Oneida Health ECF
Pandemic Emergency Plan

(Effective 2/27/24)

Download ECF Pandemic Emergency Plan

传染病是由病原微生物引起的, such as bacteria, viruses, parasites or fungi. 传染病紧急情况的情况因多种因素而异, including type of biological agent, scale of exposure, mode of transmission and intentionality.

该设施遵循预防传染病的有效战略. Each county Local Health Department-(LHD) has prevention agenda priorities compiled from community health assessments submitted by local health departments. 这些信息包括确定的优先事项和重点领域.

The local, state, 联邦卫生当局将提供有关预防的最新信息和最新指导, case definition, surveillance, treatment, 以及护理中心对特定疾病威胁的反应.

PURPOSE: To provide guidance on how to prepare for new or newly evolved Infectious diseases whose incidence has increased or threatens to increase in the near future and that has the potential to pose a significant public health threat and danger of to the residents, families and staff.

GOAL: To protect our residents, families, 工作人员在我们的设施内不会受到突发传染病的伤害

临床领导将保持警惕，随时了解世界各地的传染病情况. They will keep administrative leadership briefed as needed on potential risks of new infections in our geographic location through the changes to existing organisms and/or immigration, tourism, or other circumstances.

该设施将维持个人防护装备的供应。. 储存的数量应至少够60天使用，并应包括以下内容:

  1. N95 Respirators
  2. Face shields/Eye Protection
  3. Gowns/isolation gowns
  4. Gloves
  5. Masks
  6. 符合当前EPA指南的消毒剂和消毒剂

该设施有食品供应商协议, medications, 在正常业务中断(包括传染病爆发)的情况下，提供消毒剂和个人防护装备.

The facility will regularly train employees and practice the infectious disease response plan through drills and exercises as part of the centers emergency preparedness training

Communication Plan – 该设施将根据CMS和卫生部的指导方针更新受感染居民的授权家庭成员和监护人, and a change in a resident’s condition and at least once a week to update all residents and authorized families and guardians on the number of infections and deaths at the facility.  The facility may use email, USPS, 设施网站和电话与每个授权的家庭成员或监护人沟通.

该设施将免费为其居民提供服务, telephones, 以及与家庭成员和监护人进行远程视频会议的方法, 通过iPad(平板电脑)和/或对讲系统进行窗口访问.

Community Prevalence

  • 一旦意识到传染病可能或已经传播到周围社区, 医院的感染控制护士(ICN)将研究具体的症状, symptoms, incubation period, and route of infection, the risks of exposure, 以及疾病预防控制中心提供的熟练护理机构的建议, 职业健康与安全管理局(OSHA), and other relevant local, state and federal public health agencies
  • 跨学科的领导团队，包括医学主任，DON, ICN等. will develop, 审查和执行现有的感染预防措施, control and reporting policies, 同时考虑到疾病控制和预防中心(CDC)的指令和指导, 国家机构和/或地方公共卫生当局.
  • Conduct routine/ongoing, infectious disease surveillance that is adequate to identify background rates of infectious disease and detect significant increases above those rates allowing for immediate identification when rates increase above these usual baseline levels. 常规或基于症状的检测将根据CDC和/或NYSDOH指令进行
  • 工作人员将接受有关接触风险、症状和预防传染病的教育. 重点审查基础感染防控工作, use of PPE, isolation, 以及其他感染预防策略，如洗手.
  • ICN and purchasing department will review environmental cleaning agents and personal protective equipment to ensure products meet CDC guidelines. 采购部门将根据具体的传染病储备所需的产品和设备.
  • Environmental cleaning will be conducted according to CDC guidelines in addition to routine cleaning specific to the infectious disease. 应提供清洁用品，以鼓励增加对高接触表面的清洁.
  • Residents and families with be provided with education about the infectious disease and the facility’s response to the infectious disease. 教育材料可以书面分发，也可以通过电子邮件发送或在设施网站上提供.
  • 将张贴有关手部卫生的感染控制标志, proper PPE usage, and other infection control practices.
  • 以限制传染病传播到设施内的风险, screening for signs and symptoms may be done PRIOR to admission of a new resident and/or allowing new staff persons to report to work. 其他诊断测试可用于确定入院前的暴露或感染.
  • 工作人员将接受有关设施计划的培训，以控制对居民的暴露. 该计划包括:在下班时向主管和公共卫生部门报告任何疑似接触传染病的情况, 对报告实际或疑似接触传染病的雇员进行预防性开除, 上班前自我检查症状, prohibiting staff from reporting to work if they are sick until cleared to do so by appropriate medical authorities and in compliance with appropriate labor law.
  • 该机构可能会考虑关闭该机构，不接受新入学的学生, 并根据当地公共卫生部门的建议限制游客.
  • 该设施将对厂房进行适当的物理改造，例如为高危居民使用私人房间, plastic barriers, sanitation stations, 以及当地建议的污染废物专用区域, state, and federal public health authorities.
  • 取消集体活动和聚餐，鼓励保持社交距离.

