Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

[RNboston]

Has there been any communication with staff about pandemic underway in world?

Have any new policies been released related to infection control?

Is there a screening tool being used to identify possible H1N1 patients?

Has anyone had management go over pandemic preparedness, response with units?

Has any healthcare profession been exposed to H1N1?

Did institution alert anyone of past exposure of patient with H1N1?

Has any helathcare professional been treated with prophylactic tamiflu?

Is your institution treating any severe pneumonia as possible H1N1?

Is there any information that healthcare workers are coming across in careers related to H1N1 that they would like to share?

[Morning-glory]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

Has there been any communication with staff about pandemic underway in world? Yes

Have any new policies been released related to infection control? Still pending.

Is there a screening tool being used to identify possible H1N1 patients? No

Has anyone had management go over pandemic preparedness, response with units? No

Has any healthcare profession been exposed to H1N1? Unsure

Did institution alert anyone of past exposure of patient with H1N1? No

Has any helathcare professional been treated with prophylactic tamiflu? Not that I am aware of.

Is your institution treating any severe pneumonia as possible H1N1? Psych facility, but we can still ship them out for assessment to the acute care hospital.

Is there any information that healthcare workers are coming across in careers related to H1N1 that they would like to share? Question unclear.

We have one possible as of yesterday. She was returned to us with Temp of 40.7, no cultures done, ruled out bacterial infection. End dx after 2 hours in ER of probable viral infection. Temp down after cool shower and tylenol/ibuprofen tx. In isolation, but pt is manic and has been busy on the unit the last couple of days. Isolation procedures are more for comfort measures for the staff and other patients.

By next week, I figure that we will all have it.

[wotan]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

Has there been any communication with staff about pandemic underway in world? Some emails have been sent to all employess. There are TVs setup throughout common areas that communicate various pieces of information. One of the slides is about flu.

Have any new policies been released related to infection control? None that I am aware of, but I am not in patient care.

Is there a screening tool being used to identify possible H1N1 patients? I believe some screening is being done.

Has anyone had management go over pandemic preparedness, response with units?

I think it has been discussed with managers.

Has any healthcare profession been exposed to H1N1? Possibly, but I don't know for sure.

Did institution alert anyone of past exposure of patient with H1N1? When the pandemic was officially declared we were informed of a few patients who had had it.

Has any helathcare professional been treated with prophylactic tamiflu? I don't know.

Is your institution treating any severe pneumonia as possible H1N1? We are a specialty cancer hospital, I don't know how we would treat these places.

Is there any information that healthcare workers are coming across in careers related to H1N1 that they would like to share?

[RNboston]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

Any news healthcare preparation???

[littlebird]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

I work in a large regional Hospital in one of the largest cities in my Southern State. I can honestly say that the average healthcare professional in my workplace doesn't have a clue we are even IN a pandemic, much less is anybody doing anything to prepare. I work in Neonatal Intensive Care, and in Pediatrics. We've had a couple of young children come into our hospital with flu-like symptoms this Summer, and the doctors that I've talked to roll their eyes and smirk if I even mention H1N1... seriously. The kids are always treated for bronchiolitis, and put on antibiotics, and they get better in about a week, but nobody in my hospital is even testing for influenza at all. Even when RSV cultures come back negative etc.

It is my opinion that the majority of Health Care workers in my hospital are either in denial, or they are just not informed about Pandemic Influenza. Visitation practices haven't changed in our neonatal unit, no visitors are being screened for flu-like symptoms even though we have pregant women with preganancy complications who are are being roomed on our floor, it's a Perinatal floor as well. (The CDC guidelines are virtually unknown by anybody, and everyone thinks I am over reacting when I suggest that tour groups shouldn't be waltzing through our NICU during a world wide pandemic.)

I am amazed, by the power of the media to tell foks what to pay attention to from day to day. People look at me in disbelief when I tell them how many Americans have died from novel H1N1. They say things like "Well why isn't that on the news then?" and look at me like I am making it up. They worry about going out of our country on vacation because of the Swine Flu in "Other countries".

They're bascially completely ignorant during all of this. And THAT scares me more than anything else ever could. They think I am some wierd eccentric who just studies too much. Basically... they laugh at me.

Does it bother me? Not one bit. I sit on my limb and whistle my song to them. If they want to ignore me that's their business. I have learned that some people just will not HEAR anything that disturbs them, and some people do pay attention.

