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TRAINING NURSES IN CARING
THE PATIENTS IN
EPIDEMICS AND PANDEMICS
Dr.T.V.Rao MD
6/9/2018 Dr.T.V.Rao MD 1
Emerging Infectious disease
Can be a threat
• Infectious diseases whose incidence in humans has increased in
the past two decades or threatens to increase in the near future
have been defined as "emerging." These diseases, which
respect no national boundaries, include:
i. New infections resulting from changes or evolution of existing
organisms
ii. Known infections spreading to new geographic areas or
populations iii. Previously unrecognized infections appearing in
areas undergoing ecologic transformation
iv. Old infections reemerging as a result of antimicrobial
resistance in known agents or breakdowns in public health
measures
6/9/2018 Dr.T.V.Rao MD 2
6/9/2018 Dr.T.V.Rao MD 3
General Preparedness for Emergent
Infectious Diseases (EID)
Infection controlling
Nurse a Great boon
in Crisis
6/9/2018 Dr.T.V.Rao MD 4
How Good we are
Prepared to Face the
Crisis of Epidemics and
Pandemics
• But relatively little
attention is paid to
rebuilding the under
resourced and
underperforming
primary health care
systems in the places
most vulnerable to
epidemic disease.
6/9/2018Dr.T.V.Rao MD 5
Primary care a
priority
• We all know that primary
care providers play an
important role in initial
outbreak response and
surveillance. This has been
studied in the context of
the H1N1 flu pandemic
which infected
approximately 60 million
people and killed over
12,000 worldwide in 2009.
6/9/2018Dr.T.V.Rao MD 6
The care center’s emergency operation
program will include a response plan for a
community-wide infectious disease outbreak
such as pandemic influenza NIPAH Ebola :
• Build on the workplace
practices described in the
infection prevention and
control policies
ii. include administrative
controls (screening,
isolation, visitor policies
and employee absentee
plans.
6/9/2018 Dr.T.V.Rao MD 7
6/9/2018 Dr.T.V.Rao MD 8
Follow the Universal
Precautions save the lives
6/9/2018 Dr.T.V.Rao MD 9
6/9/2018 Dr.T.V.Rao MD 10
Aseptic practices
saves the lives and
stop spread of
Infections
•Address
environmental
controls (isolation
rooms, plastic
barriers sanitation
stations, and special
areas for
contaminated
wastes)
6/9/2018 Dr.T.V.Rao MD 11
Human Resource
Management a great
problem during epidemics
and pandemics
• Address human
resource issues
such as employee
leave
compatible with
the care center’s
business
continuity plan
6/9/2018 Dr.T.V.Rao MD 12
STAFF Education ON EXPOSURE
RISKS
• Staff will be educated on
the exposure risks,
symptoms, and prevention
of the EID. Place special
emphasis on reviewing the
basic infection prevention
and control, use of PPE,
isolation, and other
infection prevention
strategies such as hand
washing.
6/9/2018 Dr.T.V.Rao MD 13
Respiratory
protection in
Infections
• If EID is spreading through an
airborne route, then the care
center will activate its
respiratory protection plan to
ensure that employees who
may be required to care for a
resident with suspected or
known case are not put at
undue risk of exposure6/9/2018 Dr.T.V.Rao MD 14
EDUCATION OF THE
SOCIETY A PRIORITY
•Provide residents and
families with
education about the
disease and the care
center’s response
strategy at a level
appropriate to their
interests and need for
information.
6/9/2018 Dr.T.V.Rao MD 15
HAND HYGINE AND HAND WASHING A
PRIORITY
• Post signs regarding
hand sanitation and
respiratory etiquette
and/or other
prevention strategies
relevant to the route of
infection at the entry
of the care center
along will the
instruction that anyone
who sick must not
enter the building.6/9/2018 Dr.T.V.Rao MD 16
6/9/2018 Dr.T.V.Rao MD 17
EDUCATION ON INFECTIOUS
DISEASES A MATTER OF
PRORITY
• To ensure that staff,
and/or new residents
are not at risk of
spreading the EID
into the care center,
screening for
exposure risk and
signs and symptoms
may be done PRIOR
to admission of a
new resident and/or
allowing new staff
persons to report to
work.
