Antepartums, Term pregnancies and flu

[NoSocks4You]

Do your facilities have protocols in place for antes or term laboring women with probable or determined H1N1 or Influenzas A/B? We are treating flu on our ante/postpartum hallway with contact and droplet precautions but I still have issue with going into a "flu room" and then in to see a newborn or highrisk ante. Thoughts?

[mitchsmom]

Doesn't sound like a great idea for sure.

Here's the CDC page on Considerations Regarding Novel H1N1 Flu Virus in Obstetric Settings. I don't know if it specifically addresses that, but it seems like common sense!!

http://www.cdc.gov/h1n1flu/guidance/obstetric.htm

They are constantly reviewing the situation and the recommendations can change at any time, so it is good to check now and then on the latest info.

[babyktchr, BSN, RN]

It would be prudent to staff so that your infected moms are taken care of by the same nurse/nurses when that is possible. You are just going to have to creatively staff, especially if you are hit hard in your facility. You are going to have to practice diligent precautions and handwashing in order to keep everyone from being contaminated. If you have critically ill laboring or post partum patients (and hopefully not) you will have to set up a collaborative effort with your ICU. It will just be one big group effort until it passes. I, personally, am crossing my fingers that we are over-prepared and we will not have to go into crisis mode with this flu. The CDC has specific recommendations posted for just about any scenario and are quite helpful. At my facility, we have set up emergency management already in case of a catastrophic event. It is a good thing to do....being prepared is half the battle.

[bmcm2girls]

I posted about something similar not that long ago but didn't get much response, lol. My issue wasn't so much with taking care of the women themselves, it was more a matter of visitors/support persons that are infected. CDC doesn't have any recommendations on this... probably b/c they assume it is common sense that anyone infected NOT be allowed if they are not the patient. But, my facility doesn't see it that way I guess. For our patients themselves, we try to group them so that the same nurse only has the sick patients but that doesn't always work (we are still being hit pretty hard by H1N1..but we were also hit later then most other areas). For visitors, they are "screened" prior to entering and if they are symptomatic, they are *supposed* to be told to wear masks and not leave the patients room (avoid common areas). But they don't listen and we have had many cases of nurses getting sick from exposure to a visitor and then having to treat all the patients that nurse came in contact with prior to showing symptoms. We are seeing up to a 5 day incubation period but they are only treating those in the 24 hr window. Our other issue has been patients themselves not being symptomatic (thus not being put on precautions) until several hours after admit, so they were exposing everyone at prime infectious time without precautions. IMO, THAT part is par for the course. I don't think there is much we can do about that. And, there isn't much we can do about having ill patients next to healthy ones. I guess THAT situation bothers me the least b/c they ARE put on precautions and as long as you use them right, they are effective. The issue with the visitors bothers me more b/c a) they typically aren't compliant with our requests and b) we can't "control" them and who they expose as much as the patient themselves (who would be restricted to the room).