Timely Response to Influenza Outbreak - UPA Murray Vale Shalem Hostel

Use of PPE, increased cleaning measures & isolation were key strategies to successfully contain the outbreak

UPA Murray Vale Shalem Hostel is a 60 bed aged care facility, including a 20 bed memory support unit, situated in Albury NSW. We are part of the United Protestant Association (UPA of NSW), which operates Aged Care Services throughout NSW and Northern Victoria.

In early September 2016 we were notified by Albury Wodonga Health that 2 of our residents had positive swabs for Influenza A. We also had one resident who had returned from hospital with a diagnosis of exacerbation of COPD, however as her symptoms were consistent with those of Influenza we placed her immediately in isolation. Our Outbreak Management Plan was then commenced.

The Public Health Unit was notified and we were classified as “in outbreak”. We placed the entire facility in lockdown, limiting all visitors to essential only. All of our families were contacted by phone to advise of the lockdown and asked not to visit until we instructed that we were out of lockdown. Without exception, our families were supportive of this action and thankful for the contact. The Regional Manager and State Care Manager were also advised and updated daily.

In the Hostel, the dining room was closed, and residents were asked to remain in their rooms as much as possible. All meals were served in resident rooms, meaning extra staff were required to maintain food safety and ensure time was spent with each resident at all meals. A roster was developed for this, and involved the Care Manager, Team Leaders and Receptionist, as well as care and catering staff. The residents enjoyed this interaction with staff, and great verbal feedback was received.

Activity staff adjusted their program to provide 1:1 activities to residents in their rooms. This included provision of magazines, newsletters, puzzles and games. The Occupational Therapist ensured mobility was maintained by taking residents individually on short, escorted walks outside each day.

Correct hand hygiene techniques were also essential in preventing the spread of influenza

Extra staff were rostered onto every shift and we had a designated “Isolation Nurse” to care for those with flu symptoms on each shift. The “Isolation Nurse” was responsible for all care of residents with symptoms, including medication administration, meal delivery and personal care. Extra cleaning was also rostered, and the facility was cleaned twice daily with Actichlor.

As we didn’t have anyone with symptoms in our Memory Support Unit we completely isolated this part of the building, ensuring no crossover of staff. A separate staffroom was set up for staff so they did not come into contact with staff working in the main area. Meals were delivered to the door, and picked up by staff in the unit. An EEN was designated to this area to deal with clinical issues. Dirty laundry was put outside the door for pickup, and clean laundry dropped to the door. Staff from this area were not permitted in any area outside the Memory Support Unit, including the laundry and kitchen. This area remained free of Influenza for the duration of the outbreak.

Residents were updated daily on our progress, and were supportive and thankful for the hard work of staff in containing the virus.

The use of PPE resulted in nil staff Influenza cases

We liaised daily with the Public Health Unit. On their advice, we contacted all Doctors for consideration of Tamiflu. Many Doctors were supportive of this, and residents were commenced on this medication as ordered.

We remained in lockdown for 8 days, and had 4 residents in total with confirmed Influenza Type A. All but one of these residents had received the annual influenza vaccination. Nil staff were affected.  

All families were again contacted by phone to advise we were out of lockdown. We were quickly inundated with visitors, and all were complimentary of the way we managed the outbreak. Residents were excited to be out and about, particularly being able to again socialise in the dining room.

Despite being an exhausting and challenging event to manage, good planning and good processes helped minimise the effect of this potentially dangerous issue. As Care Manager, I was personally involved and my senior management team assisted greatly in getting our plans into action. These sort of events really highlight the importance of good staff and resident outbreak discipline, following process and taking the issue seriously.

Jaqui Hastings, Care Manager