Now that H1N1 fears have seemingly subsided, many infection control departments are evaluating their flu prevention programs, looking for deficiencies, while also noting effective policies and procedures.
For a number of facilities, the recent two-headed flu season proved the importance of a well-rounded respiratory infection control program.
Fred Hutchinson Cancer Research Center (FHCRC) and the Seattle Cancer Center Alliance (SCCA) created an aggressive prevention program that resulted in no increase of H1N1 cases in the facility month-to-month, despite a 100-fold increase in H1N1 cases in the Seattle area. The features of the program were published in a recent issue of Blood.
"I think we were really afraid and we didn't know how pathogenic or virulent this strain really was, especially with immunocopromised patients," says Michael Boeckh, MD, infectious disease physician at FHCRC. "There was simply no knowledge, so we took a very conservative approach. We really didn't want to find out later that it was a very bad strain, so we thought we would take the approach of designing a very comprehensive way of keeping the virus out of the system."
FHCRC already had a plan in place that was designed to incorporate a "heightened sense of alertness" beginning in October when most respiratory infections surface, and then that alertness would step down in April if activity had subsided. This allowed FHCRC to unknowingly prepare for the first H1N1 outbreaks, says Corey Casper, MD, a researcher in the FHCRC's Vaccine and Infectious Disease Institute and medical director of the SCCA's IC program.
"So ironically we had heightened our sense of alertness, and we were actually thinking of backing down when H1N1 hit, but rather than backing down we were actually able to scale back up to a higher level of alertness and take our plan off the shelf and very rapidly make it specific to H1N1," Casper says.
One of the major features of FHCRC's H1N1 plan was the screening process. Every person—patient or visitor—who entered the facility would have to answer a list of questions to determine whether they carried flu-like symptoms (see the Tools page on OSHA Healthcare Advisor to download the checklist).