What nurses need to know about seasonal influenza to protect themselves and their patients All About...
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What nurses need to know about seasonal influenza to protectthemselves and their patients
All About Influenza
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Objectives Describe seasonal influenza Discuss the value of flu vaccinations State NYSNA’s position regarding
mandatory vaccination Identify components of a
comprehensive flu prevention program Identify the elements of emergency
preparedness plan
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What nurses need to know . . .
What is influenza? Is flu vaccine safe?What are the contraindications to the vaccine?What if I have a reaction?
What questions do you have?
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General Information: Influenza
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What is influenza? Influenza (flu) is a contagious
respiratory illness caused by the influenza virus.
It can cause mild to severe illness, and at times can lead to death.
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Common flu symptomsFlu usually starts suddenly Fever (not always) Cough Sore throat Runny or stuffy nose Muscle or body aches Headaches Fatigue (may be extreme)
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How flu spreads
Droplet (coughing, sneezing, talking) Aerosolization of the virus is also a
known mode of transmission Touching a surface or object that has
the virus on it then touching your own mouth, eyes or nose
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Period of contagiousness
From 1 day before symptoms appear and up to 5-7 days after becoming sick
You can pass the flu on to someone before you know you are sick
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How serious is the flu? Flu is unpredictable and how severe it
is varies from season to season Certain people are at greater risk for
serious complications if they get the flu
In the US, seasonal influenza causes on average more than 200,000 hospitalizations and 36,000 deaths annually
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What if I get the flu? Stay home until at least 24 hours
without fever If symptoms worsen, seek care
through your healthcare provider Antiviral medications are not routinely
recommended for the average patient
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Basic preventive measures Get vaccinated annually Wash hands frequently Avoid touching mucosal areas Block coughs and sneezes Practice social distancing Use appropriate respiratory protection Practice a healthy lifestyle
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Influenza Vaccines
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Influenza Vaccines Getting vaccinated annually is
the best protection Flu strains may vary from year
to year Occasionally a new strain
emerges for which there is little immunity
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Who should get vaccinated? Beginning with the 2010–2011
influenza season, CDC recommended that everyone 6 months and older should get a flu vaccine each year.
Vaccination is especially important for health care workers because they care for those at high risk for complications of the flu.
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Why YOU should get vaccinated Many of the patients you care for will
come into the hospital with the flu. Your vaccination is one component of a
total infection prevention program designed to protect YOU!
Keeping yourself healthy helps keep your family healthy
You don’t waste sick time on a preventable illness!
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Two types of flu vaccine The “flu shot” – inactivated (killed
virus) given with a needle The nasal-spray flu vaccine – made
with live, weakened flu viruses (approved for healthy people 2-49 years of age who are not pregnant)
Both types of vaccine will not cause influenza!
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How does the vaccine work?
Antibodies develop about 2 weeks after vaccination
Protects against the three specific strains included in the vaccine
Does not protect against flu-like illnesses caused by non-influenza viruses (this is why a comprehensive infection prevention program is necessary!)
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When should I get vaccinated? Annual vaccination begins in
September and continue throughout the flu season which can last as late as May
Seasonal flu activity usually starts in October and peaks in January or later
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How are vaccines prepared? Surveillance for circulating strains Selection of virus strain(s) Seed selection and passaging Manufacturing/clinical trials Packaging and shipping
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Vaccine R&DNational Institute of Allergy and Infectious Diseases (NIAID) Technology to improve production, safety and efficacyVaccine and Treatment Evaluation Units Consortium that conducts clinical trials to evaluate treatments and vaccines
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What about side effects? Serious side effects are very rare Observe contraindications Reporting adverse events improves
vaccine safety Vaccine Adverse Event Reporting
System (VAERS)
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Vaccine injury compensation Vaccine Injury Compensation Program
accepts claims Compensation may include medical
expenses, lost income, death benefits to survivors
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Should RNs get the flu vaccine?Both ANA and NYSNA urge registered nurses to get the seasonal influenza vaccine. Nurses have an ethical obligation not only to protect ourselves, but also to protect our patients and our families from influenza illness. Vaccination is a simple step that everyone should take. – nursingworld.org
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NYSNA position: flu prevention Vaccination is an important component,
but can not be relied on as a solitary method to prevent and control influenza, as some agencies suggest
Voluntary vaccination should be part of a comprehensive program that includes infection prevention and control and emergency preparedness planning
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NYSNA’s position
NYSNA encourages voluntary vaccination of all health care workers
NYSNA does not support mandating influenza vaccination as a condition of employment, as suggested by some health care facility policies and recently proposed state legislation
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Future mandatory vaccination? NYSNA closely monitors state
regulatory and legislative activity for movement towards a change in state law or regulations that would mandate influenza vaccination of nurses and other health care workers as a condition of employment.
