Flu season brings a set of challenges each year—challenges further amplified when an outbreak occurs in a healthcare setting. From increased morbidity and mortality to longer lengths of stay and higher care costs, healthcare-associated influenza can place a huge burden on patients and healthcare providers alike.
With this in mind, prevention is the ultimate weapon in the fight against healthcare-associated influenza . If transmission between patients and healthcare workers can be minimized, so can outbreaks within healthcare settings.
As outlined by the Centers for Disease Control and Prevention (CDC), there is no single best approach to preventing the transmission of the influenza virus in healthcare settings. Instead, five measures that act synergistically should be used in combination for maximal effect. These are influenza vaccination, exposure minimization, correct management of ill workers, adherence to standard infection control measures and adherence to droplet control protocols.
Administration of the Influenza Vaccine
Administration of flu vaccines to all eligible patients and healthcare workers is often considered the most important step in preventing influenza infection; yet many healthcare professionals and patients avoid vaccination due to misconceptions about the vaccine, such as the belief that it can cause the flu or it is solely for the elderly.
Thorough education of healthcare workers and patients well ahead of flu season can help to challenge these myths and increase uptake of the vaccine. Additional strategies, such as free or mandatory vaccinations, may also be effective at encouraging patients and healthcare professionals to get the vaccine.
Minimize Exposure to the Influenza Virus
It’s often said that prevention is better than cure. Where the flu is concerned, prevention is not only better, it’s easier, safer and less expensive. Fortunately, there are many administrative policies and practices that can be used to minimize a person’s likelihood of being exposed to the influenza virus when in a healthcare setting.
The CDC places the implementation of respiratory hygiene and cough etiquette at the top of the list of effective practices. Instructing patients and staff members to report existing symptoms of flu infection before coming to a hospital or clinic, maximizing the display of signage that outlines correct respiratory hygiene (such as washing hands after coughing and sneezing) and providing ample wash stations and hand sanitizers can all help to minimize the spread of influenza in hospitals and clinics.
Management of Ill Workers
As outlined by CDC guidelines, a three-pronged approach is most effective for managing healthcare workers who could transmit flu infection. Firstly, create a standard policy that instructs personnel with fever and respiratory symptoms to stop work and go home immediately. Secondly, arrange automatic, occupational health evaluations for all healthcare workers with respiratory symptoms and no fever, to determine if they pose an infection risk. Finally, create non-punitive and flexible sick leave policies that encourage healthcare workers to stay at home when unwell.
Adherence to Standard Infection Control Measures
Given the ease with which the flu virus can be transmitted, it is important for all healthcare professionals to adhere to standard infection control precautions while caring for all patients during flu season. These precautions should include the use of gowns if contact with bodily fluids is expected, gloves for making contact with any potentially infectious materials, before and after removing gloves, and correct hand hygiene before and after making contact with patients and potentially infectious materials.
Adherence to Droplet Control
The final important strategy for controlling influenza during flu season should involve strict adherence to droplet precautions for all patients with a suspected or confirmed case. This includes placing them in a private room and instructing them to wear face masks if they have to leave their room for any reason. Healthcare workers should also wear a face mask on entering the patient’s room and remove the mask on leaving the room.
These precautions should be continued for seven days after the onset of symptoms or until 24 hours after the resolution of fever and respiratory symptoms, whichever is longer.
The True Impact of Failing to Control Healthcare Associated Flu
The CDC estimates that 48.8 million people had the flu in 2017-2018, resulting in 959,000 hospitalizations and 79,400 deaths—the highest number of influenza-associated illnesses since 2009. These figures show the burden of influenza is high and action is needed to tackle this, especially in healthcare settings.
As with all infectious disease, early action and preventive strategies are key to minimizing the risk of influenza outbreaks during flu season. Hospitals and clinics can play their part in this by encouraging flu vaccinations, strictly adhering to infection control practices and implementing strategies for minimizing exposure of sick employees and patients to uninfected patients and workers. Learn how Vitalacy is empowering hospitals with infection prevention measures using AI monitoring.
Lauretta Ihonor is a medical doctor and a freelance health journalist/writer. She is based in London, UK and specializes in writing about medical technology and general medicine. She has worked for CNN International, BBC and Sky News.
Centers for Disease Control and Prevention. Prevention Strategies for Seasonal Influenza Control in Healthcare Settings. Available at: https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm. Last accessed 5th March 2019.