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�� &#x/MCI; 1 ;&#x/MCI; 1 ; &#x/MCI; 2 ;&#x/MCI; 2 ; &#x/MCI; 3 ;&#x/MCI; 3 ; &#x/MCI; 4 ;&#x/MCI; 4 ; &#x/MCI; 5 ;&#x/MCI; 5 ;A quarterly newsletter to share tips, trends, and best practices across the state. Askingtravel questionand having workflows in place is key to control the spread of highly infectious diseasesNow that flu season is upon us, the highriskIDENTIFY Asking, “Have you traveled or lived outside of the United States in the last 21 days?” during checkcan prevent the spread of infectious diseases this season. While many HIDs present with theand rank its severity.Change patient checkin questions a Something to consider: If you have a contracted Emergency edical ystem (EMS)agencyconsider askingthem screen patients provide thehospital with advanced noticef your hospital cannot treat this patient at your facility, it’s helpful to knows ahead of time, bypassingadmitting them and gettingthem help sooner at an assessment hospital or treatment center. ISOLATE The point of isolating a patient is to lessen, or stop, the spread of adisease. The CDC not only recommends immediately isolating the patient to a room, but also masking them. f a patient comes in who needs to be isolated, here are some things to consider and plan for: Where do you place the patient?During a stressful situation, having a planwill make things go smoother. Designate aroom to take a HID patient and make staf

f aware of its locationTheroom doesn
f aware of its locationTheroom doesn’t always need to be empty, but have a plan for evacuation if not. Where is the room located?eallyisolation room would be away from heavily populated areasConsiderrooms nearthecheckor rooms located near a secondary entry point. How long does it take you to isolate the patient?Acting immediatelyto isolate a HID patient is crucial in controlling the spread of germsIf a room if used for other needsruncouple practice drills to see how long it would actually take to get the room evacuated and ready to accept a HID patient. What measures do you have to secure the isolation room?When in use, make sure staff and other patients stay safe. Immediatelyupon rooming the patient, signsplaced on the door notify others not to enterWhen entrance is required, follow isolation precautionsign in an outof the room to monitor all personnel for symptoms. Other aspects that make an isolation room ideal includenegative air pressure, an anteroom and a private patient bathroomWhen negative pressure room is not available, a room designated as the “HID” or “isolation” room that can be shut down for an extended period to completely turnover the air flow and be terminally cleaned. INFORM When apatient answers“yes” totraveling to a country with a current outbreak and they have symptoms to match, immediatelymask and isolate the patientPlan for next steps: Decide if this patient has a HID.Don’tplac

e all the pressure on one person’s
e all the pressure on one person’s shoulder. Include a team of resources. Carle’s teamincludetheChief Medical Officer, the Infectious Disease Doctor oncall, and thelocal public health department. Togetherthemake a decision For Frontline Hospitals:nowinghow and whereto take a HID patient, even in the middle of the night, is critical.Have contact numbers readily available, including afterhours information. For Assessment Hospitals: ake sure you have a plan for notifying staff about roundtheclock care for a patient for up to four days INFECTION PREVENTION CORNER Outbreaks of Zika/Dengue fever, measles and Ebola top the headlines, but other recent outbreaks also can have devastating results.Recent outbreaks include:Polio 11/26/18 NigerPolio 10/26/18 Somalia, Syria, NigeriaRubella 10/22/18 JapanMonkeypox 10/18/18 NigeriaRift Valley Fever 7/17/28 KenyaExtensively Drug resistant Typhoid Fever6/27/18 PakistanYellow Fever 5/17/18

BrazilBecause outbreaks
BrazilBecause outbreaks occur all over the world that often don’t make the news, asking travel questions are beneficial to quickly triage patients at risk of exposure to and spreading highly infectious disease. Using the Electronic Medical Record (EMR) as a tool to guide this processis essential and can send alerts right away to those thatneed to know such as providers and Infection Prevention personnel.It adds just seconds to the checkin process.t is also imperative to have a plan or a workflow to follow when apatient answers yesto the travel question and exhibits signs and symptoms. Keeping staff knowledgeable helps to keep them calm when situations arise and helps them to act quickly, minimizingthe spread.For more information about using the EMR as an HID tool or the new “Identify, Isolate, and Inform” workflows, contact Taffy Creviston, MPH, CIC, senior infection preventionist at Carle7/17/28KenyaNOTE FROM THE EDITOR: Carle updates HID workflows following CDC guidance I’ve heard a few hospitals have removed the travel questions fromtheircheckin processaving that questionin there is essential to catch some of these HIDs as it is the only thing that differentiatesthem from other common illnesses. Carlerecently updated all of our entrance workflows to address each of our entry points:callins, walkins to outpatientclinics, walkins to theemergency department, transfers of unknown person under investigation (PUI, and transfer ofknownPUI

