Covenant Health Guidelines for Influenza
Outbreak Management Edmonton Acute Care
Outbreak Management:
Surveillance
Conduct ongoing surveillance and monitoring for unusual clusters of illness in patients and staff.
Prompt reporting permits early identification and intervention to interrupt transmission, thereby
reducing morbidity and mortality.
In order to initiate and investigate outbreaks promptly, report any suspected cases of Influenza Like
Illness (ILI), (see table below for definitions) to Infection Control (IC).
ILI Definition
ILI outbreak definition for Acute Care
Acute onset of respiratory illness with fever
and cough and with one or more of the
following have one or more of the following:
- Sore throat
- Joint pain
- Muscle aches
- Severe exhaustion
2 or more cases of ILI within a 7 day period
with a common link ( e.g. same unit and
evidence of healthcare –associated
transmission within the unit) confirmed by
laboratory
Outbreak Notification Algorithm
1st call Unit Staff/Manager to
ICP
If leaving a message, ask Infection Control Practitioner (ICP) to call back immediately.
Please ensure that you are able to clearly identify suspected cases meeting the ILI definition in the table
above. Also it must be communicated to ICP symptom onset and if a specimen has been sent.
All after hour calls for ICP, contact switchboard at your site and ask them for ICP on call.
Suspected Outbreak Identified by Unit staff/Manager
ICP will report to Public Health patients affected and any
Relevant information needed.
ICP will also contact Occupational Health and Safety.
2nd call ICP to Public Health
Public health will obtain the EI number
(Epidemiological investigation number) and will provide
3rd call Public Health to
Provincial Lab
the EI number to ICP.
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NOTE: THE UNIT WILL NOT BE CONSIDERED ON OUTBREAK UNTIL MOH (Medical Officer of
Health) HAS DECLARED. DURING THIS TIME ENSURE STAFF IS FOLLOWING ICP PRACTICES AND
THOSE SYMPTOMATIC PATIENTS ARE PLACED ON APPROPRIATE ISOLATION.
Unit Manager/delegate Responsibilities while ICP is speaking with MOH (Medical Officer of Health)
1. Administrative assistant/delegate to send Healthcare worker exposure template to CSO (Central
Staffing Office) NOTE: it is the Programs responsibilities to keep this spreadsheet updated with
staff information at all times for each of the units/programs. Please ensure to send your float and
casual list as well to CSO.
staffing
template.xltx
Workplace Health – Occupational Health – Influenza Prevention – Influenza Outbreak Toolkit –
Forms/Templates- Health Care Worker Exposure Template
2. CSO to complete this spreadsheet by adding in the last day worked and next scheduled shift for
each HCW. CSO then sends the spreadsheet back to the Administrative assistant/delegate who
will then forward to OHS. Forward to the following email: occhealthnurse@covenanthealth.ca
3. Identify staff potentially exposed to influenza or who have been off sick with ILI symptoms that
have worked on the outbreak unit. ( see attached forms)
http://www.compassionnet.ca/Workplace/2014_Jan24_Workplace_OHS_EIFormBW-Fillable.pdf
2014_Dec23_HCWIL 2014_Jan24_Workpl
IInfo.pdf
ace_OHS_EIFormBW-Fillable.pdf
4. Administrative assistant/delegate is to notify Support Services Management (EVS, Laboratory,
Rehab, Dispatch, Porters, Transition Services, Pharmacy, Dietary, Radiology, Cardiac ) with the
following email:
Good day Support ServicesWe have identified 2 or more cases of ILI on Unit ___and have started to initiate ICP practices.
NOTE: the unit will not be considered on outbreak until the MOH has declared. While ICP is
working with the MOH, we ask that each department send your Healthcare worker exposure
template to OHS. You will need to identify the staff name, occupation, FTE, and when they
last worked and next shift scheduled.
Support Services contacts GNCH /MCH
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Contact Information
for GNH and MCH
5. Contact Volunteer Services at your site and request that a volunteer be placed in an Advocate role
for patients/families/staff who are entering the unit, to ensure that hand hygiene is being
completed upon entering and exiting the unit.
6. Have your CNE/delegate retrieve necessary toolkits/resources from compassionNET which can be
found by the following :
Workplace Health – Infection Prevention & Control- Acute Care- Outbreak toolkits- ILI toolkits- print
materials- (checklists for staff, signage, information for patients and visitors)
7. CNE/delegate to place table for outside affected unit with large stop sign. Place patient and visitor
information outside of unit on table.
