Many Hospitals Are Not Ready for H1N1: Nurse Survey Shows Deficiencies in Hospital Swine Flu Readiness

For Immediate Release

Contact: 

Shum Preston, 510-273-2276 or Liz Jacobs, 510-273-2232

Many Hospitals Are Not Ready for H1N1: Nurse Survey Shows Deficiencies in Hospital Swine Flu Readiness

Data from 190 Healthcare Facilities in Nine States from California to Maine

NATIONWIDE - A patient health and safety survey of 190 American hospitals
from coast to coast compiled by registered nurses in eight
different states finds that a disturbing number of our nation's
healthcare facilities are not prepared for the coming H1N1/swine
flu pandemic, according to results released today by the
California Nurses Association/National Nurses Organizing
Committee. 

The data reflects a survey conducted over the past four weeks
by RNs in hospitals in Arizona, California, Florida, Illinois,
Maine, Minnesota, Nevada, Pennsylvania, and Texas.  And it
comes just a day after release of a report from the President's
Council of Advisors on Science and Technology predicting nearly
2 million Americans could be hospitalized due to swine flu
infections this winter, and as many as 90,000 could die, nearly
triple the deaths that occur in a normal flu season.

What the RNs reported are wide gaps in safety gear, infection
control training, and post-exposure procedures.  Among key
findings:

  • At more than one-fourth of the hospitals, nurses
    cite inadequate isolation of swine flu patients, increasing the
    risk of infection to others. 

  • Nurses at 15 percent of hospitals do not have access
    to the proper respirator masks, exposing nurses and patients to
    infection;  at up to 40 percent of the hospitals, 
    nurses  are expected to re-use masks, in violation of
    Centers for Disease Control
    Guidelines. 

  • At 18 percent of the hospitals, RNs report that
    nurses have become infected; one Sacramento, Calif. RN has
    already died.

CNA/NNOC is calling on all hospitals to adhere to the highest
standard of protection for patients and nurses to combat the
expected onslaught of new cases this fall and winter, and urging
legislators to strengthen public protections.

"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, RN, CNA/NNOC
co-president. "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."

On Wednesday, nurses at more than 50 of these
hospitals, mostly large hospital systems, will hold actions to
demand hospital administrators immediately implement safety
improvements for nurses and patients.  Contact CNA/NNOC to
find out about what nurses are doing in your area.

CNA/NNOC leaders will also be testifying in a joint
California Senate hearing in Sacramento Thursday on preparedness
for swine flu in the state's health and education systems. 
The hearing is at 9 a.m. in Room 112 at the State
Capitol.

"This report should serve as a wake-up to hospital
management, policy makers, and healthcare workers across the
country.  We need to urgently increase our readiness,"
Burger said. "We do not yet have a complete picture of the
morbidity of the H1N1 pandemic. But that is no justification for
hospitals making inadequate preparations and endangering the
health and safety of patients and their community.  When
September comes, we expect that infection rates of H1N1 will
spike due to the beginning of the school year, prompting
overcrowded emergency rooms, which will put our public health
readiness to the test." 

"The swine flu is not the type of flu we are used to. 
This pandemic will stress every aspect of our healthcare
system.  Hospitals must be proactive in protecting the
public," said Houston RN Terry Hardin.

"The state of Maine has identified over 300 cases of H1N1
infection, resulting in at least 19 hospitalizations and one
death," said Cokie Giles, EMMC, president of Maine State Nurses
Association/NNOC.  "A recent survey of our membership
indicates that there may be some areas of serious concern
regarding preparedness policies.  We are calling on
MSNA/NNOC represented facilities to ensure that patients and
nurses are protected to the fullest extent from exposure to
H1N1."

"It is important for hospitals to meet full safety standards
for swine flu so that our patients and our nurses are
protected," said Temple University Hospital RN Patricia Eakin,
president of the Pennsylvania Association of Staff Nurses and
Allied Professionals/NNOC.

"I don't know how the local hospitals will staff up for the
pandemic. Nurses at my institution don't accrue sick time, we
use our accrued vacation time to call out sick.  We also
work short [staffed] instead of having a replacement when
someone does call out.  In these economic times, you tell
me who will be staffing the hospitals?" said Tampa Bay area RN
Peggy Bowen.

Illinois hospitals, says Chicago RN Brenda Langford, "are not
prepared to deal with this pandemic.  We have provided our
copies of our surveys to management and they have not moved to
change our practice to be in compliance with the recommendation
set for by the CDC.  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
the nurses and the public, it is left up to the NNOC to make
sure these needed protections are implemented." 

