Across the U.S., hospices meet swine flu challenge with education
Across the U.S., hospices meet swine flu challenge with education
Take time to review pandemic emergency plans
Increased education and diligent observation of families and patients are the key steps initially taken by hospice staff members to prevent the spread of H1N1 Flu (swine flu) among patients, staff, and family members.
"We're reviewing Centers for Disease Control [CDC] guidelines and sharing information with staff members, but we have not introduced any new protocols," says Shan-wei Ko, RN, NP, chief clinical officer for Continuum Hospice Care in New York City. "We are reminding staff members to reinforce basic infection control practices with all patients and family members."
Staff members at Heartland Home Health Care and Hospice in San Antonio also have been reminded to be diligent about the use of universal precautions, says Bart Joiner, administrator of the agency. "We have supplied everyone with extra sanitizing gel to remind them of the importance of hand washing," he adds.
Preventing the spread of the illness is one of the key goals of the CDC, and frequent hand washing is one of the primary recommendations. Mary Wagner, RN, BSN, MEd, vice president of clinical practice at Metropolitan Jewish Home Care in Brooklyn, NY, says, "Our home health staff has an excellent rate of compliance with hand-washing guidelines, but we are reminding everyone to constantly re-educate patients and their families." [See inserts: pandemic flu infection control guidelines for agencies that provide service in the home, and preparedness and response plan]
Information about swine flu and the importance of hand washing and other ways to prevent transmission of the flu are shared at team meetings, Wagner says. Infection control is a continuous effort within the agency, but it is important to remind everyone of basic procedures at a time like this, she points out. "The degree of publicity about swine flu makes staff members, patients, and family members more receptive to the education," Wagner says.
Although staff members are aware of flu seasons and do keep an eye on patients and family members for symptoms, the potential for a swine flu outbreak has increased the need for surveillance, says Joiner. "We are monitoring our patients more closely, and our staff members are more attuned to the possible symptoms of flu in family members and friends," he adds.
In addition to telling staff members to watch patients carefully for signs of flu, tell them what to do if they notice potential symptoms, says Ko. "Our staff members contact the patient's primary care physician or the hospice medical director, whichever is appropriate for that patient, to obtain an order for a flu test," she says. Family members or other visitors who exhibit symptoms are advised to see their own physicians for a test and asked to stay away from the patient while they have symptoms, Ko adds.
Even though the infection has been tied to Mexico, Ko says staff members don't initially ask patient's families and friends if they've traveled anywhere or been exposed to someone who might have traveled to any area that has had an outbreak of swine flu. "If they exhibit symptoms, we will ask, but not before," she says.
Hospices stay up-to-date
Information about the swine flu outbreak has been readily available, thanks to departments of health and the involvement of hospice associations in distributing updates, says Kathy A. McCann, president and CEO of the Hospice and Palliative Care Association of New York State in Albany. "We are careful not to repeat information that already exists, but we want people to know how to get updated information," she explains. Notices to members have focused on identifying resources for information and letting members know what the state health department is planning, McCann says. "We send e-mail alerts to our members to let them know about department of health audio conferences that provide up-to-date information on the outbreak."
There is so much information in the general media about the flu outbreak that it's important that hospice managers make sure their staff members are receiving accurate information directly from sources such as the CDC and their state or local departments of health, she says. "We want our message to patients and families to be consistent with the messages from public health authorities so that we don't cause a panic," McCann says. Hospice staff members must have accurate information because patients' families expect them to be the health experts, she adds.
"This is also a good time to pull the emergency plan off the shelf and take a look at it," McCann says. Two years ago, her association developed a pandemic flu plan for members that contains tools that can be used now, she says. "Even though we based the plan on avian flu, it applies to any flu pandemic," McCann says. "This is an opportunity to make sure everyone is ready for a pandemic, even if it doesn't occur," she adds.
Ko says, "This is a live, real-time case study that gives us an opportunity to remind employees and family members that hand washing and basic infection control practices are important. Because the potential pandemic is in the news, everyone is more receptive to infection control education." (For anatomy of the swine flu outbreak, see insert.)
Increased education and diligent observation of families and patients are the key steps initially taken by hospice staff members to prevent the spread of H1N1 Flu (swine flu) among patients, staff, and family members.Subscribe Now for Access
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