Pandemic Preparedness: It’s not if…. but when

1. Pandemic Preparedness:It’s not if…. but when An educational session prepared by the Pandemic Preparedness Response Team of the Kidney Community Emergency Response (KCER) Coalition

3. The Kidney Community Emergency Response (KCER) Coalition Goals • Continuously improving plans by learning from past responses • Building lasting partnerships to advance national goals • Keeping up with changing national procedures • Urging policymakers to integrate the special needs of the kidney community into disaster planning.

4. KCER Response Teams • Patient Assistance • Communication: 888-33-KIDNEY (888-335-4363) • Coordination of Staff & Volunteers • Federal Response • Facility Operations • Facility and Patient Tracking • Physician Placement and Assistance • Pandemic Preparedness

5. Pandemic Preparedness Resources • There are dozens of resources available on www.kcercoalition.com, including: • Find your local health department link • Information for patients/families • Information for providers/health care workers • General pandemic information • News releases

6. Resources For Patients and Families: • Checklists • Travel tips • Getting care & prescriptions • Most important things to know

7. Dialysis Provider Pandemic Response Plans: Questions to Think About • Do you have a company pandemic response plan? • Will you be distributing masks to your dialysis patients during a pandemic? What type? Who? • OSHA summary of mask guidelines is at www.kercoalition.com

8. Dialysis Provider Pandemic Response Plans: Questions to Think About • Masks: • Will you be distributing anti-viral medication to dialysis patients during a pandemic? • Will you be distributing anti-viral medication to dialysis staff during a pandemic? • If so, what types of staff will receive anti-viral medication?

9. Dialysis Provider Pandemic Response Plans: Questions to Think About • Anti-viral medication: • Are you stockpiling anti-viral medication now, or do you have a plan for stockpiling in the future? • Are there any other resources who will be distributing anti-viral medication to your dialysis patients, such as local public health departments?

10. Kidney Community Emergency Response Coalition, Pandemic Preparedness Response Team, 2007

11. Dialysis Provider Pandemic Response Plans: Questions to Think About • Education: • Has your dialysis staff/patients been educated regarding the sign and symptoms of the avian flu, hygiene, cough etiquette and distancing? • Have you, or do you plan to, provide education to dialysis patients about pandemic preparedness? • Have you received information or assistance from your ESRD Network office about preparing for a pandemic?

12. Dialysis Provider Pandemic Response Plans: Questions to Think About • Linking with disaster agencies: • Link with local, state and/or national public health entities to examine how you can provide the best up to date and accurate information • Have your dialysis facilities been in contact with their local community resources (i.e. health department, emergency management, transportation resources, nursing homes, water and electricity companies, etc)?

13. What can your dialysis facility do? • Communication • Education • Prevention of supply shortage • Contingency/Continuity Planning • Identifying Appropriate Distancing Measures • Check with your dialysis company about policies and procedures to follow specific to pandemic preparedness.

14. Communication • A person has been assigned responsibility for: • Finding up to date, reliable pandemic information from community public health, emergency management, & other sources. • Keeping abreast of newly released information during a pandemic (e.g. Public Health Alerts).

15. Communication • Identifying community sources for obtaining counter-measures (e.g. vaccines and antiviral medications). • Providing verbal reports to the Facility Administrator & coordinating release of the information to staff and patients.

16. Education • A person has been assigned responsibility for: • Patient and staff education on infection control measures to prevent transmission at home and in the facility. • Staff and patient’s role in prevention. • Use of personal protective equipment (e.g. mask), hand washing, droplet precautions.

17. Education • Identify opportunities to teach respiratory hygiene, coughing and sneezing etiquette, and importance of hand washing at home and the facility. • New policies and procedure related to avian influenza pandemic planning, transmission prevention, and management.

18. Education • Identifying and obtaining informational materials for patients and staff on pandemic influenza that are language and reading-level appropriate. • Patient and staff education on home preparation measures (e.g. arrangement for alternative transportation, two week supply of medicines, food, and water).

19. Prevention of supply shortage • A person has been assigned responsibility for: • Arranging for back up supplies for use during a time when the volume of supplies used may increase (e.g. gloves, mask, hand washing supplies, paper towels, hand gels, and tissues) and supply chain possibly disrupted. • *Making key contacts (i.e., hospitals, blood bank, transportation company) with whom the facility has an affiliation agreement to understand the contingency plan or to determine if one is in place.

20. Prevention of supply shortage • Making key contacts with any vendor or supply provider (local pharmacy, water treatment vendors) to understand the contingency plan or to determine if one is in place (i.e. standardized letter developed and sent – responses tracked).

21. Prevention of supply shortage • Frequent monitoring and ordering of supplies during a pandemic to prevent shortage and depletion of back up supplies. • Developing a plan for storage of supplies and the sharing between facilities if necessary.

22. Contingency/Continuity Planning • A person has been assigned responsibility for: • Instructing staff to develop contingency plans (i.e., alternate transportation and alternate routes to work; alternate child care services in the event schools are closed; back up child care in the event different work hours are required). • Confirm credentialing across state lines.

23. Contingency/Continuity Planning • Identifying staff that may be cross trained – Provide training now – Maintain list of cross trained staff.

24. Contingency/Continuity Planning • Coordinating with other ESRD facilities to evaluate staff availability in relation to local area maps and formulate a list of teammates; provide orientation to the facility. • Assisting patient contact with companies (phone, electricity, water) to inquire about contingency plans to prevent uninterrupted services with re- emphasis on the health care needs of the patient.

25. Contingency/Continuity Planning • Implement policy to have facility Social Worker and or Dietitian to assist patient contact with companies or services (i.e.; companies that provide glucometer strips, nutritional supplements, oxygen tanks) to inquire about contingency plans to prevent uninterrupted services (i.e.; standardized letter developed and distributed to patients or mailed by facility).

26. Contingency/Continuity Planning • Ensure there is at least 3 feet of space between patients. • Have a place for immediate screening for potentially sick patients in the waiting area. • Have patients call the facility prior to arriving for treatment if signs and symptoms of influenza are present.

27. Identifying Appropriate Distancing Measures • A person has been assigned responsibility for: • Collaborating with Medical Director to identify appropriate distancing measures & determining at what point (e.g. based on rate on infection in the surrounding community) to implement measures to modify the frequency and type of face-to face contact.

28. Identifying Appropriate Distancing Measures • Staggering treatment times to reduce time and the number of patients in waiting area. • Limiting movement and transport (working within defined, grouped areas).

29. What do I need to know right now about Pandemic Influenza? Patient care providers & patients should be educated on: • How influenza is spread, how to prevent getting influenza and how to control the spread. • Where to go for accurate information about pandemic influenza.

30. What do I need to know right now about Pandemic Influenza? Patient care providers & patients should be educated on: • The importance of seasonal influenza vaccination. • Why cough and sneeze etiquette should become second nature now, prior to a pandemic.

31. About Personal Responsibility • Learn all you can now about pandemic flu. • Have back-up systems in place: transportation, stock up on supplies, medication. • Know how to contact your local Department of Health. Volunteer to be a resource to them. • Follow instructions given by your local disaster authorities and dialysis facility.

32. References/Resources • www.pandemicflu.gov • www.kcercoalition.com • World Health Organization • Centers for Disease Control • Connecticut Department of Health • Kidney Emergency Response Coalition • ESRD Network of New England