[somebodyoutthere]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

Does it bother me? Not one bit. I sit on my limb and whistle my song to them. If they want to ignore me that's their business. I have learned that some people just will not HEAR anything that disturbs them, and some people do pay attention.

Have you brought any of this up with the administration at your hospital? Perhaps you could ask if they've done the Hospital Pandemic Planning Checklist:

http://www.pandemicflu.gov/plan/healthcare/hospitalchecklist.html

[AlaskaDenise]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

...some people just will not HEAR anything that disturbs them...

You nailed it.

.

[littlebird]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

Have you brought any of this up with the administration at your hospital? Perhaps you could ask if they've done the Hospital Pandemic Planning Checklist:
http://www.pandemicflu.gov/plan/heal...checklist.html

~ First of all, the administration at my regional hospital, appear to be business men (who don't have a clue about medicine or Science). Our hospital isn't run by doctors or senior Nurses anymore. It's run by a bunch of business guys who's only focus is "the bottom line". I'd like to believe we're an exception to the rule, and that there are hospitals out there that do think outside the box, but I am losing faith in that dream.

I'm not exactly in the best standing with our infection control person.

It happened during the Winter of SARS.... I was taking care of a two year old who was in severe respiratory distress. She had a pneumonia so atypical they had called in an infection specialist. She was really working to breathe, and as a pediatric Respiratory Therapist, I was extremely concerned. I live in a military town, and I noticed that the mom was vietnamese, so I asked her if she and her child had been out of the country lately. She said "Yes, we visted relatives in Vietnam." so .... my eyes kind of widened... and then she said "and then, we went to a wedding in Toronto."

After I finished the child's treatment, I went out and found her nurse. I asked her incredulously "Do you KNOW that they've been to Vietnam AND Toronto Canada?"

the nurse said "No, why?" This was at the PEAK of SARS. I told her she needed to notify our infection control person, and she just laughed at me, and said "YOU do it". So I did, and got laughed at then too.

That's the reality. Very few people where I work ever seem to think outside the box. I imagine that this novel H1N1 has been with us way sooner than April, but NOBODY went out of their way to think outside the box.

For example, I work in the heart of Poultry production. several years ago, I saw three poultry workers (in their 20's) from a chicken plant nearby, within the span of a couple of weeks, come into the hospital and die of Atypical pneumonia, so severe, it killed them in the prime of life within 7 days. ARDS.... total white-out by X-ray. All of their tests came back negative. Nobody could explain why these young adults died (who all happened to work in the same chicken plant.) This was several years ago. It was so common that we all used to say "If we ever lose our jobs we won't work at that chicken plant... everyone who works there dies."

Was the health department ever notified? No.

The fact is, there are greater interests involved. Agriculture for one. We're one of the biggest producers of protein for this entire planet. The broiler industry, and pork industries are billion-dollar-a-year industries in this country. You got a glimpse of how the Pork industry reacted to the decline in profit associated with this novel H1N1 this past Spring. Never underestimate the Power of the money involved. As soon as the Pork industry share-holders started seeing a crunch in their earnings... you quit hearing about H1N1 pandemic influenza in the media. It's not about NOT creating a panic. It's not about keeping order.... It's all about profit, and the bottom line. I've accepted it. So, I say my spill, and sometimes the seeds of reason fall on rocks, and sometimes they fall on fertile soil and take root. I don't stand in one place anymore and fret about the reality. I just brush the dust off my shoes and move on. When the sh*t hits the fan... I won't even be in the house.

Nature has selected you for survival if you are reading this. You are wide awake. You can't worry about everybody who refuses to open their eyes and look around.

It's all about Survival now. That's just my take on it. It's what my intuition tells me.

[RNboston]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

Thank you all for your input.. I would like to keep this poll going and see what happens over time. I have been formulating my own thoughts about human nature, society, the power of money in the world, and how it can overpower common sense. It is simple astonishing how as a whole greed, money and power are deverting us from our primary purpose, health, survival, and trust.

[mixin]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

I'm not a healthcare worker but this was just reported from one of the 2 hospitals in my county. Since we've only had 4 confirmed cases and one of them ended in death last week, maybe the hospitals here in Elkhart County, IN are waking up. Goshen General is the other smaller one and I assume they are paying attention to what's going on at EG. Good for EG for taking this seriously

Since they are taking this seriously, it makes me wonder if the other 3 cases have been bad enough that they aren't taking any chances?

