Influenza: Practical Tips for Assisted Living

September, 2019

NADONA

Wendy Gardner, BSN, RN-BC, CALN, FACDONA

Influenza: Practical Tips for Assisted Living

September, 2019

NADONA

Written by Wendy Gardner, BSN, RN-BC, CALN, FACDONA

Presented by John Grieco LPN, BS, MBA, DSc

Director of Operations/COO for Northwest Geriatrics

ILStandby

• Independent-Rental Only

• Licensable Units/Beds on Standby

AL

• Personal Care Services

• Intermittent Nursing Care

MC• Secured Unit for Memory Care

Assisted Living Model

Challenges With Symptom Monitoring

Observation

Report Changes

Evaluation & Service Plan

Update

Implement Service Plan

Evaluation

Assessment

Diagnosis

Planning Implementation

Evaluation

Outbreak Tips for Assisted Living

EducationStaff, Residents & Visitors

PoliciesPart of routine training

Infection control (supplies)Human Resources

Flu Shot ClinicsHome Office sets up vendor

Open to residents, staff, public

Observation•Key contacts

•Dining, Housekeeping, Care, Reception, Activities

Preparation

Outbreak Tips for Assisted Living

EducationStaff, Residents & Visitors

HandwashingPTO (24 hrs after fever resolves)

PoliciesWhen to implement

Shut down group settingsAlternates for activities and dining

Clean, Clean & Clean again

CommunicationTransparency: Open & regular

Letter to residentsSignage

Daily updates

Tracking•Reporting to Health Department

•Reporting to DSHS•Floorplan•Case Log

Implementation

AL Response to Influenza

Policies and Procedures

Education

Observation & Reporting

Implementation of Plan

Ongoing Communication

Lisa Stubenrauch RN-BC BSN CDONA/LTC RAC-CT

NHA

Administrator

Issaquah Nursing and Rehabilitation Center

President

WA State Chapter of NADONA/LTC

WANADONA

We get the FLU SHOT because we care

about PROTECTING OURSELVES, our

FAMILIES, and our RESIDENTS.

We encourage you to find your reason

“WHY” and get the FLU SHOT as soon

as possible!

A message from your Nurse Practitioner’s

Maura DeOliveira ARNP and Jayne Feinberg ARNP

Promote: Influenza Season Check List

• Place signs at the entrance of building at the start of flu

season that encourage visitors to get the flu vaccine and

not to visit if they have any symptoms that could be flu.

• Offer flu vaccine and encourage all staff and residents to

get flu vaccine when it becomes available.

• Refer residents >65 or who are at high risk for pneumonia

to HCP for pneumococcal vaccine

Educate

• Educate staff to flu signs and symptoms.

• Educate staff at every opportunity (such as All Staff meetings, postings, and in-services) regarding

importance of getting flu vaccine and on the importance of staying home if they have symptoms that

could be flu

• Educate each department regarding ways they can prevent an outbreak from occurring.

• Educate those that wear a mask they are educated regarding changing it if it becomes moist.

• Place Handouts at the front desk for visitors regarding flu symptoms and the dangers that getting the

flu poses to our vulnerable population.

• Increase education during flu season for staff regarding donning and doffing of PPE, hand hygiene,

and cough etiquette.

Signs and Symptoms of the Flu

• Fever or feeling feverish/chills*

• Cough

• Sore throat

• Runny or stuffy nose

• Muscle or body aches

• Headaches

• Fatigue (tiredness)

• Some people may have vomiting and diarrhea, though this is more common in children than adults.

*It’s important to note that not everyone with flu will have a fever.

https://www.cdc.gov/flu/symptoms/symptoms.htm

Flu Signs and symptoms

https://www.cdc.gov/flu/symptoms/symptoms.htm

Set Expectations

• Meet with all department heads ahead of flu season and have an open

discussion regarding what each department’s responsibilities will be if

an outbreak is to occur.

• Give each department head in writing what their department’s

responsibility will be during an outbreak and have them in-service their

staff.

• Front desk staff will be trained to encourage all visitors to use hand gel

before and after visit. Front desk will also be educated on s/sx that

could be flu, to encourage those with symptoms to either not visit, or to

wear a mask.

• Housekeeping to start cleaning high touch area’s more frequently with

bleach solution.

Activate Flu Plan

1. If any resident presents with any flu symptoms, interview them if able and specifically ask about other symptoms related to the flu. Record symptoms as they go on your Phone Line Listing for Public Health Department.

2. Place resident on droplet isolation immediately if you suspect influenza.

3. Notify the medical doctor.

4. Test for influenza via nasal swab and request that PCR test be done as rapid is not reliable.

5. Place all other residents on unit/wing on a symptoms checklist.

6. If any other residents present with flu-like symptoms, place them on isolation and test for Influenza via PCR.

7. If one positive test is returned, then start Line Listing and notify the Public Health Department via fax or phone call.

8. Notify state hotline.

9. If possible, close doors to the hall/unit/wing that reported cases are on.

10. Close dining room on the affected unit and have al residents eat in their rooms.

Activate Flu Plan

• All residents and/or their families are notified of outbreak.

• Encouraged residents that are non-symptomatic to stay in their room.

• Isolate staff to that unit, not allowing staff to float between units.

• Post signs notifying people of outbreak to all entrances of the facility and on the closed doors of the

unit that is having the flu outbreak.

• Visitors are notified verbally by receptionist that we are in the midst of flu outbreak. They are

encouraged not to visit.

• If visitors want to come into to the infected unit they are encouraged to wear a mask. Visitors are also

educated about the importance of hand hygiene.

• Front desk to have an updated copy of residents who are on isolation. If visitors are going into isolation

rooms they are educated on the use of PPE and the importance of not coming out of the room wearing

their PPE.

• All staff are notified that they must enter on unit that they work.

• Staff are told not to report to work if they have any symptoms that could be related to the flu. CDC

recommendation is excluding until at least 24 hours after they no longer have fever or exclude from

work for 7 days from symptom onset.

09/2019

Lisa Stubenrauch RN-BC BSN CDONA/LTC RAC-CT NHA

President WA State Chapter of NADONA

Administrator Issaquah Nursing and Rehabilitation Center