Influenza Precautions

[NurseQT]

How would y'all have handled this situation.. Yesterday we took an admission that had been hospitalized for the past week with influenza A. The hospital tried sending her on Tuesday but she was still being treated with Tamiflu and per our facility policy we can't take a flu pt. until they've completed the Tamiflu and are asymptomatic x 48 hrs. When I saw her name on the board for Friday I voiced my concerns. Social services said if she's been sx free then we could take her, When I took report I asked about symptoms the answer I got was "afebrile since last Friday" I asked about a cough and was told "no cough". The patient shows up wearing a mask.... She had a loose, productive cough from the moment she rolled in. She was placed in a room with another elderly lady who is quite mobile. The rooms are small so they are in close proximity. This a.m. I kept the curtain pulled as a barrier. Needless to say, room mates family came in found out their mom's new roomie had influenza and were not happy (to put it mildly). We have no open beds to move someone to. They wanted to speak with our administrator. I had no idea how to rectify the situation. We have no way of knowing if this new patient was still shedding the virus, but is it worth it to risk it? We already had a flu outbreak in the facility and actually had a resident die from flu related complications.

What would you have done? How do you properly follow droplet precautions in a semi-private room? Also how do you go about protecting the roommat's visitors without violating anyone's privacy rights?

[ann7]

Before being discharged from hospital to another facility, they are supposed to do a Infuenza-A culture, and that culture be negative before transfer.

[heartsformexico]

Well, I had the pleasure of being the first nurse to run an Influenza test that proved positive for Influenza A yesterday. What a way to start a busy shift! The resident had been sharing the room with a dialysis patient for several weeks. And then there is HIPPA...fortunately the room mate had been running a fever (r/t wounds) which I could give as an excuse to swab and test for Influenza. When the PCP came in she said, we will have to treat everyone who has worked closely with him with Tamiflu. And the roommate's PCP was quick to give me an order for Tamiflu for his patient. When I went to my DON to explain that we needed to treat caregiving staff she informed me that EVERYONE was going to have to be treated because one NAC who had just worked Sunday and Monday shift just tested positive. Big Sigh. Well, at least there will no dancing around to avoid HIPPA violations when we tell everyone that they were exposed to Influenza....

I am finally recovering from the bronchial virus (tested negative for Influenza) after 3 weeks. I am a little worried as my defenses are not restored....did not receive the questionable flu vaccine for the first time in years due to URIs.

I appreciate your experiences and wisdom about this topic, and also just talking about the craziness of our little corner of the nursing world. I love it, I really love it. But between crazy family members who think you must be available to their parent whatever the needs of the other residents, or who think they should tell the professionals how the care plan should be designed even though they have no idea what they are talking about, and the demands of the State which expects you to do an impossible job with insufficient resources.....oh, and hospitals sending you patients that haven't pooped in 5 DAYS!, well, we are special aren't we?