From the Elkhart Truth enews:
-------------------------
Beverly Myers, director of nursing at Elkhart General Hospital, said the hospital treats anyone who comes in the door with flu symptoms as if they have H1N1 until tests prove otherwise.

"As soon as someone reports to our (Emergency Department) with flu-like symptoms, we put a mask on them and we wear masks," Myers said.

Workers take a nasal swab of the patient and perform a preliminary test in the hospital, from which they see results in an hour. Then the sample gets tested by the South Bend Medical Foundation. After that, it goes to the state lab in Indianapolis to confirm it is H1N1. Patients are quarantined in one of six rooms with negative pressure so that the air does not circulate into the hallway. The precautions are similar to those taken with patients with tuberculosis, she said.

[RNboston]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

For Immediate Release
August 26, 2009
Print Text Only
Tell-a-Friend



Many Hospitals Are Not Ready for H1N1: Nurse Survey Shows Deficiencies in Hospital Swine Flu Readiness
Data from 190 Healthcare Facilities in Nine States from California to Maine

A patient health and safety survey of 190 American hospitals from coast to coast compiled by registered nurses in nine different states finds that a disturbing number of our nation?s healthcare facilities are not prepared for the coming H1N1/swine flu pandemic, according to results released today by the California Nurses Association/National Nurses Organizing Committee.

The data reflects a survey conducted over the past four weeks by RNs in hospitals in Arizona, California, Florida, Illinois, Maine, Minnesota, Nevada, Pennsylvania, and Texas. And it comes just a day after release of a report from the President's Council of Advisors on Science and Technology predicting nearly 2 million Americans could be hospitalized due to swine flu infections this winter, and as many as 90,000 could die, nearly triple the deaths that occur in a normal flu season.

What the RNs reported are wide gaps in safety gear, infection control training, and post-exposure procedures. Among key findings:

At more than one-fourth of the hospitals, nurses cite inadequate isolation of swine flu patients, increasing the risk of infection to others.
Nurses at 15 percent of hospitals do not have access to the proper respirator masks, exposing nurses and patients to infection; at up to 40 percent of the hospitals, nurses are expected to re-use masks, in violation of Centers for Disease Control Guidelines.
At 18 percent of the hospitals, RNs report that nurses have become infected; one Sacramento, Calif. RN has already died.
CNA/NNOC is calling on all hospitals to adhere to the highest standard of protection for patients and nurses to combat the expected onslaught of new cases this fall and winter, and urging legislators to strengthen public protections.

"These continuing problems increase the risk that many hospitals will become vectors for infection, with inadequate patient protections leading to a spread of the pandemic among other patients, their friends, family, and caregivers, and the surrounding community," warned Deborah Burger, RN, CNA/NNOC co-president. ?What we?re hearing from around the country is dangerous to patient health and safety, but with smart and clinically appropriate leadership we can fix policies in time for the upcoming pandemic.?

On Wednesday, nurses at more than 50 of these hospitals, mostly large hospital systems, will hold actions to demand hospital administrators immediately implement safety improvements for nurses and patients. Contact CNA/NNOC to find out about what nurses are doing in your area.

CNA/NNOC leaders will also be testifying in a joint California Senate hearing in Sacramento Thursday on preparedness for swine flu in the state?s health and education systems. The hearing is at 9 a.m. in Room 112 at the State Capitol.

?This report should serve as a wake-up to hospital management, policy makers, and healthcare workers across the country. We need to urgently increase our readiness," Burger said. "We do not yet have a complete picture of the morbidity of the H1N1 pandemic. But that is no justification for hospitals making inadequate preparations and endangering the health and safety of patients and their community. When September comes, we expect that infection rates of H1N1 will spike due to the beginning of the school year, prompting overcrowded emergency rooms, which will put our public health readiness to the test."

?The swine flu is not the type of flu we are used to. This pandemic will stress every aspect of our healthcare system. Hospitals must be proactive in protecting the public,? said Houston RN Terry Hardin.
?The state of Maine has identified over 300 cases of H1N1 infection, resulting in at least 19 hospitalizations and one death," said Cokie Giles, EMMC, president of Maine State Nurses Association/NNOC. "A recent survey of our membership indicates that there may be some areas of serious concern regarding preparedness policies. We are calling on MSNA/NNOC represented facilities to ensure that patients and nurses are protected to the fullest extent from exposure to H1N1.?