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NYSNA will continue to . . . Monitor Health Department committees. Keep members informed on a timely basis Work with unions and other groups to
promote voluntary vaccination. Urge a positive rather than punitive
infection control approach. Encourage feedback from members Negotiate protective language into NYSNA
contracts.
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Infection Prevention and Control
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Components of prevention and control plan Hazard assessment for exposure risk Listing of workers at risk Mitigation steps Engineering & administrative controls Prophylaxis, vaccination, treatment Initial and ongoing training
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Engineering controls Partitions in public areas Closed suctioning for intubated patients Negative pressure rooms Managing patient flow (move to
administrative controls section) Following NIOSH guidelines for cleaning
and HVAC systems (Move to work practices section)
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Administrative controls Non-punitive sick time policy Emergency staffing procedures Ongoing cross training of staff Staff dedicated to flu patients Reducing visitation
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Personal protective equipment Fit-tested N95 disposable respirator
or better recommended when: Within 6 feet of flu patient In small, enclosed space Performing high-risk procedures
Employer must have respiratory protection program in place
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Contract language Relevant sections of contract
agreement: Essential personnel Sick time/call in policy Family leave/personal leave Workers compensation Disciplinary policy
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Emergency Preparedness
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Is your facility prepared?
Location of policy and procedures Facility plan for allocation of
additional staffing Nurses’ roles and responsibilities Role in triage and transfer of patients Plan for alternative care sites
Nurses need to know:
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Is your facility prepared? Plans for cohorting patients Availability of PPE Plans for training and exercises Plans for adequate surge:
Capacity and Capability Staffing Supplies Beds Equipment
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Initial and ongoing training Patient care protocols for triage in
Emergency Department Nurses’ roles and responsibilities
Triage Communication Documentation Debriefing
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Surge planning capacity & capability
Capacity: How many patients can you put in beds, how many can you put on vents, how many can you put in ICU
Capability: Can you take care of the number of vents with qualified nurses, can you take care of a 110% occupancy, can you staff for all the hospital needs
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Alternative Care Sites
Patient care protocols Available equipment and staff Security Patient transportation Standing orders Points of Dispensing (PODs)
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Mandatory overtime Allowed during unanticipated staffing
emergencies Facilities should plan for increased
sick time during flu season Facilities should prepare for surges
during flu season Discuss in labor-management
meetings before flu season begins
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Working in an emergency
“Adapting Standards of Care Under Extreme Conditions”
Legal and ethical issues facing nurses practicing in emergencies or disasters
Policies and strategies to guide nurses and institutions
State and federal law may not provide sufficient legal protection
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Caring for workers in emergency
Have a family emergency plan Facilities should provide basic needs Emergency staffing plan Emotional needs must be met Workers compensation should cover
injuries resulting from emergency
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ServNY emergency registryServNY is a registry for health professionals who wish to volunteer during an emergency or major disaster. Registering does not guarantee that you will be called upon, nor does it mean that you must participate if called. Volunteers will help ensure that people affected by a disaster will receive the health care they need.
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References and contact info A reference page is provided in the
Influenza Tool Kit. For further information, contact:
Education Practice & Research Program, 800-724-NYRN(6976) ext. 282
EGW Occupational Health and Safety Representative, 888-551-3112