 2003 AJN Table of Contents
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Health & Safety
American Journal of Nursing -
October, 2003 - Volume 103, Issue 10
Preparing for a Possible SARS Resurgence
Lessons learned from Toronto’s experience.
Q. With a resurgence of SARS possible this winter, what can nurses learn from the first outbreak?
A.
Any health care worker who is the first contact for patients should know how to screen for severe acute respiratory syndrome (SARS). Since no universal screening tool is
available, health care workers and their organizations should refer to the
most recent case definition of SARS provided on the Centers for Disease
Control and Prevention (CDC) or Health Canada Web sites.
SARS is a coronavirus, related to those that
normally cause upper respiratory illnesses such as the common cold. If a
patient presents with SARS symptoms—fever, cough, shortness of
breath, or dyspnea—and has had close contact with a person with SARS
or has recently traveled to an area identified
by the World Health Organization (WHO) as a region with SARS, precautions
must be taken immediately to protect health care workers and other patients
and visitors until a diagnosis of SARS can be ruled out.
Recommended measures include N-95 filtering masks and
eye protection for all people entering the patient’s room, regular
and thorough handwashing, and the use of gowns and gloves in all
interactions involving the patient or his environment.
Recent experience with SARS in Toronto highlights the
need for an Emergency Measures Plan for Infectious Diseases. Hospitals
across the province scurried to develop specific SARS-related policies and
procedures for all departments. The following tips for dealing with SARS or
any infectious disease are based on their experience.
Use a regional approach.
Ambulance personnel, public health nurses, police, and fire responders must be given
information on personal safety and how to minimize the risk of
transmission. Containment of the disease depends on having knowledgeable
caregivers in the community to support the efforts of hospitals.
Staff entrance points to the hospital,
such as the main entrance and ED, with trained
personnel to ensure that everyone entering the building is screened.
Identify isolation rooms ;for
areas with specific functions. This would be important, for example, in a
birthing unit where health care providers would have to care for a woman
with SARS during labor, birth, and the immediate postpartum period.
Ensure immediate availability of safety garments and
education for all health care workers if
an outbreak occurs. Write specific procedures to guide nurses and other
health care workers before a crisis occurs.
Review and demonstrate the
proper use of safety equipment to ensure maximum protection.
Establish a detailed plan for communicating
effectively. Make it easier to identify
the most current information by placing the date and time on all
procedures, guidelines, and directives. Updating and sharing information is
important for staff. Understanding the disease and its method of
infection—as well as ways to manage it—contribute to successful
compliance with safety measures. Review with employees the reasons and
rationales behind the changes, and provide extra emotional support if the
crisis extends beyond a couple of days.
Provide safety plans ;to
staff members who develop allergies to hand sanitizers or N-95 masks, as
well as those who experience stress from working in physically
uncomfortable garments for hours, days, or weeks at a time.
Don’t forget the basics
of good health care. During the SARS crisis in Toronto, health
care workers were constantly reminded of the importance of frequent and
careful handwashing. Waterless hand sanitizer solutions containing
alcohol were provided at all entrances and elevators for use by
staff and visitors.
Resources
www.nursingworld.org/osh/sars.htm
Ann C. Holden is a manager for the Women’s and
Children’s Health Program at Humber River Regional Hospital in
Toronto, Ontario.
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