"It is important for hospitals to meet full safety standards for swine flu so that our patients and our nurses are protected," said Temple University Hospital RN Patricia Eakin, president of the Pennsylvania Association of Staff Nurses and Allied Professionals/NNOC.

"I don?t know how the local hospitals will staff up for the pandemic. Nurses at my institution don?t accrue sick time, we use our accrued vacation time to call out sick. We also work short [staffed] instead of having a replacement when someone does call out. In these economic times, you tell me who will be staffing the hospitals?" said Tampa Bay area RN Peggy Bowen.

Illinois hospitals, says Chicago RN Brenda Langford, "are not prepared to deal with this pandemic. We have provided our copies of our surveys to management and they have not moved to change our practice to be in compliance with the recommendation set for by the CDC. If the Cook County Health and Hospital System won?t make these needed changes and the Cook County Department of Public Health won?t support our efforts to protect the nurses and the public, it is left up to the NNOC to make sure these needed protections are implemented."

Findings of the survey include:

Half the hospitals have seen infected patients. At 18 percent, RNs have been infected, nurses say.
Nurses at 15 percent of hospitals report that they do not have access or only some have access to the appropriate N95 respirator masks, and at 19 percent of the hospitals all or some masks were not ?fitted,? to ensure their effectiveness against the virus
More than one in five, 22 percent of the facilities, do not have enough masks, say nurses.
At almost 40 percent of those which do have sufficient masks, all or some of the masks are expected to be reused, say nurses. That puts nurses and patients at risk of infection and violates CDC guidelines which say all healthcare personnel who enter rooms of patients in isolation for H1N1 should wear a fit-tested disposable N95 mask, and that the masks should not be reused.
Nurses at 26 percent of hospitals report that infected patients are not being properly isolated, in appropriately ventilated rooms, raising the possibility of the infection spreading to others in the facility. At nearly a third of the facilities, proper infection controls are not being followed.
Nurses at fewer than half of facilities (49 percent) report that they have been adequately trained on H1N1 issues, including identification of infected patients, and procedures for caring for these patients.
Nurses at only 35 percent of facilities report that they are guaranteed adequate sick leave if they become ill while caring for a patient, penalizing them for appropriately staying home while infectious.
These numbers are borne out by the controversies that have been reported at hospitals across the country. Examples include:

At the University of California Davis Medical Center (near Sacramento), a patient who subsequently died from H1N1 was transferred to an intensive care unit as the patient's condition deteriorated. But rather than be kept in strict isolation with proper ventilation, the door to the patient's room was kept open the entire time, placing other high-risk patients, visitors, and caregivers at risk.
Nurses at Temple University Hospital, a major acute-care hospital in Philadelphia, are concerned that the level of preparedness is not sufficient. The hospital has yet to make clear to nurses its plans and procedures for dealing with H1N1 which is expected to worsen with the start of the school year. The nurses are already seeing an influx of more patients due to the closure of one of Temple's nearby facilities, Northeastern Hospital, and are concerned that without better preparation and sufficient staff, the anticipated influx of patients due to the pandemic would be especially dangerous.
At Sutter Solano Medical Center in Vallejo, Calif., there were not enough masks to deal with three infected patients in the ICU. Within short order, approximately 10 nurses were affected. The state office of occupational health and safety is investigating.
Nurses report that a Kaiser Hospital South Sacramento has informed patients and visitors that N95 respirator masks are not necessary and that simple ?surgical? masks will suffice, which directly contravenes standards issued by every government agency.
Nurses at Los Alamitos Medical Center near Los Angeles report that Tenet has eliminated sick benefits that would ensure nurses could afford to take time away from work if they develop symptoms.
In conjunction with the report, CNA/NNOC is releasing a list of demands ? ?The Nurses? Swine Flu Safety Agenda? ? to adequately prepare for this pandemic.

Minimize infection of hospital patients and workers by strict adherence to the highest standard of infection control procedures, including identification and isolation with appropriate ventilation of infected patients
All hospital workers and visitors must be provided with appropriate protection gear at the highest government standards, including N95 respirator masks or better for all who enter the isolation room of a confirmed or suspected H1N1 patient.
Guarantee all patients and workers full transparency after any exposures to H1N1, in as timely a manner as possible
Healthcare workers and facility visitors must receive full information and guidelines on risk exposure and facility infection control recommendations
Any RN who is unable to work due to contracting a communicable or infectious disease identified or treated in his or her hospital/clinic shall be guaranteed sick leave, not face disciplinary action, and shall be presumptively eligible for workers? compensation benefits
Implement a moratorium on any closures of emergency rooms, layoffs of direct healthcare personnel, and reductions of hospital beds.
Federal guidelines for protection must be developed that are consistent across agencies
Disposable respirator masks must not be re-used. In the event of a demonstrated national mask shortage, facilities should adhere to government recommendations on mask conservation.


