Use of respirators (N95 masks)
CDC guidelines recommend fit-tested, NIOSH certified N95 respirators for personnel in health care settings that will have close proximity (i.e. direct medical care, delivering food tray, room cleaning) with a known, probable, or suspected case of H1N1. This recommendation applies to settings such as acute care, ambulatory care, nursing homes and home health, and also to personnel in non-health care settings where health services are delivered, such as school-based clinics and correctional facilities. OSHA has released a compliance document that will enfource these guidelines (See more below).
The Institute of Medicine convened an expert panel on occupational health, which included representatives from nursing, to examine the issue of respiratory protection. This panel determined that the N95 should continue to be the mask of choice for health care workers to avoid exposure to the virus. The report is linked below.
Sick patients should wear a surgical mask before going within 6 feet of others, including at home.
The ANA will be monitoring the discussions around mask use and possible federal standard creation. The ANA advocates for properly fitted NIOSH certified N95 or its equivalent particulate respirator as the minimum level of protection when caring for suspected or confirmed cases of pandemic influenza.
For more on PPE, see ANA's Center for Occupational and Environmental Health
Other non-pharmalogical prevention measures
Hand hygiene - The single most effective way to prevent the spread of disease! Nurses should be sure they, their colleagues, their patients, family and friends wash their hands often using soap and water or alcohol-based hand sanitizer.
Covering cough or sneeze - Use a tissue to cover a cough or sneeze to prevent the spread of infectious droplets.
Social distancing - Ill persons should stay home and not attend work, school, church, or other social events where they will have close contact with others. If social interaction is unavoidable, ill persons should maintain at a distance of 3 feet, and consider wearing a surgical mask.
Vaccines
Four vaccines against the novel H1N1 influenza virus have been approved by the FDA. Based on preliminary data from adults participating in multiple clinical studies, the 2009 H1N1 vaccines induce a robust immune response in most healthy adults eight to 10 days after a single dose, as occurs with the seasonal influenza vaccine. A large scale vaccination effort is scheduled to start in mid-October, according to HHS Secretary Kathleen Sebelius.
In official CDC guidance, healthcare workers (includes nurses) are listed as a priority group to receive vaccine in the initial phase (post-FDA approval). The federal government has committed to purchasing vaccine for everyone in America (as many as 600 million doses), and purchasing all supplies needed for vaccination, such as needles, syringes, and sharps containers. The state and local health authorities have been given the task of determining plans for local or regional vaccine distribution. HHS is recommending a voluntary, national vaccine campaign.
Linked below is Questions and Answers about H1N1 Vaccine (general information), and a document "Preparing for Vaccination with Novel H1N1 Vaccine", which gives more details on vaccine formulation, clinical trials, and safety/adverse event reporting.
In the News
OSHA Compliance Document Released on Worker Protection from H1N1
OSHA has released its enforcement policies that inspectors will be using to ensure that facilities are adequately protecting those at very high occupational risk for contact with the H1N1 virus. This could be direct care workers, or those handling the virus itself or infectious material. OSHA uses the CDC guidance for infection control in its policies, and outlines how a facility can prove that it is having enough supply problems for PPE to go to a "hierarchy of controls". The document is below.
CDC Issues Updated Guidance on Infection Control in Health Care Facilities
On October 14, the CDC issued important guidance on comprehensive infection control plans and expectation for health care settings. This guidance reaffirmed the CDC's recommendation of an N95 respirator being the minimum respiratory protection for personnel in close contact with confirmed or suspected cases of H1N1. However, it also addressed how to address supply shortages of N95s, guidance on visitor policies, duration of isolation, and return-to-work policies. A change to past guidance stated that an ill employee may return to work in a health care facility after 24 hours (formerly 7 days) of being afebrile without the use of antipyretics (e.g. Tylenol®).
Fraudulent internet ads for H1N1 medications and vaccines
Nurses should be aware that the FTC has alerted consumers to internet advertisements reportedly offering H1N1 diagnostic tests, treatments, medications, vaccines, and other products. These ads are fraudulent, and products ordered cannot be guaranteed to be safe. For more information or to report a fraudulent ad, visit the FTC's Web site.
Back to main H1N1 page.