8. CNE/delegate to assist Unit Manager with staff awareness of checklists/resources
Once Outbreak declared
1. Program Manager/Delegate in collaboration with the Senior Director of Operations/Senior Operating
Officer will call an Outbreak meeting for their site following the Acute Care Outbreak Meeting contact
list. List can be found by the following:
Workplace Health- Infection Prevention & Control- Acute Care – Outbreak Management- Outbreak
Management Resource tool kit- Outbreak Meeting Contact List Acute Care
Workplace_IPC_Acut
eCareEdmontonOutbreakMeetingContactList__Nov2014.pdf
PLEASE NOTE: due to the new site distribution lists Program Managers/Assists are to ensure that the
Unit Managers of the areas/programs are contacted.
2. Program Manager/ Delegate will contact Physician Leads to have them write orders for all patients on
outbreak unit to be started on Tamiflu. Pharmacy will work with the attending Physicians for ordering
of Tamiflu. NOTE: there are two strengths 75mg or 30mg for poor kidney function. For Confirmed
Influenza A, treatment needs to be initiated within 48 hrs. Attending teams are to work with the
Pharmacists on each team.
3. Have CNE/ delegate obtain Outbreak posters/resources and place on unit from Compassionnet which
can be found by following:
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Workplace Health – Infection Prevention & Control- Acute Care- Outbreak toolkits- ILI toolkits- print
materials- (checklists for staff, signage, information for patients and visitor, outbreak signage)
4. Communicate with the Acute care Management site by sending a MEMO. The template can be found
by clicking on the link below:
Send (see attached fill able form) to Admin and they will distribute to the Acute care site Management
Team. For Physician Chiefs and medical staff send the form to Medical affairs and ask the memo to be
forwarded.
Workplace_IPC_Acut
eCareEdmontonOutbreakMemo Closed 2015 Unit 52.doc
PLEASE NOTE: due to the new site distribution lists Program Managers/Assists to ensure that the Unit
Managers of the areas/programs are contacted.
5. Restrict unit visitors.
6. Do not cohort patients except in consultation with ICP
7. Contact Volunteer Services at your site and request to have a volunteer assigned to the units in an
Advocate role for patients/families/staff accessing the unit, to ensure that hand hygiene is being
completed upon entering and exiting unit.
8. Unit Manager/delegate to ensure that staffing is booking a HCA for daily cleaning of all equipment on
unit. If unable to book a HCA then you call Environmental Services for support from EVS staff with
cleaning. Instruction on their roles and responsibilities can be found on the cleaning checklist enclosed.
Nursing Equipment
Cleaning Scheduledraft 2 (2012).doc
9. Unit Manger/delegate to work with staffing office for any staff movement within the Program. See
orientation checklist attached.
orientation quick
checklist (2) (2).docx
10. Collaborate with ICP to do Line listing this needs to be updated daily by 10AM. Report will include any
new symptom onset or if there are no new cases. Fax this document to the number listed on the
Respiratory Outbreak Case Listing.
ILI case listings
UPdated Covenant 2015.doc
11. Continue to collaborate with ICP, OHS daily and have site outbreak meetings if warranted.
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12. If staff is required to have Tamiflu they are able to take their letter to the following Pharmacy without
seeing their physician. Please note: staff are unfit to work until they have sent their prescription
information to OHS. They are fit to work for 10 days and will need to be reassessed if the unit still
considered on outbreak.
Influenza Outbreak 20141101_OHS_Flu_
Algorithm for Staff January
Work_Restrictions_Table_Protocol.pdf
2015.pdf
13. If you have patients who have been accepted to facilities, then you can fill out your Section B of the
Risk Assessment Worksheet and Section C will be filled out by the receiving facility. ( see attached)
This will then get sent to the Public Health Outbreak Contact via fax number 780-342-0248
20150805_IPC_Admi
ssionDischargeAndTransferDuringAnOutbreak.pdf
14. Once the outbreak has been cleared, Communicate with the Acute care Management site by sending
the template MEMO, which can be found on CompassionNet by following:
Workplace Health- Infection Prevention & Control- Acute Care- Outbreak Management- Outbreak
toolkit- Outbreak Management Resource Toolkit- Outbreak Memo Template for Edmonton Acute
(see attached fill able form) Send to Admin and they will distribute to Acute site Management Team.
For Physician Chiefs and medical staff send to Medical affairs and ask them to forward the MEMO.
Update Filiable Open
Unit.doc
-
Other important information:
Ensure to communicate with your staff, that if they have received their immunization outside of
Covenant ie: Physician’s office, Pharmacy, Public Health, or other then they need to complete the
following form and send to OHS
20150928_OHS_Flu_
Employee_Influenza_Immunization_Notification_Covenant.pdf
-
Joint presentation from OHS/ICP
20150914_IPC_OHS
JointPresentationMultidisciplinary(2).pdf
Updated October 2015
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