Findings of the survey include:

  • Half the hospitals have seen infected patients. At 18
    percent, RNs have been infected, nurses say.  
  • Nurses at 15 percent of hospitals report that they do not
    have access or only some have access to the appropriate N95
    respirator masks, and at 19 percent of the hospitals all or some
    masks were not "fitted," to ensure their effectiveness against
    the virus
  • More than one in five, 22 percent of the facilities, do not
    have enough masks, say nurses. 
  • At almost 40 percent of those which do have sufficient
    masks, all or some of the masks are expected to be reused, say
    nurses. That puts nurses and patients at risk of infection and
    violates CDC guidelines which say all healthcare personnel who
    enter rooms of patients in isolation for H1N1 should wear a
    fit-tested disposable N95 mask, and that the masks should not be
    reused.   
  • Nurses at 26 percent of hospitals report that infected
    patients are not being properly isolated, in appropriately
    ventilated rooms, raising the possibility of the infection
    spreading to others in the facility. At nearly a third of the
    facilities, proper infection controls are not being
    followed.
  • Nurses at fewer than half of facilities (49 percent) report
    that they have been adequately trained on H1N1 issues, including
    identification of infected patients, and procedures for caring
    for these patients.
  • Nurses at only 35 percent of facilities report that they are
    guaranteed adequate sick leave if they become ill while caring
    for a patient, penalizing them for appropriately staying home
    while infectious.

These numbers are borne out by the controversies that have
been reported at hospitals across the country.  Examples
include:

  • At the University of California Davis Medical Center (near
    Sacramento), a patient who subsequently died from H1N1 was
    transferred to an intensive care unit as the patient's condition
    deteriorated. But rather than be kept in strict isolation with
    proper ventilation, the door to the patient's room was kept open
    the entire time, placing other high-risk patients, visitors, and
    caregivers at risk.
  • Nurses at Temple University Hospital, a major acute-care
    hospital in Philadelphia, are concerned that the level of
    preparedness is not sufficient. The hospital has yet to make
    clear to nurses its plans and procedures for dealing with H1N1
    which is expected to worsen with the start of the school year.
    The nurses are already seeing an influx of more patients due to
    the closure of one of Temple's nearby facilities, Northeastern
    Hospital, and are concerned that without better preparation and
    sufficient staff, the anticipated influx of patients due to the
    pandemic would be especially dangerous.  
  • At Sutter Solano Medical Center in Vallejo, Calif., there
    were not enough masks to deal with three infected patients in
    the ICU.  Within short order, approximately 10 nurses were
    affected.  The state office of occupational health and
    safety is investigating.
  • Nurses report that a Kaiser Hospital South Sacramento has
    informed patients and visitors that N95 respirator masks are not
    necessary and that simple "surgical" masks will suffice, which
    directly contravenes standards issued by every government
    agency.
  • Nurses at Los Alamitos Medical Center near Los Angeles
    report that Tenet has eliminated sick benefits that would ensure
    nurses could afford to take time away from work if they develop
    symptoms.

In conjunction with the report, CNA/NNOC is releasing a list
of demands - "The Nurses' Swine Flu Safety
Agenda"
- to adequately prepare for this
pandemic.

  • Minimize infection of hospital patients and workers by
    strict adherence to the highest standard of infection control
    procedures, including identification and isolation with
    appropriate ventilation of infected patients
  • All hospital workers and visitors must be provided with
    appropriate protection gear at the highest government standards,
    including N95 respirator masks or better for all who enter the
    isolation room of a confirmed or suspected H1N1 patient.
  • Guarantee all patients and workers full transparency after
    any exposures to H1N1, in as timely a manner as possible
  • Healthcare workers and facility visitors must receive full
    information and guidelines on risk exposure and facility
    infection control recommendations
  • Any RN who is unable to work due to contracting a
    communicable or infectious disease identified or treated in his
    or her hospital/clinic shall be guaranteed sick leave, not face
    disciplinary action, and shall be presumptively eligible for
    workers' compensation benefits
  • Implement a moratorium on any closures of emergency rooms,
    layoffs of direct healthcare personnel, and reductions of
    hospital beds. 
  • Federal guidelines for protection must be developed that are
    consistent across agencies 
  • Disposable respirator masks must not be re-used. In the
    event of a demonstrated national mask shortage, facilities
    should adhere to government recommendations on mask
    conservation.
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National Nurses United, with close to 185,000 members in every state, is the largest union and professional association of registered nurses in US history.

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