Flu season: Preventing the spread in a clinical setting

It’s impossible to predict how severely each flu season will affect patients, family nurse practitioners (FNPs) and other health care personnel. The only certainty is that the flu will appear, and it will be contagious. The unpredictability lies in the length and severity of each season. In a clinical setting, patients exhibiting flu-like symptoms will most likely come in between October and February (a.k.a. flu season) as an increase in influenza begins and peaks. And that’s when you need to put preventive practices into place to keep germs from spreading between patients and staff.

An update on flu statistics

The U.S. Centers for Disease Control and Prevention (CDC) estimates that the flu has resulted in between 9.2 million and 35.6 million illnesses each year in the U.S. since 2010. The reason for this large range is that flu cases are often not reported, especially if an individual who contracts the flu does not visit a physician’s office or clinic. The CDC also stated in a February 2017 Morbidity and Mortality Weekly Report that the flu vaccine in 2016–17 was only 48 percent effective in preventing laboratory-confirmed influenza A and B viral infections associated with medically attended acute respiratory illness. With that 52 percent chance of infection, a large portion of the flu-contracting population may require treatment in a doctor’s office, making the risk of spreading the infection within a clinical setting likely. Thus, during flu season, many people with the flu will meet with an FNP or other health care provider in a clinical setting.

Controlling the spread of infection

During flu season, it’s important to have the right procedures in place to prevent the spread of the virus while FNPs are working with patients. Keeping individuals coming in for well-checks safe from infection while you’re treating contagious patients is always a concern for a medical professional. This concern increases during flu season with the greater influx of respiratory illnesses.

Preventing the spread of infection can start with patients before they even meet with you in a clinical setting, and these strategies can begin once they arrive for their appointments to decrease the chances of the virus spreading.

Before the patient comes in

Before patients come into an office they usually have to set up an appointment via phone or patient portal. As an appointment is scheduled, pre-screen patients by asking if they’re experiencing typical flu-like symptoms such as coughing, sneezing, fever and aches. This not only tells you whether patients may have the flu but also allows you to decide if they need to come in for a checkup at all. If patients don’t have a pre-existing condition that puts them at medical risk if they contract the flu, or you don’t feel the symptoms warrant an appointment, consider suggesting they simply stay home and rest to recover from the flu, keeping the virus out of the office completely.

At check-in

When a patient exhibiting flu-like symptoms checks in:

• Provide a face mask to keep germs from spreading.
• Make hand sanitizer available in the waiting room and near the check-in desk for staff and patients to use.
• If possible, have separate sick and well waiting areas for patients, or ask patients with flu-like symptoms to keep some distance between themselves and others waiting.

If the clinic is walk-in-style, ask questions regarding a patient’s symptoms upon check-in. Depending on the answers, these questions will help you take precautions to prevent the spread of the flu before the patient even takes his or her seat in the waiting room.

During the clinical visit

Once you bring patients into the examination room, discuss best practices for the prevention and spread of the flu. First and foremost, educating patients on the ease with which flu can spread is important. Encourage them to stay home when they’re sick. Passing the flu on to coworkers or friends is something all patients should wish to avoid, and no matter how careful people are, being around others when they have the flu greatly increases the chance they’ll give it to someone else. Make sure patients understand the importance of frequently washing hands and regularly touched surfaces in their homes to minimize the spread of the flu to their families.

Share additional tips for controlling the spread of germs when patients are in a clinical setting or any other shared space. Tell patients to cough into the crook of their elbows rather than into their palms or over their shoulders, and make sure they know to use a tissue to cover their noses and mouths when sneezing, as well as that they should immediately throw out the soiled tissue and wash their hands or use sanitizer before coming into contact with someone else.

Keep yourself healthy

Just as you want to teach patients to control the spread of the flu among their peers, you want to make sure you don’t put yourself or your colleagues at risk of contracting the virus, potentially infecting your office. Standard precautions like receiving the flu vaccine, using good hand hygiene, wearing gloves and using masks helps you stay healthy. Following droplet isolation precautions for patients coughing and sneezing is very important as well, especially when coming into close contact with a sick patient. Sanitizing common areas in the office each night greatly decreases the risk of an infection spreading.

Patients exhibiting flu-like symptoms may not spend much time in public, but they will come to the doctor’s office or a clinic for help. Their presence can put you and the rest of the medical staff at risk for infection. By working to limit the number of flu cases that come into the office, teaching patients ways to prevent the spread of germs, and protecting yourself, you may decrease the risk of the flu spreading in your clinic.

During flu season, many patients see FNPs for relief of their symptoms. If you’re considering becoming an FNP, consider the Online Master of Science in Nursing, Family Nurse Practitioner program from Bradley University. Bradley’s program is CCNE* accredited, the coursework is 100 percent online and the curriculum expertly combines rigorous academics with real-world practice. The flexible online program lets you complete clinical hours with approved preceptors of your choice locally while the innovative curriculum prepares you for advanced practice with individuals and families throughout the continuum of care.

*The master’s degree program in Nursing, Post-Graduate APRN Certificate program, and the Doctor of Nursing Practice program at Bradley University are accredited by the Commission on Collegiate Nursing Education (http://www.ccneaccreditation.org).

Sources:
http://www.aafp.org/news/health-of-the-public/20170221fluvacceffect.html

https://www.cdc.gov/flu/about/season/flu-season-2017-2018.htm

http://www.physicianspractice.com/blog/seven-ways-flu-proof-your-medical-practice