Emergency Preparedness: Aging Services Role in Dealing with an Influenza Pandemic

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Emergency Preparedness Aging Services Role in
Dealing with an Influenza Pandemic

• Dianne Mandernach
• Commissioner, Minnesota Department of Health
• September 2006

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Preparing for Pandemic Flu

• How bad could it get?
• What should long-term care facilities and senior
  housing be doing to prepare?
• What should families be doing to prepare?

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2004 U.S. Population Estimate 294
Million(0.05 World Population)
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2004 Minnesota Population Estimate 5.1 Million
(1.75 of U.S. Population)
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Continuum of Patient Care
In-Home Family-Based Care (in-home) Homecare
Outpatient Care Medical Offices/Clinics Procedure/Day Surgery Centers Specialized Clinics (Neighborhood Emergency Help Centers) (triage and clinic level care)
In-Patient Care Long Term Care Facilities Hospitals Off-Site Care Facilities
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Pandemic planning in long-term care

• The U.S. Department of Health and Human Services
  and CDC have provided considerable guidance
• They have developed planning checklists for
  organizations, ranging from businesses to schools
  to hospitals to LTC facilities
• See handouts and www.pandemicflu.gov for more
  information

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Guidance for aging services planningPlanning
and decision making

• Incorporate pandemic flu planning into emergency
  management planning
• Designate a lead person to coordinate planning
• Create a multidisciplinary committee to address
  planning. Include
• Administration
• Medical director
• Nursing staff
• Pharmacy services
• Infection control
• Purchasing staff

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Guidance for aging care planningPlanning and
decision making

• Establish contacts with local and state health
  departments for information and resources
• Establish contacts with local hospitals,
  emergency preparedness groups and pandemic
  planning groups

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Guidance for aging care planningDeveloping a
written plan

• Refer to the federal pandemic flu plan (at
  www.pandemicflu.gov) plan and the states
  pandemic flu plan (at www.birdflu.state.mn.us)
• Identify a person to develop a plan

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Guidance for aging care planningElements of the
plan should include

• Surveillance and detection of flu among residents
  and staff, including
• A plan for monitoring public health advisories
• A protocol for regular monitoring of seasonal
  flu-like symptoms
• A protocol for diagnosing residents/staff
• A system for isolating residents with flu

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Guidance for aging care planningElements of the
plan should include

• A facility communication plan, including
• A list of key public health contacts
• Designation of someone to connect with those
  contacts
• Designation of someone to communicate with staff,
  residents and family members
• Outline of strategies (signs, phone trees, etc.)
  to keep people updated about facility status
• A list of other health care entities that would
  need to be consulted during a pandemic

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Guidance for aging care planningElements of the
plan should include

• Education and training plan, including
• A designated person to provide training on
  pandemic flu
• Easy-to-understand informational materials
• Training about infection control measures
• Plan for expediting credentialing and training of
  non-facility staff

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Guidance for aging care planningElements of the
plan should include

• Infection control plan, including
• Policy requiring staff to use Standard and
  Droplet Precautions
• Plan for implementing respiratory hygiene/cough
  etiquette in facility
• A plan for cohorting symptomatic nursing home
  residents
• Criteria and protocols for closing units and
  enforcing visitor limitations

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Guidance for aging care planningElements of the
plan should include

• Occupational health plan, including
• A liberal, non-punitive sick leave policy
• A plan to educate staff to self-assess and report
  symptoms
• A list of mental health and faith-based resources
• A system to monitor flu vaccination of staff
• A plan for managing staff who are at increased
  risk for flu complications

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Guidance for aging care planningElements of the
plan should include

• A vaccine and antiviral use plan, including
• Familiarity with current state and federal
  recommendations for vaccine and antivirals
• A plan for expediting delivery of flu vaccine or
  antivirals, as recommended by MDH

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Guidance for aging care planningElements of the
plan should include

• Plans for surge capacity, including
• Contingency staffing plan identifies minimum
  staffing needs and prioritizes services
• A person designated to conduct daily staffing
  assessment
• Strategies for collaborating with local/regional
  groups

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Guidance for aging care planningElements of the
plan should include

• Plans for surge capacity, including
• Estimates of supplies/equipment needed during a
  six-week pandemic
• A plan for addressing shortages of
  supplies/equipment
• Alternative care plans for residents
• Plans to help with surge capacity in local
  hospitals
• Planning for increased need for post mortem
  services

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Additional advice

• Always encourage staff, residents and visitors
  to
• Get seasonal flu vaccine
• Cover their cough
• Wash their hands frequently and thoroughly

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Family Emergency Preparedness

• If families are prepared, it may be easier for
  employees to come to work
• Families should be encouraged to create home
  emergency kits, to include
• Food and water (enough for up to six weeks)
• Change of clothes for each person
• Sleeping bags or blankets
• First aid kit
• Battery powered radio and flashlight with extra
  batteries
• Spare set of house and car keys
• Toiletry items

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Family Emergency Preparedness (continued)

• Home emergency kits should include
• Special items for infants, elderly and pets
• Family contact lists and meeting place
• Wills, insurance papers, medical records,
  inventory of possessions, identification
• Medications
• PPE and other medical equipment/supplies
• Basic caregiving skills

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Recommended Web Sites

• www.health.state.mn.us
• www.hsem.state.mn.us
• www.ready.gov
• www.pandemicflu.gov
• www.fema.gov/areyouready
• www.ed.gov/emergencyplan
• www.weprevent.org/usa/cover.pdf