Pandemic Influenza Plan - Questar III

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Section 3: Healthcare Planning and Emergency Response Funeral firms must also develop a mass fatality plan that reinforces infection control (e.g. vaccination, the proper use of PPE and terminal disinfection procedures) ; identifies additional funeral services resources; and assesses additional equipment and supply needs. Every LHD must work with the county OEM and county Coroner/Medical Examiner to assess current capacities and develop a plan for the care, transportation and disposition of the dead (i.e., mass fatality/mortality) including storage and dispositions that are outside of the current/standard means. The NYSDOH must: • Develop plans to modify the processing of death certificates. • Clearly communicate mortality reporting requirements to hospitals. • Require registrars, medical examiners and coroners to develop emergency staffing plans to handle the anticipated surge in volume during a pandemic. • Coordinate actions with New York City Vital Statistics. D. Altered Standards of Care Current health care standards are based on providing the best possible care for every individual that interfaces with the health care system. These standards are based on the unspoken precepts that the supply of service is essentially unlimited and that all patients, with only a few exceptions, have the right to the best level of care that society can provide, regardless of long term quality of life issues or prognosis. The possibility of the occurrence of pandemic influenza as well as other man made mass casualty situations is forcing society at all levels to re-examine these concepts. The health care system in NYS is operating roughly at 80-95% of full capacity. NYS has roughly 242 hospitals with a total of approximately 62,800 staffed beds. Of these, perhaps 3,000- 12,000 are open for new admissions at any one time. If a severe influenza pandemic were to occur, NYS, with a population of 20 million, could expect over 650,000 hospitalizations over a six week period according to numbers calculated by HHS. The peak surge of the pandemic would likely have over 200,000 weekly hospitalizations according to the same statistics. This assumes an attack rate of 35% with a 3.5% hospitalization rate. It is probable that using current disaster planning models hospitals could further expand their available bed counts by approximately 25-35%, thus making available roughly a total of 18,000 to 33,000 beds for new admissions. It becomes obvious that under these circumstances, our current health care system would be overwhelmed and incapable of meeting demand under our current standards and precepts. The New York State Department of Health will convene an expert panel to develop guidance for hospitals and other healthcare facilities on altered standards of care. This guidance will include discussion of the management of limited staff and material resources, such as ventilators, in the event of a pandemic. February 7, 2006 3-23
Section 3: Healthcare Planning and Emergency Response VI. Activities by Pandemic Period A. Occupational Health Interpandemic and Pandemic Alert Periods Healthcare Providers: • Reinforce infection control education and training of healthcare personnel regardless of the setting (i.e., hospital, long term care facility, home health agency, EMS). • Determine how training and education will be provided for all health care personnel that may be affected by a pandemic influenza outbreak. • Educate healthcare personnel about: o The importance of strict adherence to infection control measures especially hand hygiene. o Standard and transmission-based precautions, and respiratory hygiene /cough etiquette. o Avoidance of hand to mucous membrane contact (eyes, nose, mouth, etc.), regardless of glove use. o Influenza, including the signs and symptoms, epidemiology, and transmission. Include the enhanced risk of transmission involved with procedures that produce aerosols (e.g., bronchoscopy, intubation/extubation, nebulized respiratory treatments, and deep tracheal suctioning). o On the proper use of personal protective equipment (PPE) as per Standard and Transmission-based Precautions, including donning, removing and disposing of PPE (see Section 4: Infection Control). http://www.cdc.gov/ncidod/hip/ppe/default.htm • Develop work restriction policies and ensure staff members receive education and training on these policies. • Develop a strategy for regularly updating clinicians, direct patient care staff and screening/triage staff on the current status of influenza. • Develop a plan to provide for the physical needs at work (food, rest during prolonged shifts, recuperation – including breaks from PPE). • Designate those responsible for the monitoring of employee health concerns in regard to respiratory infections. The most appropriate entity would be an employee health service. If such a service is not available, then a medical director, infection control professional, or other appropriate person should be designated. • Instruct all healthcare workers to report influenza-like illness to the facility designate immediately. o If onset of employee illness occurs while working then instruct the healthcare worker to don a surgical mask and report to a designated area. February 7, 2006 3-24
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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 • 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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Pandemic Influenza Plan - Questar III

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