Did hospitals do enough to protect HCWs from H1N1?
Provide training, communication about plan
Think of the outbreak of a novel H1N1 virus this spring as a colossal pandemic preparedness drill, either for a future virus or for a stronger resurgence of the strain later this year. So, how did hospitals do in their mission to protect health care workers (HCWs), including providing appropriate protective equipment, training, and communication?
The results varied. Some hospitals moved swiftly to ensure that their employees were properly fit-tested for respirators and beefed up their stockpiles of protective equipment. Others declined to provide N95 respirators even when it wasn't clear how virulent this strain would be.
Just as the first cases were emerging in Mexico, the Service Employees International Union (SEIU) released the startling results of a survey on pandemic preparedness: About one-third of union leaders at 104 facilities in 14 states said their hospitals did not have a written pandemic plan. Less than half (43%) reported that their hospitals had provided training to employees on pandemic influenza or communicated to employees about pandemic plans (48%). In an SEIU "snapshot" survey of nurses who were union leaders at 16 facilities in California, only one said that the facility was adequately protecting its staff during the H1N1 outbreak. Some 44% said their facility had not provided worker health and safety training to staff related to H1N1. The surveys were conducted in May.
"This is an industry that continues to operate in a way that is not supportive of worker protection in many areas," says Bill Borwegen, MPH, SEIU's health and safety director. "Six years after the government put out recommendations on pandemic flu, we're showing that a very small percentage of hospitals have a level of preparedness."
Yet hospitals have improved in their ability to collaborate and work in regional cooperation, according to a report on the Department of Health and Human Services' Hospital Preparedness Program by the Center for Biosecurity at the University of Pittsburgh Medical Center. "Eric Toner, MD, senior associate at the Center for Bioterrorism, says, "Our conclusion was that hospitals are significantly better prepared now as compared to 2001."
The center interviewed 133 individuals at 97 locations across the country, including every state and territory, he reports. "The thing we found to be most significant was the degree of collaboration and cooperation among hospitals and between hospitals and public health and emergency management [agencies]," he says." That collaboration is nearly universal, in part because of the guidance from the Hospital Preparedness Program but also because of the new Joint Commission standard that requires increased collaboration among hospitals in a community."
The SEIU survey might reflect a failure of hospitals to communicate with staff and to include employees in their training and exercises, says Toner. "We've seen examples of hospitals that have done tabletop exercises that involve the administrative team, and they think therefore they're prepared. They have a written plan that's been signed off on by the administrative team, but it does nothing to reassure the staff," he says. "It's essential if you want your staff to show up [during a pandemic] that they be aware of the plan, that they have confidence in the plan, and confidence that you can keep them safe. Health care workers are courageous people who show up and do remarkable things in difficult situations, but they have to have some confidence that they're being protected and they're not being foolish in coming to work."
Think of the outbreak of a novel H1N1 virus this spring as a colossal pandemic preparedness drill, either for a future virus or for a stronger resurgence of the strain later this year. So, how did hospitals do in their mission to protect health care workers (HCWs), including providing appropriate protective equipment, training, and communication?You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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