The CDC, the Federal Emergency Management Agency (FEMA), and the department of health guidelines should be followed for Emergency Preparedness of Infectious Agents. Infectious Disease Emergency Response (IDER) Plan should be reviewed and updated annually.
Activities that may be implemented during an infectious disease emergency response include:
- Coordinating with other local, regional, state, and federal agencies and other organizations responding to the emergency
- Developing and disseminating information and guidance to residents, health care workers, responders, the general public, and special populations and settings
- Working with partners to implement public health disease containment measures such as infection control, mass prophylaxis, isolation and quarantine, or restriction and clearance
- Working with partners who coordinate medical care systems and management of alternate care and/or shelter sites
- Conducting epidemiological surveillance and investigation activities, such as surveillance, data collection, outbreak investigation, and laboratory testing
- Collecting and analyzing data to support the development of objectives, strategies, and policies
- Implementing a Hazards Response Plan if potential impact and circumstances warrant this.
General Preparedness
Infectious Disease Emergency Response (IDER) Plan should include a response plan for a community-wide infectious disease outbreak such as pandemic influenza.
This plan should:
- Build on the workplace practices described in the infection prevention and control policies
- Include administrative controls (screening, isolation, and visitor policies)
- Address environmental controls (isolation rooms, plastic barriers sanitation stations, and special areas for contaminated wastes).
The Infection Preventionist and clinical leadership should be vigilant and stay informed about infectious disease emergencies. They should keep administrative leadership briefed on potential risks of new infections in their geographic location through the changes to existing organisms and/or immigration, tourism, or other circumstances
The facility should maintain a supply of hand hygiene products and personal protective equipment including moisture-barrier gowns, face shields, surgical masks, and gloves. The amount that is stockpiled should minimally be enough for several days but should be determined based on storage space and costs
Health care workers should practice the response plan through drills and exercises as part of the emergency preparedness training.
Local Threat
- Once notified by the public health authorities that an infectious disease emergency is likely to or already has spread, activate surveillance. Screening should be done as instructed by Centers for Disease Control and Prevention (CDC), state agency and/or the local public health authorities
- The Infection Preventionist should research the specific signs, symptoms, incubation period, and route of infection, the risks of exposure, and the recommendations for long-term care facilities as provided by the CDC, Occupational Health and Safety Administration (OSHA), and other relevant public health agencies
- Working with advice from the administrator, the medical director, the clinical leadership, and public health authorities, the Infection Preventionist should review and revise internal policies and procedures, stock up on medications, environmental cleaning agents, and personal protective equipment as indicated by the specific disease threat.
- Health care workers should be educated on the exposure risks, symptoms, and prevention. Place special emphasis on reviewing basic infection prevention and control practices, hand hygiene, use of personal protective equipment, Transmission-based Precautions, and other infection prevention strategies
- If the infectious agent is spread through an airborne route, health care workers should be educated on respiratory protection to prevent transmission of infectious agents when caring for a resident or other health care workers with a suspected or known case to reduce the risk of exposure. The facility should order N-95 respirators
- Provide residents and families with education about the disease and strategy of prevention at a level appropriate to their need for information and in a manner that does not provoke fear
- Post signs regarding hand hygiene and respiratory etiquette and/or other prevention strategies relevant to the route of infection at the entry of the facility along with the instruction that anyone who is sick may not enter the building
- Screening for exposure risk, signs and symptoms of health care workers prior to reporting to work
- Health care workers should self-screen by reporting any suspected exposures while off duty to the facility
- Health care workers should be prohibited from working if symptomatic
- The facility should plan for appropriate physical plant alterations such as use of private rooms for high-risk residents, plastic barriers, sanitation stations, and special areas for contaminated waste as recommended by local, state, and federal public health authorities
- Health care workers should be educated on the facilities plan to control any exposure to the residents and health care workers.
Suspected Case in the Facility:
- Place the resident and/or health care worker in an isolation room and notify local public health authorities
- Unless otherwise directed by public health, arrange for a transfer of the suspected infectious person to an appropriate acute facility via emergency medical services as soon as possible
- If the suspected infectious person requires care while awaiting transfer, follow all infection control policies for Transmission-based Precautions, and continue with ongoing education of hand hygiene and personal protective equipment to all residents and health care workers
- Keep the number of health care workers assigned to enter the room of the isolated person to a minimum. Ideally, only specially trained staff and prepared (i.e., vaccinated, medically cleared and fit tested for respiratory protection) should enter the isolation room
- Provide care at the level necessary to address essential needs of the isolated individual unless it is advised otherwise by public health authorities
- Conduct control activities, management of infectious wastes, terminal cleaning of the isolation room, contact tracing of exposed individuals, and monitoring for additional cases
- Activate quarantine interventions for residents and staff with suspected exposure to the index case.
Sample policy for Emergent Infectious Diseases for Skilled Nursing Care Centers >