6/9/2018 Dr.T.V.Rao MD 18
Self-isolation is the need
when the Hospital restrict
the admissions
• In the event there are
confirmed cases of the EID
in the local community,
the care center may
consider closing the care
center to new admissions,
and limiting visitors based
on the advice of local
public health authorities.
•
6/9/2018 Dr.T.V.Rao MD 19
Environmental
cleaning and
sanitation
• The care center will
follow current CDC
guidelines for
environmental
cleaning specific to
the EID in addition
to routine cleaning
for the duration of
the threat.
6/9/2018 Dr.T.V.Rao MD 20
Engineering controls
In Patient care
• The care center will utilize
appropriate physical plant
alterations such as use of
private rooms for high-risk
residents, plastic barriers,
sanitation stations, and
special areas for
contaminated wastes as
recommended by local,
state, and federal public
health authorities.
6/9/2018 Dr.T.V.Rao MD 21
A great Priority to deal with Doctors, Nurses
and Health care workers in suspected
infection during epidemics
•Place a resident or
on-duty staff who
exhibits symptoms of
the EID in an
isolation room and
notify local public
health authorities.
6/9/2018 Dr.T.V.Rao MD 22
• Under the guidance of
public health
authorities, arrange a
transfer of the
suspected infectious
person to the
appropriate acute care
center via emergency
medical services as
soon as possible.
Transfer the critical
care patients to well
equipped Hospitals
6/9/2018 Dr.T.V.Rao MD 23
Risk of Infection in
transporting infectious
patients
•If the suspected
infectious person
requires care while
awaiting transfer,
follow care center
policies for isolation
procedures,
including all
recommended PPE
for staff at risk of
exposure.6/9/2018 Dr.T.V.Rao MD 24
Restrict the entry of personal
and staff to minimum
Provide protective gear who
handle the care
• Keep the number of staff
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)
will enter the isolation
room.
6/9/2018 Dr.T.V.Rao MD 25
Training the Staff in
times of Infection
epidemics to be
Mandatory
•Provide all assigned
staff additional “just
in time” training and
supervision in the
mode of
transmission of this
EID, and the use of
the appropriate PPE.
6/9/2018 Dr.T.V.Rao MD 26
6/9/2018 Dr.T.V.Rao MD 27
If feasible
• Ask the isolated person to
wear a facemask while staff
is in the room. Provide care
at the level necessary to
address essential needs of
the isolated individual unless
it advised otherwise by
public health authorities.
6/9/2018 Dr.T.V.Rao MD 28
Follow the
Guidelines advised
by CDC for safe care
• Conduct control activities
such as management of
infectious wastes, terminal
cleaning of the isolation
room, contact tracing of
exposure individuals, and
monitoring for additional
cases under the guidance
of local health authorities,
and in keeping with
guidance from the CDC.
6/9/2018 Dr.T.V.Rao MD 29
• Implement the isolation protocol
in the care center (isolation
rooms, cohorting, cancelation of
group activities and social
dining) as described in the care
center’s infection prevention and
control plan and/or
recommended by local, state, or
federal public health authorities.
6/9/2018 Dr.T.V.Rao MD 30
Activate quarantine interventions
•Activate quarantine
interventions for
residents and staff with
suspected exposure as
directed by local and
state public health
authorities, and in
keeping with guidance
from the CDC.
6/9/2018 Dr.T.V.Rao MD 31
Hospitals shall take
responsibility : in
implementing safe practices
• The degree of frailty of the
residents in the care center;
ii. The likelihood of the
infectious disease being
transmitted to the residents
and employees;
iii. The method of spread of
the disease (for example,
through contact with bodily
fluids, contaminated air,
contaminated surfaces6/9/2018 Dr.T.V.Rao MD 32
Overcoming Lack of
trust in Time of
Crisis
• A lack of trust between
communities and
government health care
systems can fuel
epidemics, in part
because people may not
follow advice from public
health authorities that
could reduce their risk of
getting or spreading
infection.