Suspected In-House Prevalence

  • 将出现传染病症状的居民隔离，并通知当地公共卫生部门
  • Under the guidance of public health authorities, arrange a transfer of the suspected infectious person to the appropriate acute care facility via emergency medical services as soon as possible.
  • 疑似感染者在等待转院期间需要护理, 遵循隔离程序的设施政策, 包括为有暴露风险的工作人员推荐的所有个人防护装备.
  • 将进入被隔离者房间的工作人员数量控制在最低限度.
  • 如果可行，当工作人员在房间时，要求被隔离者戴上口罩/面罩. Provide care at the level necessary to address essential needs of the isolated individual unless it advised otherwise by public health authorities.
  • 进行控制活动，如传染性废物的管理, terminal cleaning of the isolation room, contact tracing of exposure individuals, 并在地方卫生部门的指导下监测其他病例, and in keeping with guidance from the CDC.
  • 在设施(隔离室)实施隔离协议, cohorting, cancelation of group activities and social dining) as described in the facility’s infection prevention and control plan and/or recommended by local, state, or federal public health authorities.
  • Activate quarantine interventions for residents and staff with suspected exposure as directed by local and state public health authorities, and in keeping with guidance from the CDC.
  • The facility may use part of a unit, dedicated floor, 或设备的侧翼或单元末端的一组房间, 例如在走廊的尽头照顾疑似或受感染的人
  • 该设施将不再与非队列居民共用浴室
  • In the event that a resident is hospitalized, 该设施将保留居民的住所，并遵守所有适用的州和联邦法律法规, including but not limited to 18 NYCRR 505.9(d)(6) and 42 CFR 483.15(e).

Employer Considerations

  • 管理层将考虑OSHA的要求, Center for Medicare and Medicaid (CMS), state licensure, Equal Employment Opportunity Commission (EEOC), American Disabilities Act (ADA) and other state or federal laws in determining the precautions it will take to protect its residents. 保护居民和雇员应是首要考虑的问题.  Management shall take into account:
    • 设施中居民的虚弱程度
    • 传染病传染给居民和雇员的可能性
    • 疾病传播的方法(例如, through contact with bodily fluids, contaminated air, contaminated surfaces)
    • 可以采取的预防措施，以防止传染病的传播和
    • Other relevant factors
  • Once these factors are considered, 管理层将权衡其选择，并确定员工受影响的程度, 或者那些有传染病迹象的人, 必须禁止与居民或其他雇员接触.
  • 在类似的情况下，对所有员工采取统一的行动.
  • Do not consider race, gender, marital status, country of origin, 以及其他受保护的特征，除非它们被证明与疾病的传播有关.
  • 为员工提供合理的便利，如允许员工在家工作，如果他们的工作描述允许的话.
  • Generally, accepted scientific procedures, whenever available, 将被用来确定员工所构成的风险水平.
  • Permit employees to use sick leave, vacation time, 和FMLA(在适当情况下).
  • 允许员工在获得执业医师许可后重返工作岗位, however, 可能会采取额外的预防措施来保护居民.
  • Employees who refuse at any time to take the precautions set out in this and other sections of this policy may be subject to discipline.

Emergency Personal/Compassionate Caregiving

During a declared public health emergency, 该设施将对指定的看护来访者使用其紧急个人/同情护理政策.  请参阅紧急个人/慈悲照护政策.

