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H1N1 in prison setting

Posted

Specializes in Corrections, psychiatry, rehab, LTC. Has 25 years experience.

Just wondering if any of you have experienced outbreaks of H1N1 in your facility, how widespread it became and what measures you took when it happened. We do not have an outbreak at present, but I want to be completely prepared if we have one. Our current protocol is just to monitor for potential symptoms, then isolate if we have any cases.

military spouse

Has 20 years experience.

We haven't had any positive cases, but we really aren't testing for it. We seem to screen for high fever and other flu sx. Had one guy go to the hospital that they thought might be H1N1, but he ended up having something wrong with his lungs and died (not H1N1).

mariahas4kids

Specializes in hospice, corrections. Has 3 years experience.

I work for WA DOC, I work in a work camp, inmates live in dorm-like tiers or in 2 man rooms. We had 1 confirmed case of H1N1 so far, we isolated him in secured housing and then quarentined his cellies in a day room, isolating a bathroom for their use. State-wide almost all of our facilities have had at least one case, a couple of them are up to 15. Our healthcare staff have been planning for a flu pandemic since 2007 when bird-flu was going to get us. We are prepared for isolating, quarentining all the way up to multiple deaths. I know that sounds horrible, but we have a plan for if it gets really bad.

Orca, ASN, RN

Specializes in Corrections, psychiatry, rehab, LTC. Has 25 years experience.

We have had one confirmed case, sent out due to high temp and respiratory distress. Spent about a week in the hospital. Like most of you, we have no means to test for H1N1 here - the hospital confirmed it. The puzzle is where it came from - no other known cases in the facility, no visitors, etc.

katkonk, BSN, RN

Specializes in Occupational health, Corrections, PACU. Has 25 years experience.

I assume, then, that you all are not vaccinating for the H1N1 flu...just monitoring, correct? Even high risk patients. like CHF/COPD, oncology pt.s, etc?

shell911rn

Has 5 years experience.

We haven't been able to get the H1N1 vaccine for employees or our inmates. I can't even get it at my healthcare provider yet because they have run out of the vaccine and are only giving it to children six and under, pregnant women, and/or caregivers of children six and under. As far as measures in my particular state facility in CA, we isolate those who have symptoms and their cellie if they live in a cell setting to their cells for seven days or longer if their symptoms haven't subsided (in the case of the asymptomatic cellie, if he develops symptoms during the initial isolation, his isolation will be restarted and last seven or more days depending on duration of symptoms). We are swabbing those with symptoms that are suspect for H1N1, but it takes weeks to get the results back. I haven't heard how many confirmed cases we have actually had. We also do contact investigation (just as you would with any outbreak) although the guidelines on this are not really firm and especially difficult on a minimum support yard where the inmates work on and off site and interact at chow, at school, groups, etc. If an inmate has any chronic conditions that would make him especially susceptible to H1N1, we will usually isolate them in a single-cell in our infirmary for close monitoring by healthcare staff. Our Public Health nurses issue an updated memo as possible new cases are identified indicating which cells are currently under isolation and what date the isolation is set to expire so that custody and health care staff are aware. Early on, we were isolating entire dorms on one particular yard where inmates live in bunks in an open setting who had cases of H1N1, but this was disrupting too much of the daily prison program and was eventually deemed unnecessary by our higher ups. Our main issues now are just trying to figure out who is responsible for providing custody with N95's (medical or custody administrative staff), educating staff about the use of N95's and when they are and aren't necessary, and when are we going to get the H1N1 vaccine for staff and inmates alike. I imagine when we do get the vaccine, we will probably start with our HIV inmates first (as we have done in the past with seasonal flu shots), then those with chronic diseases, and so on and so forth.

Edited by shell911rn
Clarification

mariahas4kids

Specializes in hospice, corrections. Has 3 years experience.

Apparently getting H1N1 vaccine to prisons is a nationwide problem. We are told our patients live in a high-risk environment and yet we cannot get vaccine for our high-risk patients. I am in WA State, some county health departments have given a small amount of vaccine to some of the prisons for their high-risk patients, but my county says "It will be awhile." :smackingf We are a small facility, 480 inmates. I have 132 hi-risk patients. 1/5 of the population. Good luck everyone!

katkonk, BSN, RN

Specializes in Occupational health, Corrections, PACU. Has 25 years experience.

My friend is a "regular" public health nurse ( ...meaning state employee, but not correctional), a "PHN" in Hawaii. They have had to run all the flu clinics in the schools and will begin giving H1N1 vaccine to kids next week. And did you know that Hawaii isn't vaccinating their OWN PHN's...how is that for a slap in the face? She got her regular flu shot at a drugstore, and cannot find anyone that has H1N1 that doesn't already have a full clinic schedule with vaccines that aren't spoken for. UNBELIEVEABLE! Oh, yeah, and they just had a RIF, too (reduction in force-for the uninitiated)....so their workload has increased dramatically. From almost unmanageable to completely unmanageable.

Edited by katkonk
adding info

Orca, ASN, RN

Specializes in Corrections, psychiatry, rehab, LTC. Has 25 years experience.

I assume, then, that you all are not vaccinating for the H1N1 flu...just monitoring, correct? Even high risk patients. like CHF/COPD, oncology pt.s, etc?

We got enough vaccine for medical division employees and our pregnant inmates, but no one else. All of the eligible inmates opted for the vaccine, some employees declined (I took it). Otherwise we're just monitoring.

jschut, BSN, RN

Has 20 years experience.

We've had 2 confirmed cases of H1N1 at work. However, both were employees... not offenders.

They have made the vaccine available to us though.