--------------------------------------------------------------------------------


CNA/NNOC represents 86,000 registered nurses in all 50 states, and is working toward unification with the Massachusetts Nurses Association and United American Nurses to build a new 150,000 member national nurses organization.





http://www.calnurses.org/media-center/press-releases/2009/august/many-hospitals-are-not-ready-for-h1n1-nurse-survey-shows-deficiencies-in-hospital-swine-flu-readiness.html

[SagamoreJames]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

The discussion about the masks is upsetting to me. I'm a school teacher and several in my room were infected. I think I might have had it, but if I did it seemed more like the cold than the flu. It's disturbing because we will be exposed again all day soon and no one is talking to us about masks. I know I would be in trouble for causing panic if I wore a mask.

[tropical]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

The discussion about the masks is upsetting to me. I'm a school teacher and several in my room were infected. I think I might have had it, but if I did it seemed more like the cold than the flu. It's disturbing because we will be exposed again all day soon and no one is talking to us about masks. I know I would be in trouble for causing panic if I wore a mask.

Right. Seems that apart some Pacific Asiatic and some other countries masks good tryings,
the others plays a "what is this" mask posture, so if realy a nastier 2nd wave is to come, it will be a "bad carnival", not an masked preparedness effort ...

[Flufreak]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

Has there been any communication with staff about pandemic underway in world? YES

Have any new policies been released related to infection control? YES

Is there a screening tool being used to identify possible H1N1 patients? YES, but still requires fever

Has anyone had management go over pandemic preparedness, response with units? YES

Has any healthcare profession been exposed to H1N1? YES

Did institution alert anyone of past exposure of patient with H1N1? Unknown

Has any heathcare professional been treated with prophylactic tamiflu? NO, against policy

Is your institution treating any severe pneumonia as possible H1N1? NO, still very little in community

Is there any information that healthcare workers are coming across in careers related to H1N1 that they would like to share?

We have very limited stock of Tamiflu and NO Relenza at all. We have 1000's of N95 respirator masks, many portable ventilators, and a good supply of PAPR units, and are working on getting more, a lot more. WE are planning for AIRBORNE precautions if the virus mutates and spreads more effectively by that route. Currently, we are using CONTACT and DROPLET precautions.
Contrary to a month ago, pandemic flu is now discussed openly, often, and calmly. We are planning and preparing. IMO, the return of MSM attention had helped tremendously in getting management on board, as well as the Flu Summits, Federal and State, plus my own prodding (Which was unwelcome at first, now I am invited to be on just about all the task forces, etc.). I will now be extremely busy in a good way, but I will try to continue to follow Flutrackers when I can, watching especially for evidence of increased severity.
Good job Flutrackers, you ARE making a real difference!

[High Risk]

Re: Heathcare Worker Poll: What is your institution doing to prepare for H1N1 Pandemic?

Patient Perspective (ex-healthcare worker)
PCP Clinic in large teaching hospital: they do have appropriate respirators in quantity apparently (hopefully enough). Young doc felt H1N1 was hype, but made immediate time for me after I queried receptionist on Clinic Policy for chemoprophylaxis for patients at high risk of H1N1 complications (Say What??). Politely made time, listened to my FT rebuttals, and wrote a QD X 10 Days R(x) for Tamiflu to fill if anyone in my house appears to have H1N1. With 4 persons, my concern is that I am looking at a worst case 54-61 day contagion scenario @ home (trying to also account for the 17 day fomite transmission). Young doc did a great job considering any training was not geared to a FT educated patient (Thanks So Much FT). It is a small start in my preparedness plan, but the local pharmacy while well stocked now, thinks shortages are possible later. Yes, I know QD is prophylactic and BID X 5 Days is for actual viral control X 1 person, and yes, I am a few pills short of what I will need to get thru the 7-10 days after last known household patient is exposed. Overall, they did well for the most part, and it was a slow day. So I think I asked for chemoprophylaxis and received medication for one course of actual treatment, once symptomatic.