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Being a Nurse Manager: The Good, the Bad and the Ugly

The Flu is Coming

Published November 1, 2016 8:29 AM by Samantha Therrien
It's that time of year again when the flu season will be among us. As nurses working in a healthcare facility—whether it be in hospitals, clinics, physician's offices, schools, or ambulatory day surgeries—we need to be more diligent in preventing the spread of germs.

The flu season varies quite a bit from year to year. Some years, relatively few people die. In 1986-87, there were 3,349 flu-related deaths. In 2014, the US and Canada saw the deadliest flu season ever within the past 5 years. That year's flu killed healthy young people with healthy immune systems—not the weak or the elderly.

The 2016-17 flu vaccine quadrivalent recommendation (meaning you will only be vaccinated against the 4 most common strains of flu) includes an additional B virus. This slightly differs from the 2015-16 vaccine. Last year's vaccine recommendation was based on several factors, including global influenza virologic and epidemiologic surveillance, genetic and antigenic characterization, antiviral susceptibility, and the availability of candidate vaccine viruses for production.

Germs are everywhere. We all know that we need to prevent the spread of germs by educating your staff and patients on the importance of infection prevention measures. Work closely with your infection control preventionist and with your facility's policy and procedures for routine cleaning and disinfection of the facility's environment. It's up to us as nurses to be the "Germ Busters."

Hand Hygiene

This is the best and most efficient method of preventing the spread of germs—and the cheapest. Good hand washing consists of rubbing your hands together with soap on the back of your hands, in between fingers, and under your finger nails for 20 seconds while humming the happy birthday song from beginning to end twice. Good hand washing is the first line of defense against the spread of many illnesses, from the common cold to more serious infections such as meningitis, bronchiolitis, the flu, hepatitis A, and most types of infectious diarrhea.

So, when do we wash our hands?

  • Before and after touching a patient—even if gloves are worn.
  • After touching the patient's immediate environment.
  • After contact with blood, body fluids or excretions, or wound dressings.
  • Prior to performing an aseptic task, such as placing an IV or preparing an injection.
  • During patient care after glove removal.

Environmental Cleaning/Medical Equipment

Emphasis for cleaning and disinfection should be placed on surfaces that are most likely to become contaminated pathogens and frequently touched, including bed rails, bed side tables, TV remote controls, and call lights.

After each patient leaves their room, each surface, from their stretchers, chairs, bed side tables, blood pressure equipment, to even the remote controls, should be cleansed with selected EPA-registered/manufacturer's recommendation disinfectants. In my facility, each patient's bay has TVs with remote controls. We place the remote control in a zip lock bag with a red sticker when a patient leaves the room so that the remote is cleansed and a new bag is placed with a green sticker, indicating it's been cleaned (this is a good system at home, too, when someone is sick).

All medical equipment must be cleaned and maintained per the manufacturer's instructions to prevent patient-to-patient transmissions of infectious agents. Medical equipment is labeled by the manufacturer as either reusable or single use. Have medical staff wear and have accesses to appropriate PPE when handling and reprocessing contaminated patient equipment.

Respiratory Hygiene /Cough Etiquette

Respiratory hygiene is a component of standard precautions, emphasizing the need for prompt implementation of infection prevention at the first point of encounter with the facility. First point of encounter can refer to a number of places within the facility: reception, lobby waiting areas, admission, and triage areas. This approach is targeted primarily at patients and accompanying family members or friends with undiagnosed and transmissible respiratory infections—any person with signs of illness from point of entry to the facility and continuing throughout the duration of the visit.

I suggest you:

  • Post signs at all entrances with instructions to patients with signs of respiratory infection to cover their mouth and nose when coughing and sneezing.
  • Use and dispose of tissues, and wash hands after contact with respiratory secretions.
  • Provide no-touch hand sanitizer receptacles in waiting areas.
  • Offer masks to coughing patients when entering the building.
  • Educate patients and families on the importance of infection prevention to prevent respiratory pathogens.

These are just some key points for infection prevention expectations for safe care. Part of my job also involves being the employee health nurse, and when September and October come around, I often hear coworkers asking "Why do I need a flu shot?" or "When do I get my flu shot?"

Why do you need a flu shot? You can't get the flu from the flu shot. This is a common misconception, because vaccines used to be made with whole viruses that had been weakened; they were still strong enough to make us feel sick. Today's vaccine is made with the smallest piece of virus possible and not the virus itself, therefore it is impossible to get sick from them.

When should you get the flu shot? The CDC recommends that people get vaccinated against flu soon after the vaccine becomes available—if possible, by October. It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against the flu.

Again, though, there is nothing more than good old fashioned hand washing with soap and water to bust any germs.


My significant other was hospitalized 7 times this year. While nurses always wore gloves, seldom did they actually wash their hands, preferring to use sanitizer. I believe soap and water are better when available, sanitizer only if they are not.

Joanne, Public Health - PHN, retired November 30, 2016 8:06 AM
Rolling Meadows IL

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