  1. Reporting
    • Importance of Reporting
  • 卫生和社会福利部负责保护公众健康和确保卫生保健设施的安全.
  • 需要报告以发现设施内的疫情, geographic trends, and identify emerging infectious diseases.
  • 疫情数据的收集使纽市卫生局能够向卫生保健机构通报潜在风险和预防措施.
  • Reporting facilities can obtain consultation, 在疫情调查方面提供实验室支持和现场协助, as needed.
  • 医疗机构应将所有的媒体咨询直接导向当地或州卫生部门.
    • What should be reported?

NYSDOH Regulated Article 28 nursing homes:

  • Any outbreak or significant increase in nosocomial infections above the norm or baseline in nursing home residents or employees should be reported electronically via the NYSDOH Nosocomial Outbreak Reporting Application (NORA). NORA是NYSDOH健康商务系统应用程序. 另外，医院也可以传真感染控制医院报告表格(DOH 4018): http://www.health.ny.gov/forms/doh-4018.pdf. Facilities are expected to conduct surveillance that is adequate to identify background rates and detect significant increases above those rates. 医院感染暴发也可向卫生保健署报告.
  • A single case of a reportable communicable disease or any unusual disease (defined as a newly apparent or emerging disease or syndrome that could possibly be caused by a transmissible infectious agent or microbial toxin) should be reported to the local health department (LHD) where the patient/resident resides. In addition, 在市卫生厅第二十八条规定的疗养院怀疑或确认染上应报告传染病者, 也应通过诺拉以电子方式或交替方式向纽市卫生局报告, 传真感染控制医院报告表格(DOH 4018): http://www.health.ny.gov/forms/doh-4018.pdf.

Categories and examples of nosocomial/facility associated infections that should be reported to the county local health department (LHD) and NYSDOH include:

  • 由任何传染因子(如:传染病)引起的疾病爆发或发病率增加.g. staphylococci, vancomycin resistant enterococci, Pseudomonas, Clostridium difficile, Klebsiella, 不动杆菌)发生在居民或工作人员在设施.
  • 设施内爆发流感、肠胃炎、肺炎或呼吸道合胞病毒.
  • Foodborne outbreaks.
  • 与受污染的药物、替代液体或商业产品有关的感染.
  • 由传染病报告清单上的任何疾病引起的单一医院感染病例. For example, single cases of nosocomial acquired Legionella, measles virus, invasive group A beta hemolytic Streptococcus.
  • 一例金黄色葡萄球菌对万古霉素的敏感性降低.
  • Clusters of tuberculin skin test conversions.
  • 养老院居民或雇员一例活动性肺结核或喉炎.
  • 与医疗器械相关的发病率或死亡率增加或意外, 导致严重感染和/或住院的做法或程序.
  • Closure of a unit or service due to infections.
    • Communicable Disease Reporting[1]

《澳门线上娱乐赌城》(10NYCRR 2)要求报告疑似或确诊的传染病.10). Reports should be made to the local health department in the county in which the resident resides and need to be submitted within 24 hours of diagnosis. However, 有些疾病需要迅速采取行动，应立即通过电话向当地卫生部门报告.

有关传染病报告的更多信息:

  • Facilities should contact their NYSDOH regional epidemiologist or the NYSDOH Central Office Healthcare Epidemiology and Infection Control Program for general questions and infection control guidance or if additional information is needed about reporting to the NORA. Contact information for NYSDOH regional epidemiologists and the Central Office Healthcare Epidemiology and Infection Control Program is located here: http://www.health.ny.gov/professionals/diseases/reporting/communicable/infection/regional_epi_staff.htm. For assistance after hours, nights and weekends, 拨打纽约州监视中心(警戒点)518-292-2200.
  • Call your local health department or the New York State Department of Health’s Bureau of Communicable Disease Control at (518) 473-4439 or, after hours, at 1 (866) 881-2809; to obtain reporting forms (DOH-389), call (518) 474-0548.
    1. For facilities New York City:
      1. 请致电1 (866)NYC-DOH1(1-866-692-3641)获取更多信息.
      2. Use the downloadable Universal Reporting Form (PD-16); those belonging to NYC MED can complete and submit the form online.
  • Internal Notification

The facility will provide residents, relatives, and friends with education about the disease and the facility’s response strategy at a level appropriate to their interests and need for information. The facility will contact all staff, vendors, 其他利益相关方对设施的政策和程序，以尽量减少对居民的暴露风险.

[1] 一份疾病清单和如何正确报告这些疾病的信息见 Communicable Disease Reporting Requirements.