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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Stop the Flu Madness

Published September 24, 2009 11:43 AM by Glen McDaniel

As we approach the flu season there are lots of questions about influenza testing and  horror stories about a looming epidemic or pandemic. Patients are flooding doctors' offices and emergency departments, and clinicians are demanding widescale testing; often unwarranted, but driven by patient demand or even hysteria.

Some emergency rooms have set up customized triage to route patients with influenza like symptoms to a special area so that they can be quickly  seen and released. Most will be given common sense advice, released and simply told to stay home and treat their symptoms.Only in very rare cases are specific treatment or admission necessary.

Many state health departments have advised hospitals to adopt he protocol of not testing any outpatients for the flu and referring positive Flu A/B on inpatients to health department labs for epidemiological reasons only. What is your laboratory doing? What role did the lab play in developing institutional policies and protocols?

There are lots of questions about flu and flu vaccines. Some parts of the popular press have been recounting stories of the number of shots required and playing up the risks of Guillain Barre syndrome or even autism from taking the flu shots. There are even claims that the H1N1 vaccine has cancer cells.

The Joint Commission is encouraging healthcare workers to take the flu vaccine as a personal protection as well as acting in the interest of patient safety. One consideration for labs: do we have a plan for uninterrupted service if large numbers of staff come down with the flu?

As largely behind the scenes clinical professionals, laboratorians do not usually offer patient advice, but it behooves us to have the most credible information available. The CDC website is an excellent resource for the seasonal flu and H1N1.

There are also a few well researched, yet simply written articles in some magazines that can be used as references for the lay person. Whatever tools you use, it is appropriate and important to act as rational resource. That's a legitimate role in healthcare that we need to adopt more aggressively.

7 comments

I have no idea whether simply "signing a waiver" that forfeits liability on WFUBMC's part is an option under this hospital's policy since I do not currently work there.  My former graduate school classmate serves as Director of the Clinical Trials Unit for WFU School of Medicine.

Stephanie Mathis, MLS(ASCP), Generalist - Medical Laboratory Scientist, Danville Regional Medical Center September 30, 2009 3:52 PM
Danville VA

Our latest Opinion Poll tackles mandatory vaccines for healthcare workers. So far, 38% of readers agree hospitals should require all workers be vaccinated for the flu. What do you think? Take the poll on our home page: www.advanceweb.com/mlp.

Kerri Penno, ADVANCE - Managing Editor, Merion Matters September 30, 2009 11:15 AM
King of Prussia PA

A friend with whom I attended graduate school at WFU School of Medicine back in 2000-01, who now has a PhD in Molecular Medicine, posted about 2-3 days ago on her Facebook page that this hospital is requiring EVERYONE who works there to get a flu shot.  She also posted a link to this interesting article which points out that heart attacks, seizures, strokes, and miscarriages happen for reasons that have nothing to do with the "swine flu" vaccine:

http://www.nytimes.com/2009/09/28/health/policy/28vaccine.html?_r=1&em

Here's the link to a Greensboro TV station's news story about WFUBMC and the Moses Cone system (which runs a major trauma center in Greensboro) both requiring flu shots:

http://www.digtriad.com/news/local_state/article.aspx?storyid=130785

It mentions that at WFUBMC, rare exemptions will be granted for "religious or medical reasons;" those exempt employees must wear a mask throughout their time at the hospital.

Stephanie Mathis, MLS(ASCP), Generalist - Medical Laboratory Scientist, Danville Regional Medical Center September 29, 2009 6:57 AM
Danville VA

Stephanie:

That certainly seems excessive. Is there a declination form at least, whereby someone can refuse the shot, but absolve WakeForest of any liability by stating in writing that he/she (the employee) was offered but declined?

Glen McDaniel September 28, 2009 8:09 PM

How's this for truly terrifying - Wake Forest University Baptist Medical Center in Winston Salem, NC and Moses Cone Health System in Greensboro, NC are REQUIRING every last ONE of their employees to receive a flu immunization during this fine cooler-weather season.

Stephanie Mathis, MLS(ASCP), Generalist - Medical Laboratory Scientist, Danville Regional Medical Center September 28, 2009 4:32 PM
Danville VA

If I were to be hospitalized or be seen for the flu, I would be more worried about catching a nosocomial infection from the droves of floor personnel that I would come in to contact with that dont wash their hands before taking care of a patient than perishing from a trivial case of the flu.

Vaccine..  I havent had one in over ten years and would like to keep it that way..  That is why God gave me an immune system  -to fight infections naturally (remember our T and B cells, kids?)  Last thing is some government-concocted bio soup injected into me for nothing more than an oversensationalized media hype infection.   Yes, I would know enough not to report to work if I were ever to get sick with this flu.  

Who is benefitting from this .?  Obviously the pharmaceutical companies that are making this to sell, those that are riding on the backs of the legislation to make this mandatory in every man, woman, child and dog plus those that sell all of the hype and crap to go along with this.  

What happens when this turns out to be a big flop and they realized that they just created more apathy in the American public by shoving this down our throats every morning, evening and night?  

case in point - nobody gives a rat's ass about the terror color codes anymore,  they wore that one out real quick.  H1N1 will be nothing more than a blip on a TV special at the end of the decade, showcasing all of the crap that happened in the world over the past ten years that nobody really cares about anymore.

Wally September 28, 2009 11:09 AM

Yes you are right we need to get clear direction on what to tell patients. I work at 2 different hospitals in Atlanta and we get lots of calls all the time at both labs. At one place where I work  PRN we are told we dont have the authority to say anything and transfer the call to Infection Control. Now they are getting mad at us for all the calls. After hours the tech in charge just play it by ear and hope she doesnt get in trouble.

The other place where I work full time is much clearer and do something very similar to what Glen says.  The lab, infection control and medical staff all got together and came up with a plan. We sent it out to all doctors and have a copy posted in the lab.

We dont test outpatients at all even if tehy have an order. In the  ED it is up to the doc to decide if the patient needs a test. We do the flu screen for A/B if they order from the ED. Also the same for all inpatients. The Micro Supervisor then calls the Public Health Lab and gets permission to send them positive samples for testing for novel H1N1. I am not sure if she sends  100% of all positives or only a percentage. I need to find out.

We have had a few requests for H1N1 and we dont automatically send those out either. We do the flu screen first.

One thing which is also good about this lab is that they try to encourage a nasopharyngeal wash, so if it's positive, they just send the same sample. Some labs use a swab for Flu A/B. Then they try to get a second sample to send out for confirmation if it's positive.

I agree the lab should know what's going on, and should help in the planning and also should feel empowered to answer questions rather than say  I'll transfer you to someone else. That sounds like we are saying the other person is  really  more important  and more intelligent than the lab. Dont you agree?

Judy B. MT (ASCP) September 25, 2009 5:25 PM
Atlanta GA

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