25 Willett St, New York, NY 10002

Emergency Procedure

Emergency Procedure – Pandemic (Viral Respiratory)

Policy Statement

This facility has taken measures to prepare for a pandemic viral respiratory event.

Policy Interpretation and Implementation

  1. All staff members will be trained on facility Pandemic Viral Respiratory Plan and related policies and procedures.
  2. All prospective residents and employees shall be screened to identify exposure. Screen for symptoms following exposure.
  3. A Pandemic Plan has been established and will be initiated when a novel virus is increasing and sustaining human-to-human transmission in the United States, and cases are occurring in the facility’s state.

Emergency Procedure – Pandemic Viral Respiratory

The following procedure should be utilized in the event of a Pandemic outbreak.

  1. Declare a “CODE _________” when a novel virus is increasing and sustaining human-to-human spread in the United States, and cases are occurring in the facility’s state.
  2. Notify the Administrator and Director of Nursing if they are not on the premises. Activate Call Down List.
  3. Facility management staff should report to the Incident Command Post for briefing and instruction.
  4. Activate the Incident Command System (ICS) to manage the incident. The most qualified staff member (in regard to the Incident Command System) on duty at the time assumes the Incident Commander position.
  5. Follow guidelines of Pandemic Viral Respiratory Plan.
  6. Residents, employees, contract employees, and visitors should be evaluated daily, or more often as directed by State/National authorities, for symptoms. Employees should be instructed to self-report symptoms and exposure.
  7. Follow Pandemic Plan, or State/National guidance, in regard to managing high-risk employees and for guidelines as to when infected employees can return to work.
  8. Adherence to infection prevention and control policies and procedure is critical. Post signs for cough etiquette and activate Outbreak Policy. Adherence to droplet precautions during the care of a resident with symptoms or a confirmed case of pandemic respiratory viral illness is a must.
  9. Determine when to restrict admissions and visitations. Communicate this to the affected parties.
  10. Contact local and state health departments to discuss the availability of vaccines and antiviral medications, as well as recommendations of usage.
  11. Ensure adequate supplies of food, water, and medical supplies are available to sustain the facility if pandemic influenza occurs in the geographic region or at the facility.

  1. Cohort residents and employees as necessary.
  2. Implement contingency staffing plans as needed.

Pandemic Viral Respiratory Plan

  1. This facility has designated the Director of Nursing as the Pandemic Viral Respiratory Response Coordinator.
  2. He/she and the Pandemic Planning Committee, a sub-committee of the Quality Assurance/Risk Committee, address pandemic viral respiratory preparedness.

Surveillance and Detection

  1. The Pandemic Viral Respiratory Response Coordinator/Designee is responsible for monitoring public health advisories (federal and state) and updating the Pandemic Committee, particularly when pandemic viral respiratory illness has been reported in the United States and is nearing the specific geographic location. www.cdc.gov.htm is utilized as a resource.
  2. A protocol should be developed to monitor seasonal influenza-like illnesses in residents and staff during the influenza season, which tracks illness trends.
  1. The admission policy includes that residents admitted during periods of seasonal influenza should be assessed for symptoms of seasonal influenza.
  2. A system is implemented to daily monitor residents and staff for symptoms of seasonal influenza, as well as confirmed cases of influenza.
  3. Information from the monitoring systems is utilized to implement prevention interventions, such as isolation or cohorting.

Communication

  1. The Pandemic Viral Respiratory Response Coordinator is responsible for communications with the public health authorities during a pandemic.
  1. Local health department contact information: _________________________________________________________________________________
    _________________________________________________________________________________
  2. State health department contact information:

_________________________________________________________________________________
___________________________________________________________________________

  1. The Administrator/Designee is responsible for communicating with the staff, residents, and their families regarding the status and impact of the pandemic influenza in the facility. One voice speaking for the facility ensures accurate and timely information.
  2. Communication includes usage of the recall roster to notify staff members of the pandemic outbreak. Efforts must be made, such as phone calls and posted signage to alert visitors, family members, volunteers, vendors, and staff members about the status of the seasonal/pandemic viral respiratory illness in the facility.

  1. The DNS also maintains communications with the Emergency Management Coordinator, local hospitals, local Emergency Management Services, as well as other providers regarding the status of the viral respiratory outbreak.
  2. Family members and responsible parties are notified prior to an outbreak that visitations may be restricted during an outbreak to protect the safety of their loved ones.

Education and Training

  1. The Director of Nursing is responsible for coordinating education and training on seasonal and pandemic viral respiratory illness. Local health department and hospital-sponsored resources are researched, as well as usage of web-based training programs.
  1. Education and training of staff members regarding infection prevention and control precautions, standard and droplet precautions, as well as respiratory hygiene/cough etiquette should be ongoing to prevent the spread of infections, but particularly at the first point of contact with a potentially infected person with seasonal/pandemic viral respiratory illness.
  2. Education and training should include the usage of language and reading-level appropriate, informational materials, such as brochures, posters on viral respiratory illness, as well as relevant policies. Such materials should be developed or obtained from www.cdc.gov.
  3. Informational materials should be disseminated during before and during seasonal/pandemic viral respiratory illness outbreaks.

