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Preparing for an influenza pandemic

Staff Development Weekly: Insight on Evidence-Based Practice in Education, July 2, 2004

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An emergency department (ED) experiences a significant increase in respiratory-associated cases over the weekend. With the influx of patients, staffing changes have occurred. Two nurses from other departments are transferred to the ED for the weekend to assist with triage. The facility does not have a protocol in place for respiratory hygiene, and only approximately 36% of the facility's staff has been vaccinated. One of the nurses transferred has already been vaccinated, and one has chosen not to be vaccinated. The ED sees a record number of patients over the weekend, and during that time has implemented its long-term action plan for staffing. Now that the plan is in place, the two nurses return to their respective units (one in pediatrics and one in critical care). Two days after returning to the pediatrics unit, that nurse is out sick with "flu-like" symptoms. Within two weeks, the majority of the staff has called in ill with similar symptoms. Additionally, most of the pediatric patients have developed these same symptoms. One pediatric patient, originally admitted in serious condition for another illness, was slowly improving. However, the patient is in critical condition with "flu-like" symptoms that were not present during the initial admission. The 6-year-old patient subsequently dies from complications of influenza and the original illness. Eventually, 60% of the pediatric staff experience "flu-like" symptoms.

Question: How could this situation have been prevented?

Answer: Healthcare workers are at increased risk of exposure to influenza, and they are at increased risk of exposing their patients to influenza. Yet only 36% of healthcare workers were vaccinated in the year 2000. If healthcare workers think they don't need the vaccine for themselves, they need to think about their patients; otherwise, a healthcare worker may be the next one to help cause the death of a patient. The IC department is responsible for preventing outbreaks in its facility. The department should have had a better picture of what was happening in the pediatric unit. The influenza situation among staff in the pediatric unit should have been reported to the IC department for monitoring before it reached the point that it did. Intervention measures could have been implemented to prevent the spread of the disease.

Editor's note: The above case scenario is from the new online course, "Nursing CE Series: Preparing for an influenza pandemic." For more information on this and other courses in our Nursing library, go to www.hcprofessor.com and click on Nursing CE.

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