Protecting Health Care Workers from Pandemic Flu

Protecting Health Care Workers During Pandemic Flu

Why should health care workers get special health and safety protections during a pandemic flu virus?

Health care workers are more likely to get sick with the pandemic flu virus because they treat patients who have or may have the virus. If health care workers are not protected, they could get sick and die. Sick health care workers could also spread the virus to other patients, family members, and the community. The fear of getting sick could keep health care workers from going to work. This could seriously hurt our ability to care for sick patients.

There is presently no vaccine to protect workers from the current outbreak of H1N1 (swine) flu. Some antiviral medications, like oseltemivir (Tamiflu) and zanamivir (Relenza) can be used to treat those workers who get the H1N1 flu.

But health care workers need to be protected so that they do not get the flu. There are effective ways to protect them and it is the employer’s responsibility to put these protections into place. And unions need to be involved in developing and putting into place all programs to protect health care workers. 

How can employers protect health care workers before and during a pandemic flu?

Employers are responsible for protecting health care workers during a flu pandemic. There has been an outbreak of H1N1 (swine) flu and protections for health care workers need to be put into place NOW – otherwise it will be

too late. This fact sheet outlines health and safety actions that employers should take to protect health care workers as well as their patients.

Most of these actions are recommended by Occupational Safety and Health Administration (OSHA) and the Centers for Disease Control (CDC).

Employers should do the following to protect the health and safety of health care workers:

1. Set up an infection control program

Employers should develop an infection control program for workers in their clinics and hospitals. The goal of this program is to help prevent the spread of the pandemic flu virus. The key parts of the program should include:

·        A written plan explaining how to control exposure to the virus,

·        A program to monitor workers’ health (medical surveillance),

·        Worker training,

·        Warning signs and labels,

·        The importance of regular cleaning, and

·        A system to keep records on workers’ health.

See “Factsheet #2: Protecting Workers During Pandemic Flu” for details on setting up a program.

Health care employers can prepare for a pandemic flu virus by doing the following:

·        Identify ways to control exposure to the flu virus in the workplace.

·        Have enough personal protective equipment (PPE), respirators, cleaning supplies, and other safety equipment for workers.

·        Give workers safety and health training.

·        Keep supplies of vaccines and other medicines that can fight the virus (if they are available).

·        Identify which health care workers will provide care for patients with the pandemic flu.

·        Have a respiratory protection program in place that complies with OSHA’s 1910.34 standard.

·        Identify workers who will be required to wear respirators.

·        Give workers who will be required to wear respirators a medical evaluation to make sure they are able to wear a respirator.

·        Fit-test workers who will be required to wear respirators to make sure that the respirator they will use fits properly and seals tightly on their face.

See “Factsheet #3: Respirators: One Way to Protect Workers Against Pandemic Flu” for more details on respirators.

3. Give training to health care workers

Health care employers should give workers safety and health training on pandemic flu in the language and at the literacy level they understand. The following topics should be covered:

·        Pandemic flu and its symptoms,

·        How the flu virus spreads to workers,

·        Risks of coming into contact with the pandemic flu virus in the workplace,

·        The employer’s infection control plan,

·        Ways to control the spread of infection – from most to least effective,

·        Uses and limitations of personal protective equipment (PPE),

·        How to safely put on and take off PPE,

·        Types of respirators required under OSHA’s Standard 1910.134,

·        The employer’s program to monitor workers’ health (medical surveillance), and

·        Personal hygiene, like washing hands often and covering the nose and mouth when coughing or sneezing.

To stop the spread of the virus, it is very important to limit contact between people who have and do not have the pandemic flu virus. Employers should set up a way to identify patients early on who may be infected. These patients should be kept away from other patients by moving them to isolated areas of the clinic or hospital. This is called isolation precautions.

To set up the isolation precautions, clinics and hospitals should do the following:

·        Separate persons with flu symptoms and other persons by allowing enough space between them in waiting rooms and common areas.

·        For persons with flu symptoms in waiting rooms, ask them to wear a surgical mask (if possible), or to cover their nose and mouth with a tissue when coughing or sneezing (and to throw away the tissue in the trash).

·        Move patients who have or might have pandemic flu to single patient rooms (negative pressure isolation rooms are best) or isolated areas in the hospital or clinic.

·        Assign specific health care workers to treat patients with pandemic flu. Only allow those workers to enter rooms or areas where pandemic flu patients are located.

·        Use a negative pressure isolation room if giving care to the patient’s airway (like bronchoscopy and intubation). 

·        Make separate entrances and passageways at the hospital or clinic for pandemic flu patients, if possible. 

Teach all patients who have or may have pandemic flu how they can prevent the spread of the virus. Since the virus lives in the respiratory system (mouth, throat, lungs), patients need to be taught respiratory hygiene.

·        Reporting symptoms of respiratory problems to a health care worker,

·        Covering nose and mouth with tissue when coughing or sneezing,

·        Throwing away used tissues right away in nearest trash can,

·        Placing a surgical mask on a coughing patient, if possible, and

·        Washing hands after touching the nose or mouth.

6. Stress the importance of frequent handwashing

Washing hands is one of the most important ways to control the spread of the virus. It can include washing with soap and water or using alcohol-based disposable hand wipes or gel sanitizers.

·          Before and after touching a patient,

·          After removing gloves, and

·          After removing any personal protective equipment (like respirators).

Health care workers should not touch their eyes, nose, mouth, or skin with contaminated hands. They should also remove contaminated gloves before touching any surface.

Steps to identify sick workers include:

·        Have health care workers report their flu-like symptoms,

·        Screen all health care workers for flu-like symptoms before they begin their shift, and

·        Send home workers with flu symptoms or pandemic flu. Allow them to return to work 24 hours after their symptoms/illness is gone. Note: in order for this to be effective, if workers are out sick, they must not be penalized or disciplined, and they should have “medical removal protection” which means they continue to receive pay and benefits.

PPE is especially important in controlling the spread of infection. Respirators are the most important type of PPE during a pandemic flu. See “Factsheet #3, Respirators: One Way to Protect Workers Against Pandemic Flu,” for more detailed information.

• Gloves (disposable nitrile or vinyl gloves, not latex),
• Gowns (disposable and resistant to fluids),
• Eye protection (face shield or goggles),
• Respirator (at least an N95 respirator; a P100 elastomeric respirator is better), and
• Headcover and shoe covers (optional).

Health care workers who have to work directly in a patient’s airway, for example to do a bronchoscopy, intubation or resuscitation of patients (best ifdone in negative pressure isolation rooms), should wear the following PPE:

·        Gloves,

·        Gowns,

·        Eye protection,

·        Headcover and shoe covers,

·        Respirator (a powered air purifying respirator or PAPR, with P-100 cartridges).

Other workers who do not give direct care, like janitors, but still have to enter rooms with patients who have or may have pandemic flu should wear the following PPE:

• Gloves,
• Gowns,
• Eye protection, and
• Respirator (at least an N95 respirator; a P100 elastomeric respirator is better).

Is your hospital or clinic prepared for a pandemic flu?

By taking action NOW, it is possible to protect the health and safety of health care workers. Being ready is the only way to protect the health of workers and their patients.

·        Health care workers are at a very high risk of getting the pandemic flu virus because of their role in caring for sick patients.

·        An infection control plan can protect the health of workers and their patients. This plan must be in place NOW.

·        Worker training and patient education play an important part in preventing the spread of the pandemic flu virus.

·        The right kind of personal protective equipment is especially important during a pandemic flu.