Pediatric influenza and "universal respiratory etiquette": preparing and protecting your staff and the public.

Jeanette H. Walker is Nurse Manager, Primary Children’s Medical Center, Salt Lake City, Utah. Reprints are not available from the author. J Emerg Nurs 2004;30:367-70. 0099-1767/$30.00 Copyright n 2004 by the Emergency Nurses Association. doi:10.1016/j.jen.2004.04.006 T he 2003-2004 influenza season hit Utah early, and it hit hard. By mid November we were seeing unprecedented numbers in the emergency department at Primary Children’s Medical Center. Typically a slower month, November was the busiest month in 2003. It also was the busiest month in our history. Thanks to an ample supply of flu vaccine available early in October and the persistence of the ED charge nurses who strongly encouraged prophylaxis and willingly gave many flu shots, a high percentage of the ED staff had been immunized. Sick calls were not significantly higher than in previous months; had they been, a bad situation quickly could have become a disaster. We share the following information in the hope of helping ED managers mount a coordinated effort to deal with the next flu season. As the infection control coordinator for the emergency department, I was already involved in a hospital task force addressing severe acute respiratory syndrome (SARS) and an upcoming respiratory season that was predicted to be severe. The Task Force was using the SARS plan developed by the Centers for Disease Control and Prevention as a guide. One of the key concepts was a respiratory infection control strategy called ‘‘Universal Respiratory Etiquette.’’ When I saw the first televised reports of the influenzalinked deaths of 4 children in Colorado, it became obvious we were not going to have an ordinary influenza season. I called my director, and she immediately began implementing the strategy (see Figure 1). We followed up with an article in the ED newsletter (see Figure 2). We placed ‘‘Fight the Flu’’ signs in prominent locations throughout the waiting room to educate parents and visitors about respiratory precautions. We also placed signs Pediatric Influenza and ‘‘Universal Respiratory Etiquette’’: Preparing and Protecting Your Staff and the Public P E D I A T R I C U P D A T E