INSURANCE INSIGHTS Risk management solutions from CNA Healthcare Enhancing Vaccination Compliance, Pandemic Preparedness and Endoscope Reprocessing THE CALIFORNIA MEASLES OUTBREAK in late 2014 and reports of nationwide infections linked to contaminated endoscopes (see Section C) underscore the risks of pathogen transmission and the vital importance of vaccination compliance, pandemic preparedness and medical scope hygiene. This edition of Insurance Insights offers strategies designed to help medical providers increase patient confidence in vaccination protocols and prepare for potential epidemics. It also reports on new guidelines from the Centers for Disease Control and Prevention (CDC) for cleaning and reprocessing endoscopic devices, and presents effective response strategies following possible scope-related bacterial transmission. A. Communicating the Benefits of Vaccination Avoidance of childhood immunizations or recommended adult vaccinations can result in under-treatment on a regional scale, creating the risk of major outbreaks of preventable contagious diseases, due to a breakdown in so-called “herd immunity.” Individuals may be reluctant to vaccinate due to anxiety about potential side effects, religious beliefs or the idea that vaccine-preventable diseases no longer pose a serious threat. Regardless of the reason, patients or parents who refuse vaccination should be educated by their providers about the health risks posed by non-vaccination and the benefits they are rejecting for themselves or their children. 26 Medicine in Oregon Oregon www.TheOMA.org A candid and non-confrontational dialogue, appropriately documented, can serve a variety of purposes, including: Œ Answering patient or parent questions and obtaining genuinely informed consent for vaccinations. Œ Reminding patients of the recommended schedules for childhood and adult immunizations. Œ Reinforcing the relative safety of vaccinations and the positive benefit-to-risk ratio. Œ Dispelling any misconceptions concerning the advantage of community-wide immunization against childhood, seasonal and opportunistic diseases. For best results, adopt a written procedure regarding vaccinationrelated communication, advocacy and documentation. Numerous resource lists on this subject are available from government agencies and not-for-profit organizations, including the following: Œ “Communicating with Patients About Vaccinations,” issued by the National Foundation for Infectious Diseases. http://www.familyvaccines. org/hcps/communicating Œ “Increasing Vaccination Rates,” issued by the Oregon Patient Safety Commission. http://oregonpatientsafety. org/healthcare-professionals/providerresources/ increasing-vaccination-rates/590 Œ “Provider Vaccine Conversation Tools,” issued by the Oregon Health Authority. https://public.health.oregon.gov/ PreventionWellness/VaccinesImmunization/ Pages/ProviderVaccineSafetyTools.aspx B. Preparing for a Pandemic Managing and containing a fast-spreading infectious disease outbreak requires quick, decisive intervention. The first step is to provide staff with a refresher course on basic infection control procedures, focusing primarily on how to prevent transmission between patients, staff and the larger community. Be sure to document attendance at the program. In addition, draft a rapid-response protocol designed to safely vaccinate and/or treat large numbers of patients under high-stress conditions. The protocol should include the following elements, among others: Œ Triage guidelines for prioritizing administration of vaccines and medications in the event of a shortage or rationing. Œ A rapid, high-volume screening and testing procedure for potential disease victims or carriers. Œ Measures for maintaining or (if necessary) augmenting staff during the height of a pandemic via per diem registries and/or agencies. Œ A policy regarding furlough of staff with suspected exposure to contagions, focusing on such issues as disease indications, duration of furlough period and on-leave compensation. Œ An emergency response plan designed to facilitate coordination with acute care providers, fire/EMS personnel, law enforcement officers and public health workers. The rapid-response protocol should be regularly reviewed, updated and discussed with staff members.
OMA Medicine in Oregon Fall 2015
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