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CUPS Health and Education Centre Response to H1N1

CUPS Health and Education Centre Response to H1N1. Who we are. Health Education Housing Outreach 140 staff total. Health Clinic. Health Clinic: 1800 visits per month Primary, episodic, crisis based care

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CUPS Health and Education Centre Response to H1N1

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  1. CUPS Health and Education CentreResponse to H1N1

  2. Who we are • Health • Education • Housing • Outreach • 140 staff total

  3. Health Clinic • Health Clinic: • 1800 visits per month • Primary, episodic, crisis based care • Mental Health, Women’s Health, Prenatal Care, Chronic Disease Management, Specialist

  4. Family Resource Centre 1000 visits/month Crisis Counselling & Advocacy Goal Setting & Ongoing Support Parenting & Life Skills Low-income Housing Assistance Children’s Programming

  5. One World Child Development Centre Early intervention education centre Thriving, instead of surviving Preschool to Kindergarten 60 students

  6. Outreach and Housing Other agencies visited by CUPS RNs, NPs and MDs: Hospitals Shelters Detox and Treatment Centres The street (DOAP & Outreach team) 2000 visits/month – the absolute homeless

  7. Inner City Agencies: What did we do? • Dec 2008 - Pandemic Planning Committee • Jan 2009 - Influenza Pandemic Preparedness for Inner city Agencies • Feb 2009 - City of Calgary Infectious Disease Management Plan • April 2009 - Personal Emergency Preparedness • May 2009 - Pandemic Influenza 101

  8. CUPS: What did we do? • Jun-Aug 2009 • set up our emergency structure • June 2009 • Instructions for staff, Microsan stations • July 2009 • Patient triage process implemented and inventory organized • The ‘Black Book’

  9. PATIENT RECEPTION ?? ASK ?? -cough/cold/fever in last 48hrs? OR Patient looks very unwell/ is coughing NO YES MICROSAN MASK Continue as usual MICROSAN HANDS Seat pt in reserve seats 2nd LPN to Triage need for immediate care ( treatment room) : ILI symptoms : temp/O2 sats/HR Notify LPN URGENT fever> 38 oral Non urgent Pt to wait in lab chairs Refer MD/NP only Call Agency PRN Pt to wait in reserve seats. Refer to RN, MD, NP

  10. Getting ready continued… • Sept 2009 • Train the Trainer program for managers. • Presentation on influenza preparedness given to all staff, by department • N 95 masks for medical staff • Mandatory staff meeting to present CUPS plan and to address expectations and concerns.

  11. How doesinfluenza spread?

  12. What was our experience? • More staff than patients sick • Close to 30% absenteeism at the peak • One ICU admission • Camp Bus Driver: resulted in one child treated withTamiflu. • 8-10 patients with ILI symptoms in any one day • NP swabs only on those with risk factors or very ill. • Aug 2009- First positive H1N1 patient • Only 3-4 positive H1N1 patients thereafter • H1N1 <10% of all NP swabs • No known deaths

  13. Immunizations Seasonal flu vaccine was received from AHS on Oct 16/09. • Oct 16/09 – Nov 4/09 320 given • Nov 5/09 – Feb 28/10 103 given H1N1 vaccine was received from AHS on Dec 6/09. • December/09 109 given • January/10 64.5 given • February/10 12 given

  14. Other clinic actions: • CUPS • Fluids available for patient distribution. • Individual patient teaching on hand washing and use of masks • H1N1 Flu talks for clients - LPN • H1N1 inservices for staff throughout organization - RN • Agencies • H1N1 inservices for agencies - RN • Patient assessment, and assistance with suspected outbreaks • Teachingand advocacy to other agencies on behalf of patients. • Community Medicine residents helped agencies develop their pandemic plans • Outreach staff transported patients to shelters, hospitals, urgent care centre , hospital pharmacy

  15. Patient Reactions to H1N1Measures • Mostly good • Receptive to teaching, well informed • Barriers: Fluids, Tamiflu • Felt hyped by media • Started asking for H1N1 shots in October • Transportation • Addiction, Mental Health • Other barriers

  16. Tamiflu • CUPS received Tamiflu from AHS on Nov 4/09 • 1 course dispensefor an adult in early December • Prescriptionswritten once universal coverage approved • Tamiflu prescriptionsissued for few staff who became ill

  17. Concerns • Earlier access to vaccine • Immunization for all staff at partner agencies • Earlier and easier access Tamiflu • Central distribution centre for required supplies • Better communication, clear guidelines for who to contact

  18. What if things had gotten worse? • Phase 1: described • Phase 2: 2 clinic sites • Ill patients • Well patients for routine care • Phase 3: Shut down majority of programs, organize 3 teams • Team 1: Routine care for prenatal patients at CUPS site women’s clinic. • Team 2: Ill patients at CUPS site main clinic, home visits and care by support staff • Team 3: Outreach RN/NP/MD/support staff going to shelters for triage and care.

  19. If you are sick at home with influenza symptoms, please call CUPS. If sick more than three days please call Health Link: 403-943-LINK

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