What comes to mind when you hear the words influenza (flu) outbreak?

AnnMarie Penney, infection control coordinator, posts a sign about infection control procedures at Hoyles-Escasoni Complex.

For Eastern Health’s long-term care staff, residents and their families, it is an all too familiar word – bringing with it a variety of thoughts and emotions. Over the winter and spring of 2012-2013, we were faced with several outbreaks presenting many challenges and opportunities.

One Monday morning in December 2013, I had just returned from a week of vacation. Word travels fast in our facilities – and as I was saying my good mornings, I was informed that we were in the midst of an influenza outbreak at the Hoyles-Escasoni Complex.

I opened my office door to find my message manager blinking, not a good sign after a weekend, especially when you work in Infection Prevention and Control.

A check of the phone messages, emails and laboratory reports and collaboration with a colleague confirmed it: we were indeed experiencing an “Influenza A” (respiratory) outbreak.

(l-r) AnnMarie consults with Licensed Practical Nurse Dianne Petten.

Then I was off to the units to assess the sick residents, get updated information and ensure that we had everything we needed to manage the outbreak and prevent the spread of this flu. As I walked through the affected units, I was excited and proud to see the excellent work all staff were doing:

• Droplet and contact precautions were being followed with appropriate signage posted.
• Environmental Service employees were in full swing with cleaning and disinfecting processes.
• Education on the flu was being provided to residents and their families – empowering all of them with the resources needed to help us care for and visit our residents safely.

Our ‘huddle’ at the nursing station became a daily occurrence and included all staff working on the unit.

During an outbreak, the Outbreak Management team meets on a regular basis. As an infection control coordinator, I provide a daily update of the status of the outbreak and the residents who are currently affected. We discuss and review the information, the best practices for infection prevention and control and any other issues brought forward during an individual outbreak to ensure that the outbreak is prevented or contained.

Outbreak Management briefing at Hoyles-Escasoni. Standing (l-r): Dianne Petten, LPN; Joan Decker, Environmental Services Supervisor; AnnMarie Penney, IPAC; Sandra McCarthy, Environmental Services; Pam Noseworthy, Medical Services Aide. Seated: Melissa Badcock, B.N., R.N.

Often, we find ourselves making difficult decisions such as cancelling special social activities, events and spiritual gatherings because of an outbreak. These are not decisions we make lightly, as social interaction has a very positive impact on the lives of our residents.

Visitor precautions are also an important part of outbreak management. Eastern Health has developed an information pamphlet for family, visitors and staff on how to safely visit a long-term care facility during an outbreak. It is available on nursing units during an outbreak and can also be found on the Eastern Health website under About Us: Visitor Precautions.

During the course of an outbreak, communication is key. Updated information is circulated to all persons involved: the Infection Prevention and Control Program, departmental managers and front line staff within the affected facility, along with residents, families and visitors.

We acknowledge the stress that both an infectious illness – and the precautions and restrictions we need to take – can place on residents and families. However, given the speed at which infection can spread, we must take every measure to protect all residents, staff, family and visitors within a safe environment.

From October 2012 to June of 2013, we handled more than 40 respiratory and gastrointestinal flu outbreaks in our long-term care homes throughout the whole Eastern Health region.

Was everything perfect? No, there were a few bumps along the way, but even the bumps presented us with opportunities to learn, to improve and to grow as individuals and as a team.

AnnMarie Penney practising infection prevention and control.

It’s my experience that you not only have to be professional but also compassionate – a good listener and a strong team member to be effective in outbreak management. I have gained valuable knowledge and experience during every outbreak I have been involved in. It is truly my privilege to work with the Infection Prevention and Control Program, in a supportive and mentoring environment. It is also a pleasure to work side-by-side with such hard working compassionate and resident-focused colleagues at the Hoyles-Escasoni Complex.

I have learned from the best!

It gives me a great sense of personal accomplishment and job satisfaction to see a flu outbreak through with minimal impact to our residents.

It is very rewarding at the end of the day, at the end of the outbreak, for us all to be able to say:

“I made a difference.” ■

This story was written by AnnMarie Penney, R.N., an infection control coordinator  with Eastern Health, based at the Hoyles-Escasoni Complex in St. John’s.