essential purposes only. If transport or movement is necessary, patients should be masked. Contact Precautions should be added if the patient has diarrhea. During aerosol-generating procedures, gloves, gowns, face/eye protection and an N95 (fit-tested) or other appropriate respirator should be worn by health care workers. The patient should also be placed in an Airborne Infection Isolation Room (AIIR). Additional work practice controls are summarized in Section 4: Infection Control. Nosocomial outbreaks of influenza most often occur in residential facilities and are less commonly reported in acute care facilities. The risk of a nosocomial outbreak of influenza would increase if an influenza pandemic affected a local community for the following reasons: February 7, 2006 3-20
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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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Section 4: Infection Control Policy
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Section 4: Infection Control o Staf
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Section 4: Infection Control • De
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Section 4: Infection Control • Pr
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Section 4: Infection Control The ma
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Section 4: Infection Control • Up
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Section 4: Infection Control Health
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Appendix 4-A Soiled linen and laund
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Appendix 4-B Respiratory Hygiene/Co
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Section 5: Clinical Guidelines I. O
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Section 5: Clinical Guidelines incu
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Section 5: Clinical Guidelines 1) N
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Section 5: Clinical Guidelines infe
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Section 5: Clinical Guidelines Alth
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Section 5: Clinical Guidelines Infe
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Section 5: Clinical Guidelines •
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Appendix 5-B Clinical Evaluation of
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Appendix 5-C Special Situations 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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