WHO declares H1N1 pandemic; researcher describes key LTC practices

Cleveland-With an estimated 28,000 cases of the H1N1 swine flu virus worldwide as of June 11, including 141 deaths in 74 countries, the World Health Organization (WHO) declared a pandemic during an emergency meeting with global health officials. It was the first declaration of a global flu pandemic in more than 40 years.

Citing sustained community transmission of swine flu in countries outside of North America, WHO said the definition of a pandemic was met, but stressed that the declaration only signifies geographic spread of a disease, not severity. The organization said the virus is mild and has yet to mutate-keeping it from becoming more deadly-and held off from making its decision for fear of triggering global panic.

WHO said it hopes the pandemic announcement will incite drug makers to quickly produce of a swine flu vaccine, and therefore cause governments to spend more money on containment of swine flu.

Lona Mody, MD, MSc, assistant professor of internal medicine at the University of Michigan Geriatrics Center, warned that while the swine flu has not affected older adults and nursing home residents disproportionately, it is “crucial” for long-term care facilities to institute the following practices:

  • develop protocol to limit access to the facility by visitors who are sick;

  • conduct clinical surveillance to detect increases in influenza-like illness among staff and residents;

  • monitor employee absenteeism;

  • track transfers to and from the facility and monitor for influenza-like illness;

  • update information on data to be reported to health departments;

  • collaborate with public health officials, other government officials, neighboring healthcare facilities, the lay public, and the media to ensure rapid and ongoing information sharing during an influenza pandemic;

  • keep facility personnel, patients, and visitors informed of the ongoing preparedness planning and the impact of the pandemic;

  • develop a detailed educational plan for staff, patients, family members, and visitors;

  • develop educational material in different languages, directed at different educational levels, and incorporate materials developed by the Department of Health and Human Services as well as state and local health departments; and

  • plan for adequate staffing and have a nonpunitive sick policy.

Staff and administration of long-term care facilities should also have hand hygiene products easily available throughout a facility to protect residents from contamination while emphasizing appropriate cough etiquette, Mody says. Limiting visitors and ensuring a nonpunitive sick leave policy was also reemphasized with caution.

If a resident contracts any flu-like symptoms, Mody says to “isolate possible pandemic influenza patients and follow CDC recommended procedures in taking care of patients. It is absolutely crucial for nursing homes to have a person designated as a pandemic coordinator.”

Kevin Kolus, Associate Editor

Emeritus gets ready for flu season

Seattle-Emeritus Senior Living is partnering with VaxAmerica, an influenza vaccine manufacturer, to make flu shots available to their residents as well as people in the local community.

The program will encourage the 26,500 seniors living in Emeritus’ communities and 19,000 Emeritus employees to receive their vaccination, according to the company. In addition, Emeritus is opening its doors to provide convenient access for local seniors who live near any of its 309 communities to also receive their flu vaccine.

“In light of the increased awareness surrounding swine flu, we anticipate there will be a higher demand for vaccines this fall. Our goal is to make it easy and convenient for people in our communities and the surrounding areas to protect themselves against the flu,” says Granger Cobb, co-chief executive officer, Emeritus Senior Living.

According to the Centers for Disease Control, the seasonal flu claims approximately 36,000 lives each year, with vaccination especially important for those in the high-risk categories including children, seniors, and those with compromised immune systems.

“Because there has been so much attention paid to swine flu in recent weeks, Emeritus is taking the opportunity to educate people about precautions they can take to help prevent the spread of the flu,” Cobb continued. “Through this nationwide vaccination program, we hope to protect our residents and the seniors living near our communities from the potentially devastating effects of the flu virus.”

Flu shots will be given at all Emeritus communities beginning October 1.

NNHS Survey 2004 Overview: beds and resident numbers down

Washington-The National Center for Health Statistics has released The National Nursing Home (NNHS) Survey: 2004 Overview. The report describes U.S. nursing homes and nursing home use for current residents. The data highlights key findings related to the quality of care, including advance directives, emergency care, and medications taken by nursing home residents. The NNHS is administered periodically, the last one being conducted in 1999. In addition to summarizing the 2004 findings, the survey highlights statistically significant differences in selected national estimates between the 1999 and 2004 surveys. The 2004 NNHS estimates in this survey are based on the 1,174 responding facilities and on data collected from the administrative and medical records of 13,507 of their current residents. The data highlights include:

  • In 2004, there were 1.7 million nursing home beds in the United States compared with 1.9 million beds in 1999.

  • The number of nursing home residents decreased from 1.6 million in 1999 to 1.5 million in 2004.

  • Mental disorders were the second leading primary diagnosis among residents at the time of interview (22%). This represents more than a 20% increase over the 1999 estimate, when 18% of nursing home residents had a primary diagnosis for a mental disorder at the time of interview.

  • Almost 9% of current residents had a fall reported in the 30 days prior to the facility interview.

  • About 65% of current nursing home residents had at least one type of advance directive.

  • In the 90 days prior to the facility interview, almost 11% of current nursing home residents had at least one hospitalization or emergency department visit while in the care of the nursing home.

A copy of the full report can be accessed online at https://www.cdc.gov/nchs/data/series/sr_13/sr13_167.pdf.

FDA warns not to use Clarcon products

Washington-The U.S. Food and Drug Administration (FDA) reports Clarcon Biological Chemistry Laboratory Inc., Roy, Utah, has voluntarily recalled some skin sanitizers and skin protectants marketed under several different brand names because of high levels of disease-causing bacteria found in the products during a recent inspection. The FDA’s warning is not to use any Clarcon product and to dispose of them.

Analyses of several samples of over-the-counter topical antimicrobial skin sanitizer and skin protectant products revealed high levels of various bacteria, including some associated with unsanitary conditions. Some of these bacteria can cause opportunistic infections of the skin and underlying tissues. Such infections may need medical or surgical attention, and may result in permanent damage. Examples of products that should be discarded include: CitruShield Lotion, Dermassentials DermaBarrier, Dermassentials by Clarcon Antimicrobial Skin Sanitizer, Iron Fist Barrier Hand Treatment, Skin Shield Restaurant, Skin Shield Industrial, Skin Shield Beauty Salon Lotion, Total Skin Care Beauty, Total Skin Care Work.

Findings from the FDA’s recent inspection of the Clarcon facility are particularly concerning because the products are promoted as antimicrobial agents that claim to treat open wounds, damaged skin, and protect against various infectious diseases. The inspection uncovered serious deviations from FDA’s current Good Manufacturing Practice requirements.

The FDA advises healthcare professionals to report serious adverse events or product quality problems with the use of any of these products to the FDA’s MedWatch Adverse Event Reporting program either online, by regular mail, FAX, or phone.

Online: https://www.accessdata.fda.gov/scripts/medwatch/medwatch-online.htm U.S. Mail: use postage-paid FDA form 3500 found at https://www.accessdata.fda.gov/scripts/medwatch/, and mail to MedWatch, 5600 Fishers Lane, Rockville, MD 20852-9787FAX: (800)FDA-0178Phone: (800)FDA-1088


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Long-Term Living 2009 July;58(7):10-12

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