Mohave County
Department of PUBLIC HEALTH
700 W. Beale Street, Kingman AZ
Planning for pandemic influenza
is critical. The Department of Health and Human Services (HHS) and the Centers
for Disease Control and Prevention developed the following checklist to help
organizations that provide home health care services assess and improve their
preparedness for responding to pandemic influenza. Home health agencies will
likely be called upon to provide care for patients who do not require
hospitalization for pandemic influenza, or for whom hospitalization is not an
option because hospitals have reached their capacity to admit patients. These
agencies may become overburdened very quickly and shortages of personnel and
supplies for providing home health care may occur.
The list is comprehensive but not complete; each
home care agency will have unique issues that will need to be addressed as part
of a pandemic planning exercise. Also, some items on the checklist may not be
applicable to a given agency. Collaboration with hospitals, local pandemic
planning committees and public health agencies will be essential to ensure that
the affected population receives needed health care services.
Pandemic influenza has been incorporated into
emergency management planning for the organization.
A planning committee has been created to
specifically address pandemic influenza preparedness.
A person has been assigned responsibility for
coordinating preparedness planning for the practice or organization.
(Insert name, title and contact information)
Members of the planning committee1
include the following: (Insert name, title and contact information
for each)
Administration:
Nursing:
Clerical:
Other:
A point of contact has been identified for questions/consultation
on infection control (e.g., hospital- or state health
department-based infection control professional, healthcare
epidemiologist). (Insert name, title, and contact information)
Copies of relevant sections of the Department
of Health and Human Services Pandemic Influenza Plan have been
obtained. (www.hhs.gov/pandemicflu/plan/)
Copies of available state and/or local
pandemic influenza plans have been obtained.
A written plan has been completed or is in
progress that includes the elements listed in #3 below.
The plan describes the organizational
structure (i.e., lines of authority, function and assignment of
responsibility) that will be used to operationalize the plan.
The plan complements2
local response plans in communities served by the home health care
agency.
A plan is in place for monitoring
for pandemic influenza in the population served.
Responsibility has been
assigned for monitoring national and state public health
advisories (e.g., www.cdc.gov/flu/weekly/fluactivity.htm)
and updating members of the pandemic influenza planning
committee when cases of pandemic influenza have been
reported in United States and in the geographic area.
(Insert name, title, and contact information)
A system has been created to
monitor influenza-like illness in patients cared for in the
home (i.e., weekly or daily number of patients with
influenza-like illness). www.cdc.gov/flu/professionals/diagnosis/
(Having a system for tracking illness trends during seasonal
influenza will ensure that organizations can detect
stressors that may affect operating capacity, including
staffing and supply needs, during a pandemic.)
A system is in place to
report unusual cases of influenza-like illness and
influenza-related deaths to local health authorities.
A communication plan has been
developed and includes the following information:
Key public health points of
contact for pandemic influenza have been identified. (Insert
name, title, and contact information for each)
Local health department
State health department
Local emergency management
The organization's point
person for external communication (e.g., with hospitals,
nursing homes, health departments, social services agencies)
has been assigned. (Insert name, title and contact
information)
A list has been created of
healthcare entities and their points of contact (e.g., other
home care services providers, local hospitals, residential
care facilities, social service agencies, emergency medical
services providers, health centers and rural health
facilities, relevant community organizations [including
those involved with disaster preparedness]) with whom the
home care agency anticipates that it will be necessary to
maintain communication and coordination of care during a
pandemic. (Insert location of contact list):
The pandemic response
coordinator has contacted local or regional pandemic
influenza planning groups to obtain information on
communication and coordination of plans.
The pandemic response
coordinator has contacted other home care services providers
in the area regarding their pandemic influenza planning
efforts. (Whenever possible, home care agencies should
consider joint planning and coordination opportunities.)
An education and training program
has been developed to ensure that all personnel understand the
implications of, and control measures for, pandemic influenza
and the current community response plan. (For more information
on the scope of recommended education and training, see www.hhs.gov/pandemicflu/plan/sup3.html#edutrain)
A person has been designated
to coordinate education and training (e.g., identify and
facilitate access to education and training programs, ensure
that home care personnel attend, and maintain a record of
attendance). (Insert name, title, and contact
information):
Current and potential sites
have been identified for long-distance (e.g., web-based
programs offered by professional associations or federal
agencies) and local (e.g., health department or hospital
sponsored programs) education of home care personnel. (www.cdc.gov/flu/professionals/training/)
Language and reading-level
appropriate materials have been identified on pandemic
influenza (e.g., available through state and federal public
health agencies and professional organizations) and a plan
is in place for obtaining these materials.
The education and training
program includes information on infection control measures
to prevent the spread of pandemic influenza, including
information on measures home health care personnel should
apply during home care of patients. (For further information
on infection control recommendations for home care, see www.hhs.gov/pandemicflu/plan/sup4.html#care)
Informational materials on
pandemic influenza for patients and their families have been
identified that are language and reading-level appropriate for
the population being served and a plan is in place to obtain and
disseminate these materials.
