Swine Flu: Here's What My Hospital is doing ...

>>> Public Affairs (UMC - Campus Notification) 4/30/2009 4:55 PM >>>

FROM:
Rathel L. Nolan M.D. F.A.C.P., Professor of Medicine, Interim Director - Division of Infectious Diseases, Hospital Epidemiologist
Karen Moise R.N. C.I.C. C.L.N.C., Interim Director of Infection Prevention

TO:
All Faculty and Staff

(Please share with your co-workers who may not have e-mail.)

H1N1 Swine Flu Update April 30, 2009

Swine flu continues to spread in the U.S. Although a cause for considerable concern we need to remember a few facts.

No cases have yet been reported in Mississippi.

Cases in the U.S. to date have been the usual spectrum of flu symptoms. This is not some new "killer flu". Although one death has occurred in the U.S. and many in Mexico, mortality occurs in any flu outbreak. In a normal year 35,000 persons succumb to flu, mostly the very old, and those with certain other chronic illnesses.

The flu in the U.S. so far has NOT been that contagious. Although this might change, as it can with any flu strain, cases to date have occurred in those returning from trips to Mexico and their close contacts in school or at home. "Casual" transmission, such as an exposure occurring in a restaurant, theatre, clinic etc. does not seem to be occurring presently.

What you can do to protect yourself and co-workers

- Adhere to good handwashing practices, preferably with alcohol foam or rub.

- Cough/sneeze into a Kleenex or your shirt sleeve.

- Stay at home if you have a cold or other respiratory illness.

- Wipe common use computer key boards with a disinfectant wipe each shift since these have been proven to be potentials for infection.

What's the hospital is doing to prepare

- Our first action is to resume the use of "cough etiquette" stations in the outpatient areas. This is to try to limit risk of transmission in the outpatient area by recognizing patients who might be affected and separating them from others. (Ordering information below) These are small stations that go in waiting areas that supply patients with Kleenex, gloves, masks and hand sanitizer.

- Upon entering outpatient areas, patients should be asked if they have a runny nose, nasal stuffiness, cough or sore throat.

- If they answer yes to 2 or more symptoms, they should be asked to use hand sanitizer and don a mask. If they can't wear a mask, then they should cough or sneeze into a Kleenex, discard in trash and use hand sanitizer.

- If at all possible these individuals should be placed in a separate area in the waiting area at least 3, and preferably 6 feet away from unaffected individuals.

- These individuals should be given priority in being placed in exam rooms.

- Once in exam rooms, they should be managed in Contact and Airborne Isolation Precautions with use of N95 particulate respirator mask if available. Hepa Filter Units may be used as available (See the Infection Control web page under Departments for details).

- If warranted, rapid tests for flu and culture for flu are available.

- When the room is vacated a hospital approved disinfectant wipe or spray should be used to clean all items touched by the patient and allowed to dry for 10 minutes before reuse.

Patients with Swine flu admitted to the hospital

- The hospital has a pandemic flu preparedness plan as part of general disaster preparedness. This may be invoked if things get bad enough (which as of today we're not expecting).

- This plan addresses where patients will be placed in the hospital, allocation of resources, delay or discontinuation of non-essential services, etc.

- Patients should be placed in Contact and Airborne Infection Isolation Precautions , using N95 particulate respirators and placed in negative pressure rooms or rooms with heap filter units if available.

- Patients should remain in isolation for 7 days or until symptom free, whichever is longer, and should wear a surgical mask if leaving the room as a medical necessity.

- Visitors to room should be limited to at most immediate family and must be given surgical masks.

- Individuals caring for affected workers may be offered anti-viral medications on a preventative basis.

If a patient is suspected or confirmed as a case of Swine flu please contact Infection Prevention:

Jolynn Lewis, Office 984-2189; Pager 929-0485

Debbie McCaffrey, Office 984-6783; Pager 929-2473

Karen Moise, Office 984-2999; Pager 929-2446

Office fax: 984-67

Cough etiquette stations and supplies

1. Kleenex

WIPE TISSUE (COUGH STATION ONLY) LARGE 005044 BX .64

2. Child's Face Mask (Kimberly-Clark Ref # 47127)

MASK FACE CHILD (COUGH STATION ONLY) 4052 BX 11.21

3. Procedure Mask-Adult (Kimberly-Clark Ref # (48100)

MASK SURGEON DISPOSABLE STANDARD 4049 BX 3.55

4. Hand Sanitizer (Kimberly-Clark DIN: 02243379 - 8 FL oz.)

SOAP SANITIZER (COUGH STATION ONLY) 007195 BT 2.49 BT.

5. Station Hygiene (Cough Station) Cat. No. 1010 Unit Price $53.05 Charge Code: 36012

PLEASE NOTE: Use supplies as stated in protocols. No stockpile of any supplies will last if used inappropriately.

N95 Particulate Respirator Fit Testing: Although there are presently there are no swine flu cases in Mississippi, it is possible we might see our first case at any time. If we do hospitalize affected patients they will need to be cared for in Droplet Precautions with the use of N95 Particulate respirators. These masks require fit testing to assure they work as intended. If you haven't been fit tested then call Employee/Student Health at 4-1185 to schedule fit testing. Priority appointments will be scheduled for direct care workers who have NEVER been fit tested, or whose most recent fit test was more than 1 calendar year ago. All others will be scheduled as quickly as possible

For additional authoritative information, visit cdc.gov.