6/9/2018Dr.T.V.Rao MD 33
Universal precaution are basis
for all other practice in Health
care
•The
precautions
which can be
taken to
prevent the
spread of the
infectious
disease and v.
Other relevant
factors
6/9/2018 Dr.T.V.Rao MD 34
6/9/2018 Dr.T.V.Rao MD 35
6/9/2018 Dr.T.V.Rao MD 36
Learning from the Past for the Better
future in control of Epidemics and
Pandemics in future
• The epidemic
emergencies that ended
in 2016 have awakened
us to the threat that
weak health systems
and poor primary health
care pose. We must
repair these systems
and improve primary
care now, or risk being
similarly unprepared for
the next wave. 6/9/2018
Dr.T.V.Rao MD
37
It is the Great Responsibility of
the Health administration to
protect the Nursing and Health
care workers
• We owe it to every
healthcare provider to
make sure that they are
equipped with resources
that will protect them
from harm., it is that
nurses and other health
care workers were left in
a precarious and
unacceptable situation.
6/9/2018 Dr.T.V.Rao MD 38
Preparing for Epidemics
and Pandemics a
Priority
6/9/2018 Dr.T.V.Rao MD 39
We need a Greater
knowledge and
preparedness in all
Emergency matters
• Indeed, every
healthcare institution
should have a
readiness plan that
outlines what needs
to be done in case an
infected patient
arrives on their
doorstep.
6/9/2018
Dr.T.V.Rao MD
4
0
INSPITE OF MANY ADVANCES YET THERE IS
NO SUBSTITTUE FOR HAND WASH
6/9/2018 Dr.T.V.Rao MD 41
TRAINED INFECTION CONTROL
NURSES SAVE MANY LIVES
6/9/2018 Dr.T.V.Rao MD 42
• Program Created by Dr.T.V.Rao MD with resources from
CDC/WHO/ NIH and Google resources for benefit of
Nursing and Health care workers in dealing with epidemics
and pandemics to protect self and many others
• Email
•doctortvrao@gmail.com
6/9/2018 Dr.T.V.Rao MD 43

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TRAINING NURSES IN CARING THE PATIENTS IN EPIDEMICS AND PANDEMICS by Dr.T.V.Rao MD

  • 1. TRAINING NURSES IN CARING THE PATIENTS IN EPIDEMICS AND PANDEMICS Dr.T.V.Rao MD 6/9/2018 Dr.T.V.Rao MD 1
  • 2. Emerging Infectious disease Can be a threat • Infectious diseases whose incidence in humans has increased in the past two decades or threatens to increase in the near future have been defined as "emerging." These diseases, which respect no national boundaries, include: i. New infections resulting from changes or evolution of existing organisms ii. Known infections spreading to new geographic areas or populations iii. Previously unrecognized infections appearing in areas undergoing ecologic transformation iv. Old infections reemerging as a result of antimicrobial resistance in known agents or breakdowns in public health measures 6/9/2018 Dr.T.V.Rao MD 2
  • 4. General Preparedness for Emergent Infectious Diseases (EID) Infection controlling Nurse a Great boon in Crisis 6/9/2018 Dr.T.V.Rao MD 4
  • 5. How Good we are Prepared to Face the Crisis of Epidemics and Pandemics • But relatively little attention is paid to rebuilding the under resourced and underperforming primary health care systems in the places most vulnerable to epidemic disease. 6/9/2018Dr.T.V.Rao MD 5
  • 6. Primary care a priority • We all know that primary care providers play an important role in initial outbreak response and surveillance. This has been studied in the context of the H1N1 flu pandemic which infected approximately 60 million people and killed over 12,000 worldwide in 2009. 6/9/2018Dr.T.V.Rao MD 6
  • 7. The care center’s emergency operation program will include a response plan for a community-wide infectious disease outbreak such as pandemic influenza NIPAH Ebola : • Build on the workplace practices described in the infection prevention and control policies ii. include administrative controls (screening, isolation, visitor policies and employee absentee plans. 6/9/2018 Dr.T.V.Rao MD 7
  • 9. Follow the Universal Precautions save the lives 6/9/2018 Dr.T.V.Rao MD 9
