No One's Immune

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The impact of the flu season is being felt well before the bug arrives.

People like to talk about the flu; it goes well with their talk about the weather. But for healthcare professionals, the H1N1 flu goes beyond casual conversation. The final impact of the coming swine flu season may be difficult to predict, but it is clear that healthcare leaders need to be prepared—and not just medically.

The news team that puts together the "HealthLeaders Media Daily News & Analysis" report has examined the phenomenon from various perspectives.

Here we excerpt three pieces that consider: the potential for public panic and proper triaging; the poor record of healthcare workers actually getting vaccinated; and the positive side benefit that swine flu preparations have had in fire-ravaged California.

Feds Clarify Hospital Triage Rules in Event of H1N1 Frenzy
Hospital and public health officials who are concerned about being deluged this fall by sick and worried well patients fearing H1N1 now have comforting federal guidance from the Centers for Medicare & Medicaid Services on how to redirect crowds without violating the law.

First, jammed hospital emergency departments can set up alternate screening sites elsewhere on campus, with personnel stationed outside the emergency department to log in and redirect patients seeking care to that alternate site.

This triage system is acceptable as long as the personnel are qualified physicians, RNs, physician assistants, or nurses trained to perform such exams.

Second, hospitals may set up screening at an off-campus site if it is controlled by the hospital.

Third, hospitals and community health officials may encourage the public to go to those sites instead of the hospital for influenza screening.

And fourth, the required medical screening exam does not need to be an extensive work-up in every case.

However, there are some important caveats.

A hospital may not tell individuals who have already come to the ED to go to the off-site location for the exam. And the hospital cannot announce or advertise the off-site location as a place that provides care for general, urgent, unscheduled emergency medical conditions, other than those involving influenzalike illness.

Hospital and public health officials' concerns stem from requirements under the federal Emergency Medical Treatment and Labor Act. The law says hospital emergency rooms that participate in the Medicare program must provide medical screening exams to any patients who arrive at their doors, regardless of the patients' ability to pay.

Reported Aug. 25 by Cheryl Clark for

Healthcare Facilities Should Require Staff Vaccinations to Prepare for H1N1
The Association for Professionals in Infection Control and Epidemiology (APIC) urged healthcare organizations to mandate that staff members in direct contact with patients are vaccinated during the upcoming flu season.

"Immunization will be especially critical for healthcare personnel during the 2009-2010 flu season because we will have more than one virus circulating," says Christine J. Nutty, RN, MSN, CIC, president of APIC. "All healthcare workers, including those who are pregnant, need to be immunized against seasonal influenza and 2009 H1N1 virus when vaccines become available. This is vitally important to healthcare worker and patient safety."

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