Influenza A Outbreak – After Action Report



Influenza A Outbreak – After Action ReportJanuary 242018Name – Title Report Completed: 2 February 2018Location NameContents TOC \o "1-3" \h \z \u EXPLANATION OF TERMS PAGEREF _Toc390182215 \h 2INTRODUCTION PAGEREF _Toc390182216 \h 3AFTER ACTION REPORT OVERVIEW PAGEREF _Toc390182217 \h 3STRENGTHS PAGEREF _Toc390182218 \h 5AREAS OF IMPROVEMENT PAGEREF _Toc390182219 \h 5RECOMMENDATIONS PAGEREF _Toc390182220 \h 5CONCLUSION AND NEXT STEPS PAGEREF _Toc390182221 \h 5IMPROVEMENT PLANNING MATRIX PAGEREF _Toc390182222 \h Error! Bookmark not defined.EXPLANATION OF TERMSExamples:AAR After Action ReportCMSCenters for Medicaid/MedicareEPPEmergency Preparedness ProgramEOPEmergency Operations PlanFSXFull Scale ExerciseHPPHospital Preparedness ProgramHSEEPHomeland Security Exercise Evaluation ProgramHVAHazard Vulnerability AssessmentICIncident CommandICSIncident Command SystemIPImprovement PlanMHOACMedical Health Operational Area CoordinatorNIMSNational Incident Management SystemOEMOffice of Emergency ManagementPIOPublic Information OfficerTTXTable Top ExerciseINTRODUCTIONOn January 24, 2018 an influenza outbreak activates the Incident Command System and the Infectious Diseases procedures outlined in the Emergency Operations Plan. Sequence of events:On January 21, 2018 a resident family member responds to a call from nursing and indicated that he had come down with the flu and had gone to the doctor where it was confirmed that he had the influenza A. He called in and reported that he had been in contact with this mother during a bingo game at 3 pm on 1/19/18 and had also assisted other residents play bingo so other residents had been in contact with him. Staff distributed the bingo participant list to each wing on 1/22/18 to watch for flu symptoms. His mother tested positive on 1/22/18 and 4 others on 1/24/18 her wing also contracted flu-like illness. Several employees had also reported contracting influenza A and had been off work until they were symptom free. The Director of Post-Acute Care/Incident Commander decided to activate the Infectious Disease procedures outlined in the Emergency Operations Plan.Actions TakenThe wing was shut-down to all visitors and staff to prevent further infection.Signs posted at front entrance for cough etiquette, hand washing and other hygiene measures. Hand sanitizer and face masks made available at the front door.Called Palliative care doctor and nurse practitioners. The Dr. authorized Tamiflu be dispensed to all residents and employees. Two residents did not take the Tamiflu per their family members direction.Called County Public Health Department. County referred us to Iowa Department of Public Health Flu Tracker, who we called and reported.Called Department of Inspections and Appeals.All family members were called by the staff to alert them. Advised to delay visits if needed to reduce exposure. Requested permission to be granted for use of Tamiflu.Building-wide activities changed to neighborhood activities only X 7d. Laundry informed not to deliver clothing to marked rooms. Nursing staff entering rooms will change laundry.Kept same staff on each neighborhood as much as possible.AFTER ACTION REPORT OVERVIEWThis report is a compilation of information from the different departments and staff who participated in the response to Influenza A outbreak. The information was gathered from the staff involved in the event, including: The Director of Post-Acute Care, Director of Nursing, and Director of Admissions. The recommendations in this AAR should be viewed with considerable attention to the needs for providing safe care to residents. Each department should review the recommendations and determine the most appropriate action and time needed for implementation.The issues outlined in this AAR will be addressed in the Improvement Plan and will list corrective actions to complete. This Improvement Plan will serve as a summary of the AAR and as a guide for corrective action over the course of the following year’s training program for staff.Incident Overview:Influenza A outbreak. 1st case 1/22/18. Starting 1/24/18 (** C4 Indicator - When 2 or more residents develop respiratory illness within 72 hours of each other) One resident’s family member and four residents were infected resulting in shutdown of the wing and activation of the incident command structure and infectious disease procedures in the emergency operations plan. The wing was re-opened on a restricted basis on January 31, 2018. Duration:EVENT - Start 24 January 2018 – End 1 February 2018 (last PM dose of Tamiflu)Focus (Check appropriate area(s) below): PreventionX Response Recovery OtherNote: Droplet precautions should be implemented for residents with suspected or confirmed influenza for 7 days after illness onset or until 24 hours after the resolution of fever and respiratory symptoms, whichever is longer, while a resident is in a healthcare facility – CDC guideline.Activity or Scenario (Check appropriate area(s) below): Fire Severe Weather Hazardous Material Release Bomb ThreatX Medical Emergency Infectious Disease – Influenza A Power Outage Evacuation Lockdown Special Event Exercise/Drill Other Location:Insert Building Name/Location Participating Organizations: List Participating Organizations and Individuals/TitlesSTRENGTHSCommunication with family members, awareness and quick response time to flu-like symptoms resulting in quarantine of the neighborhood. Team effort to call all resident family members and responsible parties as well as key staff at the Community. Involvement of Medical Director and Nurse Practitioners.Followed CDC guidelines for dosing. Activated incident command structure. Incident commanders led efforts and followed established Infectious Disease procedures outlined in the Emergency Operations Plan. Communicated campus-wide via mass email on 1/24/18.AREAS OF IMPROVEMENTFor future influenza outbreaks we will include the Iowa Department of Public Health to our list of contacts. Because the influenza outbreak is statewide, the County referred us to the state flu tracker. RECOMMENDATIONSAdd Iowa Department of Public Health Flu Tracker, who we called and reported, to Infectious Disease procedures.Train agency and weekend staff on flu protocols.CONCLUSION AND NEXT STEPSConclusion: Incident command activated and infectious disease procedures followed. All the Woodlands staff acted quickly and effectively in response to this event.Next Steps: Add Iowa Department of Public Health Flu Tracker, who we called and reported, to Infectious Disease procedures.Train agency and weekend staff on infectious disease procedures.Signature of Preparer: ______________________________________________Signature of Reviewer: ______________________________________________________ ................
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