  • 11. Aseptic practices saves the lives and stop spread of Infections •Address environmental controls (isolation rooms, plastic barriers sanitation stations, and special areas for contaminated wastes) 6/9/2018 Dr.T.V.Rao MD 11
  • 12. Human Resource Management a great problem during epidemics and pandemics • Address human resource issues such as employee leave compatible with the care center’s business continuity plan 6/9/2018 Dr.T.V.Rao MD 12
  • 13. STAFF Education ON EXPOSURE RISKS • Staff will be educated on the exposure risks, symptoms, and prevention of the EID. Place special emphasis on reviewing the basic infection prevention and control, use of PPE, isolation, and other infection prevention strategies such as hand washing. 6/9/2018 Dr.T.V.Rao MD 13
  • 14. Respiratory protection in Infections • If EID is spreading through an airborne route, then the care center will activate its respiratory protection plan to ensure that employees who may be required to care for a resident with suspected or known case are not put at undue risk of exposure6/9/2018 Dr.T.V.Rao MD 14
  • 15. EDUCATION OF THE SOCIETY A PRIORITY •Provide residents and families with education about the disease and the care center’s response strategy at a level appropriate to their interests and need for information. 6/9/2018 Dr.T.V.Rao MD 15
  • 16. HAND HYGINE AND HAND WASHING A PRIORITY • Post signs regarding hand sanitation and respiratory etiquette and/or other prevention strategies relevant to the route of infection at the entry of the care center along will the instruction that anyone who sick must not enter the building.6/9/2018 Dr.T.V.Rao MD 16
  • 18. EDUCATION ON INFECTIOUS DISEASES A MATTER OF PRORITY • To ensure that staff, and/or new residents are not at risk of spreading the EID into the care center, screening for exposure risk and signs and symptoms may be done PRIOR to admission of a new resident and/or allowing new staff persons to report to work. 6/9/2018 Dr.T.V.Rao MD 18
  • 19. Self-isolation is the need when the Hospital restrict the admissions • In the event there are confirmed cases of the EID in the local community, the care center may consider closing the care center to new admissions, and limiting visitors based on the advice of local public health authorities. • 6/9/2018 Dr.T.V.Rao MD 19
  • 20. Environmental cleaning and sanitation • The care center will follow current CDC guidelines for environmental cleaning specific to the EID in addition to routine cleaning for the duration of the threat. 6/9/2018 Dr.T.V.Rao MD 20
  • 21. Engineering controls In Patient care • The care center will utilize appropriate physical plant alterations such as use of private rooms for high-risk residents, plastic barriers, sanitation stations, and special areas for contaminated wastes as recommended by local, state, and federal public health authorities. 6/9/2018 Dr.T.V.Rao MD 21
  • 22. A great Priority to deal with Doctors, Nurses and Health care workers in suspected infection during epidemics •Place a resident or on-duty staff who exhibits symptoms of the EID in an isolation room and notify local public health authorities. 6/9/2018 Dr.T.V.Rao MD 22
  • 23. • Under the guidance of public health authorities, arrange a transfer of the suspected infectious person to the appropriate acute care center via emergency medical services as soon as possible. Transfer the critical care patients to well equipped Hospitals 6/9/2018 Dr.T.V.Rao MD 23
  • 24. Risk of Infection in transporting infectious patients •If the suspected infectious person requires care while awaiting transfer, follow care center policies for isolation procedures, including all recommended PPE for staff at risk of exposure.6/9/2018 Dr.T.V.Rao MD 24
  • 25. Restrict the entry of personal and staff to minimum Provide protective gear who handle the care • Keep the number of staff 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) will enter the isolation room. 6/9/2018 Dr.T.V.Rao MD 25
