Controlling influenza outbreak in aged care facilities

As we head into the middle of Winter the risk of influenza outbreak in aged care facilities is increased. The NSW health department outline key steps to take when an outbreak occurs. (see below)

Pro-val stock a range of gloves that will provide protection for workers when an influenza outbreak occurs. We have a selection of medical and diagnostic gloves that are Listed on the Register of Therapeutic Goods and meet Australian Standard AS/NZS 4011:1997/Amdt 1.1998. The Chemoprene is a neoprene examination glove with excellent resistance to cytotoxic chemotherapy drugs and many chemicals. The Securitex HR is three times thicker than standard latex gloves, with extra long cuffs providing more protection for the user. Securitex is our standard latex examination glove available in powder free or lightly powdered. Nite Safe is made from 100% nitrile with a high resistance to puncture and tear, strong and extra stretchy with superior dexterity.

The pro-val disposable glove range include the Stretch PF, a medical and diagnostic vinyl glove that looks and fits like latex.

CONTROLLING INFLUENZA OUTBREAKS IN AGED CARE FACILITIES

Taking precautions

Normally, standard precautions for infection control should be used when caring for residents. During a suspected outbreak, droplet precautions should be used. If an outbreak is suspected, follow these steps.

1. Confirm the cause

Make sure the appropriate respiratory tract specimens are collected for rapid laboratory testing for influenza and other viruses (PCR, immunofluorescence, point-of-care test kits, or virus isolation) to quickly determine if the outbreak is due to influenza or another respiratory infection.

Contact your local laboratory or reference laboratory for advice.

2. Set up an outbreak control team

In the event of an outbreak of influenza-like illness, it is strongly recommended that facilities set up an outbreak control team that includes clinical, infection control and management staff.

Seek input from your local Public Health Unit, as well as from a microbiologist and respiratory physician, if they are available.

3. Isolate ill residents and restrict staff and visitors

Isolate residents with influenza from other residents, and confine ill residents to their rooms for five days after the onset of illness or until symptons have completely resolved, whichever is shorter.

Exclude staff with influenza-like illness from work for five days from the onset of symptons or until symptons have resolved. Encourage ill staff to seek medical care for treatment and/or confirmation of their illness.

Place affected residents in a single room, preferably with ensuite facilities. If a single room is not available, place ill residents with other residents suspected of having influenza. Place all confirmed influenza cases together. Ill residents should use seperate toilet and bathroom facilities from unaffected residents.

Avoid moving residents and staff between different units or wings of the facility.

Cancel group activities.

Discourage visitors during the outbreak, especially visitors with respiratory symptons.

Postpone transfers, new admissions and the re-admissions of residents who were hospitalised before the outbreak commenced.

Before sending residents to hospital, inform the hospital and transport staff of the outbreak.

4. Wash your hands regularly

Alert staff, residents and visitors to the outbreak and reinforce the need for frequent hand washing.

Post hand washing signs.

Make sure that hand washing facilities are available to staff, residents and visitors.

Wash hands vigorously for a minimum of 15 seconds with a antimicrobial soap:

• before and after touching ill residents
• after touching ill residents' environment, including used tissues
• after touching ill residents' respiratory secretions.

Alternatively, if your hands are not visibly soiled and hand washing facilities are not immediately available, use a non water-based cleaner or antiseptic (eg. alcohol handrub).

5. Wear a mask

When caring for resident with influenza, wear a fluid-repellent surgical mask when you enter the resident's room or when you are working within one metre of the resident. Remove the mask when you leave the resident's room, dispose of it in a waste container, then wash your hands.

Consider your mask contaminated if it gets wet, and dispose of it. Do not re-use masks.

If you are moving or transporting a resident with influenza, get them to wear a mask, if possible.

Always wear a fluid-repellent surgical mask and protective eyewear if there is a likelihood that blood or other body substances will be splashed.

6. Wear gloves and gown

Wear gloves if you expect that your hands will come in contact with bloody or body substances (including respiratory secretions), or on potentially contaminated surfaces.

Wash your hands after removing and disposing of gloves.

Wear an imprevious gown if you expect your clothes to be soiled with resident's respiratory or other body substances.

Be careful to avoid contamination of clothing and skin when removing personal protective equipment.

Change gloves, gowns and masks after each encounter and wash your hands thoroughly.

7. Keep your environment clean

Use a neutral detergent to clean commonly-touched surfaces such as handrails, chair arms, doorknobs, hand basins, taps, toilet handles.

Clean isolation areas with cleaning equipment designated for the affected area.

Wear personal protective equipment, including a mask, when cleaning isolation areas.

Provide residents with tissues and appropriate disposal containers.

8. Consider anti-influenza medication

Anti-viral medications can be used to treat those who are ill with influenza. These medications can shorten the duration of illness if they are administered within 48 hours of onset of influenza symptons (fever, headache, muscle and joint pain, fatigue, sore throat, cough, runny or stuffy nose).

If an influenza outbreak is confirmed, consider anti-viral medication for residents - irrespective of vaccination status - and unvaccinated staff (or all staff if the outbreak involves a strain not covered by the vaccine). Seek the advice of clinical or public health specialists.

9. Immunise staff and residents every year

To prevent outbreaks, arrange vaccination for all residents and staff before Winter each year.

If an outbreak occurs, arrange vaccination for all unvaccinated residents and staff (including volunteers) and suggest that visitors also be vaccinated. It takes up to two weeks for the vaccine to become fully effective.

Source: http://www.health.nsw.gov.au/factsheets/infectious/flucontrol_cdfs.html Last updated 15 September 2004