Lack of sufficient safety gear, infection control training, and knowledge of post-exposure procedures are jeopardizing H1N1 readiness in hospitals in at least nine states.
That's the conclusion from a survey of 190 health facilities sponsored by the California Nurses Association and the National Nurses Organizing Committee.
The two groups released a list of demands they call "The Nurses Swine Flu Safety Agenda," which seeks to pressure hospitals to require more strict adherence to federally recommended infection control guidelines.
Among the findings:
- Nurses at more than 25% of the hospitals said there is inadequate ability to isolate H1N1 patients, increasing potential infection transmission to others.
- Nurses at 15% of hospitals do not have access to proper N95 respirator masks, also potentially exposing nurses and patients to infection. At 40% of the hospitals participating in the survey, nurses said they are expected to re-use their masks, in violation of current policy guidelines issued by the Centers for Disease Control and Prevention.
- At 18% of the hospitals, registered nurses reported that nurses have become infected, and a registered nurse who practiced in Sacramento has died.
The survey was conducted at hospitals in Arizona, California, Florida, Illinois, Maine, Minnesota, Nevada, Pennsylvania, and Texas, and comes just after the President's Council of Advisors on Science and Technology suggested two million Americans might be hospitalized, and 90,000 could die in an H1N1 outbreak this year in the U.S. That's three times the usual number of deaths during a typical influenza season.
"These continuing problems increase the risk that many hospitals will become vectors for infection, with inadequate patient protections leading to a spread of the pandemic among other patients, their friends, family and caregivers, and the surrounding community," warned Deborah Burger, co-president for the CNA and NNOC.
"What we're hearing from around the country is dangerous to patient health and safety, but with smart and clinically appropriate leadership, we can fix policies in time for the upcoming pandemic."
Unfortunately, CNA officials say, hospital administrators are doing little to fortify their preparedness.
For example, one registered nurse in Chicago, Brenda Langford, says hospital managers have been presented with copies of the survey findings, but "have not moved to change our practice to be in compliance" with CDC recommendations.
"If the Cook County Health and Hospital System won't make these needed changes and the Cook County Department of Public Health won't support our efforts to protect nurses and the public, it is left up to the NNOC to make sure these needed protections are implemented," says Langford.
Survey respondents at the 190 hospitals reported that in general, nurses have not been properly fitted for masks and have not been given adequate training on how to identify infected patients and procedures for caring for them.
At 65% of the facilities, nurses have not been guaranteed adequate sick leave if they become ill while caring for a patient, which would result in a penalty for staying home while they were potentially infectious.
The CNA/NNOC says it represents 86,000 registered nurses in 50 states.