Pandemic Influenza Plan - 2009

• Maintain adherence to current LTC centre policies and procedures.
• Provide each resident with care and services consistent with his/her plan of care in accordance with the Residents’ Bill of Rights, the Health Care Consent Act and/or the Substitute Decisions Act.
• Employ continuous surveillance for FRI/ILI to provide a baseline for seasonal influenza vs. pandemic influenza.
• Initiate planning for resident care during a pandemic.
• Encourage eligible residents to receive the annual Influenza and Pneumococcal Vaccines.
  
  

Actions:

• Maintain adherence to current LTC centre policies and procedures.
• Initiate education for residents/families regarding Pandemic Influenza.
• Encourage eligible residents to receive the annual Influenza and Pneumococcal Vaccines.
• Develop a written plan for a pandemic including how to manage residents if the hospital is unable to accept residents from LTC.
  
  

Actions:

• New admissions and residents returning from the hospital will be closely screened and monitored for FRI/ILI symptoms.
• Prepare plans to cohort ill residents to their rooms and units, limiting movement within the facility.
• The OMT will identify units or designated areas used by residents experiencing pandemic influenza symptoms.
• If residents have shared accommodations, the room mate will be treated as a close contact and placed on precautions.
• The ICP/DOC will ensure staff receive specific information on how to care for the ill residents and provide refresher infection control measures and updates.
• Active screening for staff, visitors, family members, students and volunteers will be implemented.
  

• Identify
  • who could go home to family members temporarily
  • who could be discharged home temporarily with home care services
  • who must continue to be cared for in the centre⁴⁹
  • Resident transfers to another LTC home are not recommended at this time.  The centre will collaborate with the Community Care Access Centre (CCAC) regarding any potential transfers.

The level of care to be provided to residents during a pandemic is dependent upon the staffing levels available. The minimum basic care will be provided as follows:

• Essential personal care (essential bathing limited to baths/showers as needed only; face hands and perineum twice daily and as needed to maintain skin integrity).
• Medication administration.
• Personal hygiene and grooming may be modified depending on staff availability (see LTC9-5.3.1). Care of fingernails and feet may not be available.
• Oral care BID (LTC9-5.3.2).
• Ongoing assessment of care needs.
• Clothing and bedding will be changed only as needed.
• Routine toileting and continence care will be based upon the resident’s individual need to maintain skin integrity. Routine catheter care will be maintained as ordered.
• Skin and wound care management including routine aseptic dressings and sterile dressings, and colostomy care must be maintained.
• Assistance with eating as needed. G-tube feeding and maintenance will be maintained as ordered.
• Oxygen therapy as required (a one month stockpile of O2 supplies will be available for use).
• Bedridden residents will be repositioned every two hours and as needed.
• Maintain regular communication with the relatives/substitute decision makers of residents in the centre to keep them updated and reassured about the situation and discourage unwarranted visiting.
• Non urgent medical appointments will be cancelled and rescheduled.
• Residents with ILI/Pandemic strain of influenza will automatically be placed on Additional Precautions, isolated in a designated area in the LTC centre or cohorted in a room/unit with residents exhibiting like symptoms. 
• All residents with ILI will be restricted to their rooms with no exceptions.
• Ensure that appropriate respiratory outbreak signage indicating additional precautions and updates are posted for staff, family, visitors and other services.
• The OMT will decide which resident-based contract services/activities can be curtailed during the pandemic flu outbreak (e.g. foot care, hairdressing, activation programs, physiotherapy, psychiatry visits, etc).\Ensure the Adult Day Service and other non-essential programs (e.g. Moms and Tots program) are closed.
• The DOCs/designates will ensure that resident prescriptions for pandemic influenza vaccine are obtained from the attending physicians or Medical Director.
• Registered staff will ensure consent for administration of antiviral and pandemic influenza vaccinations are obtained from the residents or SDM.
• Ensure advance directives are updated with SDM of residents who are ill and appropriate changes made accordingly.