Prevention of respiratory outbreaks in the rehabilitation setting

Corpus, Carla; Williams, Victoria; Salt, Natasha; Agnihotri, Tanya; Morgan, Wendy; Robinson, Lawrence; Maze Dit Mieusement, Lorraine; Cobbam, Sonja; Leis, Jerome A

Between September and December 2017, new processes were fully implemented to address the most important contributors of RV outbreaks. Table 1 summarises the four new processes developed and their relationship to the problems identified. First, clarity was achieved regarding the criteria for initiation of droplet and contact precautions to include any patient with any of the following symptoms: new or worsening cough, runny nose, congestion or sore throat (September 2017). Second, communication to visitors to please not visit if they have any of those symptoms was included in two forms: an automated telephone message heard on calling the rehabilitation centre and signs placed in the lobby entrance (November 2017). Third, communication to staff regarding exemption for illness due to infectious causes was communicated to all healthcare providers in an attempt to address the perceived barrier of not coming to work ill (October 2017). To mitigate the risk of abuse of this exemption policy, improved reporting to OHS was required, which in turn necessitated a more efficient process for reporting to OHS. The fourth intervention was the development of an electronic programme allowing staff to report illness to OHS and simultaneously receive guidance about whether they are excluded from work due to infectious illness (December 2017). This programme incorporated questions about specific symptoms and symptom-onset and provided a personalised recommendation about whether the healthcare provider should work or remain home, based on whether or not they were considered infectious (see online supplementary material). In the event that the system identified a staff person as being infectious, the recommendation could be forwarded to the manager of the unit in order to exempt the employee from the attendance management system.