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What do you do if SARS shows up at your door?
SARS requires constant readiness, at least until health authorities determine that the virus is no longer spreading, says Susan Kinter, RN, JD, director of claims litigation and risk management at the University of Maryland Medical System in Baltimore. Recent comments by federal officials and guidance offered by the Centers for Disease Control and Prevention indicate that is not yet the case. For the near future, risk managers will have to ensure that the facility is ready to respond when a patient arrives with a suspected case of SARS.
Kinter suggests taking a walk through the emergency department — the most likely point of contact for a SARS patient — and asking staff how they would respond. Do they know what policies and procedures have been put in place for SARS? Do they have the necessary equipment, such as N95 masks and warning signs, as well as a room for isolating the patient? Do they know whom to call when they suspect SARS?
Make sure the policies and procedures include a call notifying the risk management department. That call may come straight from the emergency department, or perhaps infectious diseases will notify you when they find out. Either way, the protocol should ensure that you are notified immediately, Kinter says. And what will you do when you get that call about a suspected SARS case? Here are the five steps Kinter plans to follow:
1. Call the infectious disease department to discuss the case.
Confirm that the patient is being isolated and treated according to the pre-arranged protocols. Determine the specifics of the case and the likelihood that this is actually a SARS case.
2. Go to the unit where the suspected SARS patient is and verify the precautions.
Personally visit the unit and verify that the appropriate precautions are being taken. Ask the staff if they have any questions or concerns and if they have all the necessary equipment. Verify for yourself that there are warning signs and that no one can accidentally walk in on the patient without proper precautions.
3. Remind the unit’s staff that they are at risk.
Though you should have told them already, remind the staff working on the unit that it is personally at risk from SARS more than they might be with other infections. Stress to them that their own health is at risk if they do not follow the precautions carefully.
4. Alert the media relations staff.
Word of your suspected SARS case will spread quickly, so make sure you inform your media contacts as soon as possible. Make sure they understand the facts clearly and determine what should be released to the media. If the clinicians only suspect SARS, have the media relations staff emphasize that the hospital is being cautious and erring on the side of safety until you can confirm whether the person actually has SARS. Stress that the hospital has prepared for this event and is taking all the necessary precautions.
5. Make arrangements to monitor the patient’s condition and care.
Working with the infectious disease department and possibly employee health, work out a plan for how you can monitor the patient’s condition and watch for any spread of the virus. One idea might be to have a short meeting or conference call each morning to update each other on the situation until SARS is ruled out. If SARS is confirmed, you might need to move to a more in-depth daily meeting to ensure that the virus is contained.