  • 26. Training the Staff in times of Infection epidemics to be Mandatory •Provide all assigned staff additional “just in time” training and supervision in the mode of transmission of this EID, and the use of the appropriate PPE. 6/9/2018 Dr.T.V.Rao MD 26
  • 28. If feasible • Ask the isolated person to wear a facemask while staff is in the room. Provide care at the level necessary to address essential needs of the isolated individual unless it advised otherwise by public health authorities. 6/9/2018 Dr.T.V.Rao MD 28
  • 29. Follow the Guidelines advised by CDC for safe care • Conduct control activities such as management of infectious wastes, terminal cleaning of the isolation room, contact tracing of exposure individuals, and monitoring for additional cases under the guidance of local health authorities, and in keeping with guidance from the CDC. 6/9/2018 Dr.T.V.Rao MD 29
  • 30. • Implement the isolation protocol in the care center (isolation rooms, cohorting, cancelation of group activities and social dining) as described in the care center’s infection prevention and control plan and/or recommended by local, state, or federal public health authorities. 6/9/2018 Dr.T.V.Rao MD 30
  • 31. Activate quarantine interventions •Activate quarantine interventions for residents and staff with suspected exposure as directed by local and state public health authorities, and in keeping with guidance from the CDC. 6/9/2018 Dr.T.V.Rao MD 31
  • 32. Hospitals shall take responsibility : in implementing safe practices • The degree of frailty of the residents in the care center; ii. The likelihood of the infectious disease being transmitted to the residents and employees; iii. The method of spread of the disease (for example, through contact with bodily fluids, contaminated air, contaminated surfaces6/9/2018 Dr.T.V.Rao MD 32
  • 33. Overcoming Lack of trust in Time of Crisis • A lack of trust between communities and government health care systems can fuel epidemics, in part because people may not follow advice from public health authorities that could reduce their risk of getting or spreading infection. 6/9/2018Dr.T.V.Rao MD 33
  • 34. Universal precaution are basis for all other practice in Health care •The precautions which can be taken to prevent the spread of the infectious disease and v. Other relevant factors 6/9/2018 Dr.T.V.Rao MD 34
  • 37. Learning from the Past for the Better future in control of Epidemics and Pandemics in future • The epidemic emergencies that ended in 2016 have awakened us to the threat that weak health systems and poor primary health care pose. We must repair these systems and improve primary care now, or risk being similarly unprepared for the next wave. 6/9/2018 Dr.T.V.Rao MD 37
  • 38. It is the Great Responsibility of the Health administration to protect the Nursing and Health care workers • We owe it to every healthcare provider to make sure that they are equipped with resources that will protect them from harm., it is that nurses and other health care workers were left in a precarious and unacceptable situation. 6/9/2018 Dr.T.V.Rao MD 38
  • 39. Preparing for Epidemics and Pandemics a Priority 6/9/2018 Dr.T.V.Rao MD 39
  • 40. We need a Greater knowledge and preparedness in all Emergency matters • Indeed, every healthcare institution should have a readiness plan that outlines what needs to be done in case an infected patient arrives on their doorstep. 6/9/2018 Dr.T.V.Rao MD 4 0
  • 41. INSPITE OF MANY ADVANCES YET THERE IS NO SUBSTITTUE FOR HAND WASH 6/9/2018 Dr.T.V.Rao MD 41
  • 42. TRAINED INFECTION CONTROL NURSES SAVE MANY LIVES 6/9/2018 Dr.T.V.Rao MD 42
  • 43. • Program Created by Dr.T.V.Rao MD with resources from CDC/WHO/ NIH and Google resources for benefit of Nursing and Health care workers in dealing with epidemics and pandemics to protect self and many others • Email •doctortvrao@gmail.com 6/9/2018 Dr.T.V.Rao MD 43