Prevention is key to influenza pandemic
CMs should help their clients stay healthy
The most important thing that case managers can do in case of a pandemic, or even an outbreak of influenza, is to educate their clients on disease prevention, says Isela Luna, RN, PhD, director of nursing at Pima County Health Department in Tucson, AZ.
"Prevention, prevention, prevention. That's the most important thing we can do. We need to make sure that everyone we come in contact with is educated about the disease and takes steps to stay healthy," she adds.
In the early weeks of the current H1N1 influenza outbreak, Pima County health officials confirmed more than 113 cases of flu and one death, that of a 13-year-old boy whose family members also contracted the disease.
The health department sent nurses on home visits to test for possible cases of H1N1 influenza in high-risk individuals.
"All of the cases we tested in the homes turned out to be negative. This is good prevention work and it relieved the family members of the person who was sick," she says.
Since there currently is no vaccine available for the H1N1 flu, the most important thing that case managers can do is to help their clients avoid exposure to the disease, says Connie Commander, RN-BC, BS, CCM, ABDA, CPUR, president of Commander's Premier Consulting Corp.
Commander has been a national speaker for a pharmaceutical company presenting training for case managers on how to prepare for a pandemic.
"Case managers are really instrumental in educating their clients about infectious disease. It all goes back to the wellness piece that we all promote. The best thing the case managers can do is help prevent people from becoming ill in the first place," Commander says.
That's what case managers at Hudson Health Plan in Tarrytown, NY, are doing as they talk to their clients, reports Margaret Leonard, MS, RN-B, C, FNP, senior vice president for clinical services.
The case managers have been reinforcing information in the health plan's newsletter by educating their clients about the importance of good hand-washing techniques, covering their mouth when they cough, and other preventive measures, she says.
"Throughout the company we're reinforcing those measures. We have put up hand-washing signs and strategically placed bottles of hand sanitizers for our staff to use," she says.
Educate people about keeping their personal space and staying out of crowds if there is an influenza outbreak so they aren't exposed to the disease, Commander says.
First and foremost, educate your clients to stay home from work or school if they feel ill and to contact their doctor if they are exposed to the flu or start experiencing flu-like symptoms, and do the same for your co-workers, she suggests.
When people are exposed to the flu, they have a 48-hour window in which to take an anti-viral medication that will lessen the symptoms, she adds.
Case managers who work with their clients telephonically don't have the ability to take vital signs and view the signs and symptoms the person is experiencing but they can listen and advise their clients on what steps to take, points out Catherine M. Mullahy, RN, BS, CRRN, CCM, president and founder of Mullahy & Associates, a case management training and consulting company.
If your clients report flu symptoms, refer them to their primary care provider, and if you have any sense that they are seriously ill, urge them to go to the emergency department, she says.
Some flu-like symptoms could be due to allergic rhinitis and not a cause for a panic, Mullahy points out.
It is particularly important for case managers to educate chronically ill patients with multiple comorbidities or people who have a catastrophic illness or injury on what to do if a flu outbreak occurs, Commander says.
"Teaching preventive measures may not be the initial focus of the treatment plan, but case managers still need to teach their at-risk patients how to stay healthy and avoid exposure if a flu pandemic occurs. If someone has a chronic illness or is recovering from a catastrophic illness or injury, they certainly don't need to become ill with the flu," she says.
Whether you're a telephonic case manager or someone who sees clients face to face, you can play a valuable role in the case of an influenza outbreak by ensuring that your clients are educated about the disease, its symptoms, and what they can do to lessen their exposure, Mullahy says.
"As part of the health care system, case managers have a responsibility not to be in a panic mode. Their role is to keep their clients informed about the flu and refer them to reliable sources for information," Mullahy says.
This means keeping up to date on bulletins and other information from the Centers for Disease Control and Prevention and your local health department to ensure that the information you are passing on is valid and based on evidence-based practice, she adds.
The initial outbreak of the H1N1 virus in the United States appears to have been mild, but it is an indication that people need to be prepared for future outbreaks that may be more severe, Commander says.
Be aware that a pandemic is likely to have the same impact on your community as a major natural disaster such as a hurricane or an earthquake.
"A pandemic can shut down the infrastructure. Schools and restaurants may be closed, and there may be shortages if the warehouse and delivery people are sick and can't come to work. It all goes back to wellness. We don't want people to get the flu in the first place," she says.
At Hudson Health Plan, the case management team is trying to encourage people to be a little more prepared in case there is a pandemic, Leonard says.
"We don't want people to panic, but we want to get away from the idea that this is no big thing. There were several schools closed down in New York City because of the flu. This is the first time in a long time there has been any reason to take such steps. We all need to be prepared for whatever may come about in the future," she says.
(For more information, contact: Connie Commander, RN, BS, CCM, ABDA, CPUR president of Commander's Premier Consulting Corp. E-mail: [email protected]; Margaret Leonard, MS, RN-B, C, FNP, senior vice president for clinical services, Hudson Health Plan. E-mail: [email protected]; Catherine M. Mullahy, RN, BS, CRRN, CCM, president and founder of Mullahy & Associates. E-mail: [email protected].)
The most important thing that case managers can do in case of a pandemic, or even an outbreak of influenza, is to educate their clients on disease prevention, says Isela Luna, RN, PhD, director of nursing at Pima County Health Department in Tucson, AZ.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content