Outbreak Investigation, Public Health and Health Policy
Background : The Infection Prevention and Control (IPC) Department is responsible for coordinating responses for patient/staff exposures to communicable diseases. An annual risk assessment identified the probability of an exposure was a rare event but had high potential to cause serious risk to patient/employee safety and stress institutional operations. Although current preparedness measures were in place, a need was identified for a central resource to assist with standard control and rapid response to exposures.
Methods : From 2015 to 2018 IPC responded to approximately ten exposure events at a large, academic pediatric network. Documents developed during these events served as the backbone for standardized resources. Events requiring a departmental response were defined as those that: (1) included a large number of patients and/or staff, (2) presented safety concerns for staff and/or families, (3) resulted in emotional trauma, or (4) involved a poorly understood organism. Diseases/organisms meeting this criteria include, but are not limited to tuberculosis, Middle Eastern Respiratory Syndrome (MERS), measles and resistant organisms such as Carbapenem Resistant Enterobacteriaceae (CRE). IPC reviewed previously developed resources and identified additional resources needed to enhance future responses.
Results : IPC created an exposure playbook accessible to team members on our SharePoint site. A checklist was generated for tracking response and includes templates for line listings and epidemic curves, health department contacts and staff notification templates. Each identified disease/organism has specific information sheets for staff/families, family notification letter templates, health department reporting forms, screening algorithms and quick links to policies and procedures. To date the exposure playbook has been successfully trialed in two real-time events.
Conclusions : The playbook has better equipped IPC to rapidly respond to urgent events. IPC departments must be prepared for rapid and efficient response within their institutions and an exposure playbook can be a beneficial tool for such events.