Section UTMB On-line Documentation Subject Healthcare Epidemiology Policies and Procedures Topic: Detection and Disposition of Outpatients with a Suspected Emerging Infectious Disease (EID)

Policy 3.13 Revised 08.31.09 2004- Author

3.13 Detection and Disposition of Outpatients with a Suspected Emerging Infectious Disease (EID)

Purpose	Early detection, isolation and evaluation of outpatients with a suspected EID.
Audience	Healthcare workers (HCWs) in outpatient clinics, outpatient surgery, the Emergency Department (ED) and in any other services where outpatients receive care.
Policy Statement:	I. All outpatients must be screened for an EID at the site of first contact with outpatient clinics and services that provide outpatient diagnostic tests and patient care. A. Each outpatient clinic and service that provides outpatient care must designate a person to screen patients for a possible EID on arrival. B. At the point of screening, the person who performs this task will have a supply of tissues, surgical masks, thermometers and bottles of alcohol hand rub. II. Screening will be done using a standardized set of screening questions. See Policy 3.01 Screening Policy for Persons with a Possible Emerging Infectious Disease [EID]) A. The screener will wear an N-95 mask for SARS and avian influenza or a surgical mask for swine influenza, goggles, gown and gloves. B. The patient’s temperature will be taken. C. Patients who are afebrile and have no respiratory symptoms will be admitted to the clinic for their scheduled appointment. D. Patients who have a fever and respiratory symptoms that meet one of the case definitions in Policy 3.01 will have a surgical mask placed on them and an alcohol hand gel applied to their hands. The patient will be placed in an exam room or in a waiting room with other patients at least 3 feet apart. E. The screener will apply an alcohol hand rub to his or her hands. III. Disposition of a patient who screens positive for suspected EID. A. A patient with a suspected EID may be managed as an outpatient by his/her care provider. If the care provider determined that the patient is ill enough to require hospitalization, the care provider will arrange for transport of the patient to the ED at UTMB. B. The Department of Healthcare Epidemiology will be notified that a patient with a suspected EID is being transported to the ED. C. The ED will be notified that a patient with a suspected EID is being transported to the ED. IV. When the HCW who is screening for EIDs prepares to discontinue screening, he/she should remove gloves, goggles and gown in that order, and discard these items in the trash can. Next, wash hands with an antimicrobial soap and water or apply an alcohol hand rub. The mask should then be carefully removed so as to avoid contamination of the hands by secretions on the front of the mask. The mask should be placed in a trash receptacle. The HCW should then wash their hands with an antimicrobial soap and water or apply an alcohol hand rub.

Appendix

Emerging Infectious Diseases (EIDs) Supply Distribution for Clinics

Supplies:	The following supplies will be available in all clinics during an Emerging Infectious Disease (EID) event:
	1. Gowns 2. Gloves (all sizes) 3. Surgical masks 4. N95 masks (all sizes)	5. Eye protection 6. Facial tissues 7. Alcohol hand rub
Distribution	Supplies will not be released from the stockpile until the Department of Healthcare Epidemiology notifies materials management. University Hospital Clinics: The UHC clinics will get their supplies from materials management storeroom via their normal practices. Regional Maternal Child Health Clinic: RMCH clinics will have a one week supply of each of the items listed above stored in each clinic. • Each clinic will set their PAR level with UTMB Materials Management. In the event of an emergency the RMCH clinics will try to order further supplies through Physician Purchasing Services (PSS). • If supplies are not available through PSS, the clinic may obtain supplies via UTMB Materials Management. • The PeopleSoft ordering system shall be used by activating a pre-populated supply list. • Federal Express will be used for delivery. • The Women’s Center at Victory Lakes (a department clinic) will be included in communications with the RMCH group. Mainland clinics, University Ophthalmology Clinic, Stuart Road Clinic and IPUC: • The large primary care clinics will keep a week’s supply in a storage area in the clinic. • The smaller specialty care clinics will keep a small supply in their clinic and call for additional supplies if necessary. • A UTMB courier will bring the supplies from a central storage area. • If additional supplies are needed, they may be obtained from PSS or UTMB Materials Management. • The PeopleSoft ordering system shall be used by activating the pre-populated supply list. • Federal Express or a courier will be used for delivery.
Non-Stock Items	A pre-established emergency fund will be designated for ordering non-stock items (such as influenza test kits). When it is determined that special items are needed, the various entities will place their order in PeopleSoft and the purchasing department will process the request using the emergency fund.