Influenza Infection Control Tabletop Exercise August 2019 Expectations

Influenza Infection Control Tabletop Exercise August 2019

Expectations This is a stress-free, fun environment There is no failing, just learning! Dialogue is encouraged There is no single solution Respond based on existing plans and policies Focus on problem solving Treat the scenario as if it were currently happening

Objectives Review procedures for receiving a person at your facility/agency with a suspected infectious disease. Discuss infection prevention and control standard procedures and how they are used in your facility/agency. Discuss emergency preparedness functions as they relate to caring for a patient with a suspected infectious disease in your facility/agency. Identify the key areas where infection prevention planning and emergency preparedness planning intersect. Identify any planning gaps.

Background – November 11, 2019 The CDC reports on a suspected novel strain of influenza A (H 4 N 8). A few isolated cases have been found within the United States. The traits follow the same timeline as H 1 N 1 with efficient human-to-human transmission taking place. Antivirals do not appear to be effective and a vaccine is not yet available. The CDC is advising precautionary methods to take place among all health facilities, reminding everyone to use effective PPE and proper sanitization procedure.

Scenario – November 18, 2019 Covenant Hospital receives a patient with severe flu-like symptoms. Initial tests reveal it to be Influenza A. They send a throat swab to the lab to determine the strain.

Scenario – November 25, 2019 Covenant Hospital receives lab results back revealing that the patient has the new H 4 N 8 influenza strain. They report this to the health department and the City of Lubbock releases the following Health Alert. Significant human-to-human transmission is beginning to take place throughout the U. S.

Health Alert - Lubbock Health Department NEWS RELEASE Nov. 25 th, 2019 *Double Click Image Above to Open Document!*

Initial Questions What would your facility/agency do with this information? Would this be discussed among all staff? What difficulties do you expect your facility/agency to face hearing this warning? How would updates about the situation be delivered to the staff? Who takes care of contacting and transmitting this information? Who makes the final say on any changes that take place?

Scenario A– November 27, 2019 Hospitals/LTC 11: 00 A. M. : A patient at your facility/agency has been diagnosed with Influenza A(H 4 N 8). 12: 00 P. M. : They are experiencing severe symptoms and you find out that yesterday they attended a sporting event with many people in attendance.

Hospital/LTC Questions What are you doing internally with this information? At this point what staff safety precautions are you initiating? How do you ensure PPE is donned and doffed correctly? What does this look like? How are your facility/agency leaders maintaining accurate situational awareness with each other? What is your process for sharing information regarding this situation with all staff? Do you have any additional training and education around communicable disease preparedness? What are your isolation procedures? How would your sanitation and cleaning procedures be modified?

Hospital/Long Term Care Specific Your facility/agency is being overwhelmed leading to a shortage of available beds and ventilators Has this situation reached a level that you would stand up your facility’s/agency’s command center? If not, what are some of your trigger points that warrant standing up your command center? What does the process for standing up your facility’s/agency’s command center look like? Long Term Care How would you coordinate moving an infected patient to a hospital? Would it be any different than normal patient transfers? Who would be coordinating this procedure? How will you maintain safe conditions for the staff and other patients throughout this procedure? What if the hospital is full & cannot accept the patient?

Scenario B– November 27, 2019 Other Facilities/Agencies Hospitals are full and home care is being encouraged A client/patient/resident that was at your facility/agency yesterday reports that they have been diagnosed with H 4 N 8. Your staff have been noticing that residents/clients are showing flu like symptoms.

Other Facility/Agency Questions How would communicate to your other clients/residents about the individual diagnosed with H 4 N 8? How do HIPPA restrictions impact this? Would you develop additional triage questions? What would you ask them? How would you determine to care for someone showing symptoms but still needing your facility’s services? What would be the cut off point for symptoms that are too severe for your staff to manage? How could you use this to further educate your patients on proper hygiene and health care? How can your facility/agency reduce contact between clients/residents? What are you doing to maintain the health/safety of your staff?

Scenario Update – November 29, 2019 Several local schools are closed due to high absenteeism. Several of your staff are reporting that they are sick. By 10: 00 A. M. 30% of your staff have not shown up due to sickness or fear. An estimated 15% of the local population has become ill.

Questions Staff-focused Who would you communicate with if you are experiencing symptoms of the flu? When? How? How will you know if your site will be open if there is a pandemic flu? Do you know how decisions are made in your agency? Executive-focused If the primary method of communication is unusable how will you communicate with your staff? Is there a policy and procedure on how staff will be notified if the agency is closed? Who is responsible for ensuring this task is completed? What is the process if the staff member can not be reached?

Questions (cont. ) What are your agency’s critical services? What services would your agency be able to continue to provide in this scenario? Which services could you delay/discontinue? How will organizational leadership make these decisions? How will you communicate these decisions to your clients? For the discontinued services, are there resources you can refer the patients/clients to?

Scenario – December 1, 2019 Although you ordered extra supplies during the health alert your facility/agency is starting to run low. You estimate enough materials for 3 more days of operation. Your attempt to order new supplies was delayed due to the widespread outbreak. New supplies expected arrival is 5 days.

Questions How will you manage your current functions with limited supply of PPE available? Are there alternative resources you can rely on for supplies?

Debrief/After Action Report Identify the strengths you discovered in this exercise. Identify areas of improvement for your organization. What unanticipated issues arose during the exercise? What do you need to more effectively perform your role during an actual emergency? What additional community partners should be included in future planning efforts to assist the facility/agency in responding to this type of event?

Infection Control Tabletop Exercise