Influenza outbreak in a long-term-care facility: considerations for pharmacy
S K Bowles1, N Kennie, L Ruston
1Geriatrics and Palliative Care, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Ontario, Canada. susan.bowles@swchsc.on.ca
Insights
Hospital pharmacists effectively managed an influenza A outbreak in a long-term-care facility by providing amantadine prophylaxis, education, and individualized dosing, achieving a 91% acceptance rate.
Area of Science:
- Infectious Diseases
- Public Health
- Hospital Pharmacy
Background:
- Influenza A outbreaks pose significant risks in long-term-care facilities.
- Effective infection control measures are crucial during such outbreaks.
Purpose of the Study:
- To describe the role of a hospital pharmacy department in managing an influenza A outbreak.
- To evaluate the impact of pharmacist-led interventions on outbreak management.
Main Methods:
- A hospital pharmacy department managed an influenza A outbreak in an affiliated long-term-care facility.
- Pharmacists provided amantadine prophylaxis, patient education, individualized dosing, and adverse effect monitoring.
- Drug distribution and timely administration were prioritized.
Main Results:
- 48 cases of influenza-like illness (ILI) and 62 staff absences due to ILI were reported.
- The acceptance rate for amantadine chemoprophylaxis was 91% among 349 patients.
- Pharmacists managed 22 adverse effects, often by dose reduction, ensuring prompt drug delivery.
Conclusions:
- Hospital pharmacists played a vital role in controlling the influenza A outbreak.
- Pharmacist involvement ensured effective and safe chemoprophylaxis delivery in a long-term-care setting.
Abstract:
The role played by a hospital pharmacy department in managing an influenza outbreak at an affiliated long-term-care facility is described. In February 1998 an outbreak of influenza A was confirmed in a 570-bed long-term-care facility. During the outbreak, a total of 48 cases of influenza-like illness (ILI) were reported to infection control, and 62 staff members missed work because of ILI. Infection control measures included a recommendation for prophylaxis with amantadine. Pharmacists assumed responsibility for educating patients and families about amantadine prophylaxis, providing individualized dosing, evaluating reported adverse effects, and drug distribution. Pharmacists developed an information sheet on amantadine for patients and met with patients and their families. The overall acceptance rate for chemoprophylaxis was 91%. Of the 349 patients receiving amantadine during the outbreak, 203 (58%) were given 100 mg daily, 136 (39%) were given 100 mg every other day, and 10 (3%) were prescribed 100 mg weekly. Pharmacists confirmed a total of 22 adverse effects; generally the problem was solved by reducing the dosage rather than discontinuing the drug. In all cases, the first dose of amantadine was provided to the nursing units within three hours of an order being written. Pharmacists played an active role in managing an influenza A outbreak at a long-term-care facility.
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