Infection Prevention and Control

  1. Cleaning and disinfection for pandemic viral respiratory illness follows the general principles used daily in health care settings (1:10 solution of bleach in water).
  2. Infection prevention and control policies require staff to use Standard and Droplet Precautions (i.e., mask, and possible eye protection, for close contact with symptomatic residents).
  3. Respiratory hygiene/cough etiquette should be practiced.
  4. The IPCC shall develop procedures to cohort symptomatic residents or groups using one of more of the following strategies:
  1. Confining symptomatic residents and their exposed roommates to their room.
  2. Placing symptomatic residents together in one area of the facility.
  3. Closing units where symptomatic and asymptomatic residents reside, i.e., restricting all residents to an affected unit, regardless of symptoms.
  4. Develop criteria for closing units or the entire facility to new admissions during a pandemic outbreak.
  5. Ensure visitor limitations are enforced.

Occupational Health

  1. Practices are in place that addresses the needs of symptomatic staff and facility staffing needs, including:
  1. Handling staff members who develop symptoms while at work.
  2. When staff members who are symptomatic, but well enough to work, are permitted to continue working.
  3. Staff members who need to care for ill family members.
  4. Determining when staff may return to work after having a pandemic viral respiratory illness.

  1. A contingency staffing plan is in place that identifies the minimum staffing needs and prioritizes critical and non-essential services, based on residents’ needs and essential facility operations. The staffing plan includes collaboration with local and regional planning and response groups to address widespread healthcare staffing shortages during a crisis.
  2. Staff are educated to self-assess and report symptoms of pandemic viral respiratory illness before reporting to duty.
  3. Mental health services or faith-based resources may be available to provide counseling to staff during a pandemic.
  4. Appropriate vaccinations of staff are encouraged and monitored.
  5. High-risk employees (pregnant or immuno-compromised) will be monitored and managed by placing them on altered work assignments.

Vaccinations and Antiviral Usage

  1. The Centers for Disease Control (CDC) and the Health Department will be contacted to obtain the most current recommendations and guidance for the usage, availability, access, and distribution of vaccines and antiviral medications during a pandemic.
  2. Guidance from the State Health Department will be sought to estimate the number of staff and residents who are targeted as first and second priority for receipt of pandemic vaccine or antiviral prophylaxis. A plan is in place to expedite delivery of vaccine or antiviral prophylaxis.

Preparedness of Supplies and Surge Capacity

  1. Quantities of essential food, materials, medical supplies, and equipment have been determined to sustain the facility for a six-week pandemic. A predetermined amount of supplies are stored at the facility or satellite location.
  2. Plans include strategies to help increase hospital bed capacity in the community.
  1. Agreements have been established with area hospitals for admission to the facility of non-infected patients to facilitate utilization of acute care resources of more seriously ill patients.
  2. Facility space has been identified that could be adapted for use as expanded inpatient beds and information has been provided to local and regional planning contacts.
  1. Capacity for deceased residents has been determined, including a space to serve as a temporary morgue.

Certain Phases of a Pandemic Alert Should Include Specific Precautions:

  1. When a novel strain of a viral respiratory illness has been detected in the United States with increased and sustained human-to-human spread:
  1. All prospective residents and employees will be screened if they have had recent travels or close contact with other ill persons who have recently traveled to a previously affected areas.
  2. Infection prevention and control training will be initiated for Pandemic Viral Respiratory Preparedness.
  1. When a novel strain of a viral respiratory illness is increasing and sustaining human-to-human spread in the United States and cases are occurring in the facility’s state:
  1. All prospective residents and employees will be screened to identify exposure. Fever and respiratory symptoms will be screened following exposure.

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  1. Residents, employees, contract employees, and visitors will be evaluated daily for symptoms. Employees will be instructed to self-report symptoms and exposure.
  2. Guidelines will be established as to when infected employees can return to work.
  3. Adherence to infection prevention and control policies and procedure is critical.
  4. Signs will be posted to remind staff, residents and visitors of cough etiquette. Adherence to droplet precautions during the care of a resident with symptoms or a confirmed case of pandemic viral respiratory illness is a must.
  5. The Director of Nursing will determine when to restrict admissions and visitations. Communicate this to the affected parties.
  6. Local and state health departments will be contacted to discuss the availability of vaccines and antiviral medications, as well as recommendations of usage.
  7. Adequate supplies of food, water, and medical supplies will be available to sustain the facility if pandemic viral respiratory illness occurs in the geographic region or at the facility.
  8. Residents and employees will be cohorted as necessary.
  9. Contingency staffing plans will be implemented as needed.