Flu precautions in community homes

Posted
by ocean.baby ocean.baby Member Nurse

Specializes in corrections and LTC. Has 25 years experience.

I work for a company that owns several homes for the developmentally disabled. These homes are scattered throughout the town. The smallest has a census of 4, the largest has a census of 18. The majority of our residents and staff get an annual flu shot, though it is not mandatory. The following story happened on a house that housed 8 residents, each with a private bedroom, all other areas are shared.

On Saturday evening we had a resident who had a sore throat as well as significant swelling to one side of her neck. We sent her to the Emergency Room. She came back with a diagnosis of influenza and a prescription for 5 days of Tamiflu and a new order for oxygen. I sent the following e-mail to all staff, including administration, regarding her precautions:

'She is to stay in her room except for showering and toileting - please visit her so that she does not feel isolated and remember that someone will need to be in her room with her while she eats. Wear gloves and a clean mask EVERY time that you interact with her. Do not wear the mask outside of her room. You cannot put it in your pocket or let it hang around your neck to re-use. She now wears oxygen at 3 liters using a nasal cannula. I do not know if this will be long term or not, that will be determined within the next few weeks. The only time she can have her oxygen off is when she goes to the bathroom or takes a shower.'

Three days later the administrators decided that the resident who was positive for influenza needed to attend a movie in a main building, residents from all community homes attended this movie. Even though staff reminded administration that she was not to leave her room, they said that she had the right to do so and that we cannot keep her in her room. That evening they again took her to a main building where a special dinner was prepared (per orders from administration).

The facility has no policy on communicable diseases, which will change here shortly. However, I feel that administration should have followed the guidelines that nursing gave them. These guidelines were based on information obtained from the Public Health Department as well as the CDC. Our residents all have compromised health and are at high risk for contracting any illnesses.

I welcome any feedback. Thank you.

Lunah, MSN, RN

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 14 years experience. 33 Articles; 13,699 Posts

What you did sounded perfect. What they did was ignorant. Transmission-based precautions (droplet) should be implemented in these situations.

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, SOL (Student of Life). Has 20 years experience. 4 Articles; 4,573 Posts

You need to check Title 22 which sets the standard and laws for group home consumers. While your actions are sensible they may not be legal under Title 22 as it may constitute seclusion which is a violation of a consumer's rights.

The state inspectors are nuts

Hppy

Lovecaring

Lovecaring, BSN, RN

Specializes in Infection Control & Wound Care. Has 20 years experience. 21 Posts

She may attend the movie session with other residents if she is willing to wear a mask.