Nursing Travel February 26, 2018

By Debra Wood, RN

How Healthcare Staff Can Combat Flu Symptoms

Whether in the hospital or at a clinic or outpatient facility, healthcare professionals are encountering patients with influenza and others who are trying to avoid becoming sick. 

Nurses and other healthcare workers can help prevent the flu by following best practices and educating their patients about ways to reduce transmission and what to do if symptoms develop.

“The flu is wicked this year,” said Deana Goldin, PhD, DNP, ARNP, FNP-BC, Family Nurse Practitioner Program leader at Florida International University’s Nicole Wertheim College of Nursing & Health Sciences (FIU) in Miami. She reported seeing “quite a bit of flu.”

Franz Josef Cordero, RN, BSN, OCN, assistant unit director of the Oncology unit at UCLA Medical Center, Santa Monica, added that the “flu will be – and already is- very bad.”

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According to the Centers for Disease Control and Prevention, flu is widespread in all states except Hawaii, and 37 children had died since the start of the season, October 1, 2017, through January 20, 2018. 

Additionally, overall, 41.9 per 100,000 people have been hospitalized, with people age 65 and older hospitalized at a rate of 183.1 per 100,000 population. 

“If people have comorbidities and they get the flu, their immune system is already weakened,” Goldin said.

How to Prevent the Flu: Tips for Healthcare Workers

Good hand hygiene is important for preventing flu, as are covering coughs and sneezes, and disinfecting potentially contaminated surfaces, said Richard Webby, PhD, a member of the Department of Infectious Diseases at St. Jude Children’s Research Hospital in Memphis. 

“[People] should avoid touching their eyes, nose and mouth,” Goldin said. “Rest is so important and eating healthy.”

Rest, healthy eating and managing stress can help people maintain a healthy immune system, able to fight off flu. 

FIU faculty members begin educating students early about flu and reinforce the information when flu cases start occurring in the community. Students placed in clinical sites must have received the influenza vaccine. 

The CDC strongly recommends the flu vaccine as the best way to prevent the flu, even though the vaccine has not been a good match with the H3N2 strain that is circulating. The vaccine is only about 30 percent effective. 

“While our flu vaccines are far from perfect, they are the best way to prevent getting sick from the flu, and it is not too late to get one,” said Brenda Fitzgerald, director of the CDC, during a press briefing. 

Webby explained that the vaccine “works by inducing immunity against the virus.” Therefore, when a vaccinated individual gets infected the person’s immune system ramps up more quickly, which in turn reduces the amount of virus that they produce and shed. Less virus means less likelihood of infecting someone else. 

Avoid close contact, including shaking hands with people during the flu season. And clean surfaces, phones, tables and toys. 

Goldin also recommends nurses and students become familiar with the CDC website and its resources to stay aware of what is going on with influenza. 

Protecting Patients Against the Flu

The Oncology Unit at UCLA Medical Center, Santa Monica, has taken extra precautions to protect patients, who are often immune suppressed and at greater risk of infection than people with healthy immune systems.

“Right now, we put a box of masks in each patient’s room for when they leave the room or have visitors,” said Franz Josef Cordero, RN, BSN, OCN, assistant unit director of the Oncology unit at UCLA Santa Monica. 

“It’s not mandatory that [patients] use them, but they’re right there in front of them if they do. And they’re disposable, which means they or their visitors will only use them once.”

Additionally, supervisors work to limit neutropenic patients’ possible exposure situations. 

“We assign nurses and care partners to the room, and, as much as possible, don’t have other nurses or staff enter the room,” Cordero said. “RNs and care partners assigned to these patients don’t get patients that are on droplet [precautions]. We also advise the patients to limit the number of visitors.”

Cordero said that the oncology patients have been grateful for the extra efforts. 

Recognizing Flu Symptoms

With flu, people feel miserable. Flu symptoms include fever, cough, body aches, headache, sore throat and nasal congestion. 

“If you are starting to feel symptomatic, it is important to contain it,” Goldin said. “[People] should stay home. And then they should get tested for the flu, especially if they have been around someone with the flu.”

The CDC recommends healthcare providers start patients on an antiviral flu agent, such as Tamiflu, and not wait for confirmatory testing. 

The national supply should be sufficient, but the CDC reports some manufacturers are experiencing delays in filling orders, and there are spot shortages of the drugs. 

Influenza antivirals should be started within 48 hours of symptoms starting. 

People should not go back to work or school until the fever has been down for 24 hours, Goldin added. They should also avoid running errands. 

Goldin teaches cough etiquette to cough or sneeze into a tissue and then throw the tissue in the trash. She added that people can carry a small bottle of alcohol hand sanitizer, and then clean their hands after the cough or sneeze. 

“While our surveillance systems show that nationally the flu season may be peaking now, we know from past experience that it will take many more weeks for flu activity to truly slow down,” Fitzgerald said. 

“We also know that you can reduce your risk of getting the flu through everyday good health habits like covering your mouth when you cough and frequently washing your hands. You need, of course, to limit contact with others who might be sick and if possible, stay home when you are sick to help prevent the spread of germs and respiratory illnesses like the flu. These are the most important measures that we all should be doing.”

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