). Modeled after the CDC workflows, Carl
). Modeled after the CDC workflows, Carle’s are included for use as samples. We welcome your questions.Test your knowledge with this brief 3question survey. PATIENT ADVISORY NURSE, AMBULATORY, OR CARLE DIRECT Identify, Isolate, Inform: Infectious Disease Person Under Investigation (ID PUI)1IDENTIFY EXPOSURE HISTORY:In the past 21 days has the patient lived or traveled outside of the United States?2IDENTIFY SIGNS AND SYMPTOMS:F�ever (100.4° F or 38.0° C), diarrhea, cough, vomiting, headache, muscle pain?3ISOLATE:A. Notify the patient that they:a. Will need further evaluationb. Should remain in place to minimize exposing othersc. Should prepare for transportB. Follow Public Health instructions for patient transport 4AINFORM:A. Initiate ID PUI Conference Calla. Call comm. center at (217) 383-3399B. Join ID PUI Conference Call as Chairpersona. Conference # - (800) 747-5150b. Access Code # - 3834963c. Chariperson # - 0559C. Is patient a conrmed PUI AND being transported to Carle?4BA. Activate ID PUI Team Page in Comm. Center (217) 337-3911 C. Complete patient registration in EPIC a. Flag patient as “condential” b. Select “yes” for “Private Encounter”A. Continue to assess patient using standard precautionsB. Refer to Infection Control as appropriateNOYESYESNOWORKFLOW #1: CALL-INX6001-1218YESNOCONVENIENT CARE & AMBULATORY OFFICES Identify, Isolate, Inform: Infectious Disease

Person Under Investigation (ID PUI)1I
Person Under Investigation (ID PUI)1IDENTIFY EXPOSURE HISTORY:In the past 21 days has the patient lived or traveled outside of the United States?2IDENTIFY SIGNS AND SYMPTOMS:F�ever (100.4° F or 38.0° C), diarrhea, cough, vomiting, headache, muscle pain?3ISOLATE:a. Asks patient to wear a maskb. Escorts patient to designated room AND closes the doorc. Dons enhanced PPE and implements standard, contact, and droplet precautions4AINFORM:A. Initiate ID PUI Conference Calla. Call comm. center at (217) 383-3399b. Ask for ID PUI Conference Team to be pagedB. Join ID PUI Conference Call as Chairpersona. Conference # - (800) 747-5150b. Access Code # - 3834963c. Chariperson # - 0559C. Is patient a conrmed PUI AND being transported to Carle? 4BB. Notify Arrow Ambulance (217) 337-3911C. Complete patient registration in EPICa. Flag patient as “condential”b. Select “yes” for “Private Encounter”NOYESYESWORKFLOW #2: WALK-INX6002-1218A. Continue to assess patient using standard precautionsB. Refer to Infection Control as appropriateYESNOEMERGENCY DEPARTMENTIdentify, Isolate, Inform: Infectious Disease Person Under Investigation (ID PUI)1IDENTIFY EXPOSURE HISTORY:In the past 21 days has the patient lived or traveled outside of the United States?2IDENTIFY SIGNS AND SYMPTOMS:F�ever (100.4° F or 38.0° C), diarrhea, cough, vomiting, headache, muscle pain?3A. Staff member:a. Asks patie

nt to wear a maskb. Escorts patient to
nt to wear a maskb. Escorts patient to room 17 AND closes the doorc. Dons enhanced PPE and implements standard, contact, and droplet precautions4AINFORMa. Call comm. center at (217) 383-3399b. Ask for ID PUI Conference Team to be pagedB. Join ID PUI Conference Call as Chairpersona. Conference # - (800) 747-5150b. Access Code # - 3834963c. Chariperson # - 0559 C. Is patient a conrmed PUI?A. Activate ID PUI Team Page in Comm. CenterB. Complete patient registration in EPICa. Flag patient as “condential”b. Select “yes” for “Private Encounter”A. Continue to assess patient using standard precautionsB. Refer to Infection Control as appropriateNOYESYESNOWORKFLOW #3: WALK-INX6003-1218YESNOSUSPECTED PUI (not under current observation)Identify, Isolate, Inform: Infectious Disease Person Under Investigation (ID PUI)1IDENTIFY:A. Prior to arrival:and symptom questionsb. EMS personnel will have masked patientB. Upon arrival:a. Patient stays masked in ambulanceb. EMS personnel reports positive responses to EDi. Does ED identify patient as PUI?2ISOLATE:A. Staff member:a. Dons enhanced PPE and implements standard, contact, and droplet precautionsb. Escorts patient to room 17 AND closes the doorc. Limits and logs all persons entering and exiting the room3AINFORM:A. Initiate ID PUI Conference Calla. Call comm. center at (217) 383-3399b. Ask for ID PUI Conference Team to be pagedB. Join ID PUI Co

nference Call as Chairpersona. Conferen
nference Call as Chairpersona. Conference # - (800) 747-5150b. Access Code # - 3834963c. Chariperson # - 0559 C. Is patient a conrmed PUI?3BA. Activate ID PUI Team Page in Comm. CenterB. Complete patient registration in EPICa. Flag patient as “condential”b. Select “yes” for “Private Encounter”NOYESX6004-1218A. Continue to assess patient using standard precautionsB. Refer to Infection Control as appropriateYESNOSUSPECTED PUI (under current observation)Identify, Isolate, Inform: Infectious Disease Person Under Investigation (ID PUI)1IDENTIFY:Prior to arrival the ID PUI conference call will have taken place and the Carle ID PUI team will have been 3INFORM:A. Transferring facility will notify the patient that they:a. Need further evaluation at Carlec. Should remain in place to minimize exposing othersB. Follow Public Health instructions for patient transportC. Complete patient registration in EPICa. Flag patient as “condential”b. Select “yes” for “Private Encounter”2ISOLATE:A. All staff interacting with patient should don enhanced PPEB. Patient remains in ambulance until dedicated room and staff are readya. Emergent: ED room 17b. Non-emergent: PV8 Infectious Disease UnitC. When patient is placed:a. Keep doors closedb. Continue standard, contact, and droplet precautions.c. Limit and log all persons entering and exiting roomWORKFLOW #5: TRANSFERX6005-1018