Materials have been
identified or developed to guide family members on infection
control and care of patients with pandemic influenza in the
home. www.pandemicflu.gov/plan/tab3.html
Patients and families are
encouraged to maintain a 30-day supply of medications and
medical supplies as well as a two-week supply of
non-perishable food and water.
A plan has been developed for the
management of patients during a pandemic, which covers the
following issues:
Plans have been developed to
manage patient care during the height of a pandemic to
accommodate the increased number of patients who will need
home care services.
The scope of services that
the agency will provide and those that will be denied or
referred to other providers has been clearly defined.
The role and responsibility
of the agency regarding distribution of infection control
supplies (e.g., masks, hand hygiene materials), food,
medications, and other necessities in the home to patients
and their families has been discussed with a local or
regional pandemic influenza planning group.
Plans include decision tools
for determining which patients can have altered service
schedules based on their health conditions, needs, and
available resources.
Local plans and criteria for
the disposition of patients have been discussed with area
hospitals and other home care agencies. (Hospitals may
discharge patients to home and home health care agencies
early to free-up bed space for critically ill patients.)
The plan considers how social
service agencies (e.g., Red Cross, Salvation Army) will help
meet the needs of families in the community (e.g., by
providing child- or elder-care meals, shopping services) in
homes where there are patients with pandemic influenza,
particularly where the primary adult support person living
in the home is ill.
The plan considers how the
agency will maintain a database of clients who require
electrically-dependent technology-driven care (e.g.,
ventilators, breathing treatments, suction, pumps, turning
devices), oxygen, special nutrition requirements, dialysis,
etc.
An infection control plan is in
place and includes the following:
A list has been developed of
supplies (e.g., surgical masks, gloves, alcohol-based hand
hygiene products) that will be used during home care of
patients with pandemic influenza.
An occupational health plan has
been developed that includes the following:
A liberal/non-punitive sick
leave policy for managing home care personnel who have
symptoms of, or documented illness with, pandemic influenza.
The policy considers:
The handling of staff who
become ill at work
When personnel may return
to work after recovering from pandemic influenza
When personnel who are
symptomatic, but well enough to work, will be permitted
to continue working
A system for evaluating
symptomatic personnel before they report for duty has been
developed and tested during a non-pandemic (e.g., seasonal)
influenza period.
Mental health and faith-based
resources have been identified that are available to provide
counseling to personnel during a pandemic.
The management of personnel
who are at increased risk for influenza complications (e.g.,
pregnant women, immunocompromised healthcare workers) has
been addressed by placing them on administrative leave or
altering their work location.
Staff have been encouraged to
develop their own family care plans for the care of
dependent minors and seniors in the event community
containment measures (e.g., "snow days," school
closures) are implemented and for possible illness in adult
family members.
The agency has the ability to
monitor influenza vaccination of healthcare personnel.
Influenza vaccine is offered
or made available on an annual basis to healthcare
personnel.
A vaccine and antiviral use plan
has been developed.
Websites containing current
federal and state health department recommendations for the
use and availability of vaccines and antiviral medications
have been identified. (www.cdc.gov/flu/professionals/vaccination/)
An estimate has been
developed of the number of personnel who would be targeted
as first and second priority for receipt of pandemic
influenza vaccine and antiviral prophylaxis, based on HHS
guidance for use. (www.hhs.gov/pandemicflu/plan/appendixd.html)
The potential role of the
home health care organization in the distribution of vaccine
and antivirals in the community has been discussed with the
local health department and/or regional pandemic planning
committee.
Issues related to surge capacity
during a pandemic have been addressed.
A plan is in place for
managing a staffing shortage within the organization due to
illness in personnel or their family members.
The minimum number and
categories of nursing staff and other professional personnel
necessary to sustain home care services for a given number
of patients or on a day-to-day basis have been determined.
Cross-training (where applicable) has been implemented.
Priorities for providing care
have been established.
Contingency staffing plans
have been developed for either limiting home care access or
recruiting temporary personnel during a staffing crisis.
Hospitals and other
appropriate healthcare service providers have been consulted
regarding contingency staffing resources.
Anticipated consumable
resource needs (e.g., masks, gloves, hand hygiene products)
have been estimated.
A primary plan and
contingency plan to address supply shortages have been
developed, including detailed procedures for acquisition of
supplies through normal channels as well as requesting
resources for replenishing supplies when normal channels
have been exhausted.
Plans include stockpiling at
least a week's supply of resources when there is evidence
that the potential for pandemic influenza has reached the
United States.
There is an understanding of
the process for requesting and obtaining assets (e.g.,
personal protective equipment, medical supplies) made
available through the community's response plan.
Information has been obtained
on local and regional plans and resources for dealing with
mass fatalities including removal of the deceased from the
home.
1 The committee
could be very small (e.g., two or three staff members) or very large,
depending on the size and needs of the organization. Members of the
"group of professional personnel" required by CMS as one of the
Home Health Agency Conditions of Participation should be included on the
planning committee.
2 As communities develop their pandemic response
plans, the provision of home health care will be a pivotal concern. Home
health care agencies should have input into these plans to ensure there are
no conflicts between what the agency can provide and what the community
expects.
3 Most home health agencies will already have a
list of healthcare organizations and points of contact that can be used for
this purpose.