Correctional facilities are arranged to keep the bad guys in, but during flu season you need to consider ways to also keep swine flu (H1N1) virus out. The close environment within a facility can become an incubator in which even a small entry of flu virus to multiply. Consider any new individual coming into the security perimeter as a potential vector carrying in the virus. Don’t let this happen to your facility!
Scenario #1: Breaking Out at Intake
Arrestees coming in off the street have potential for bringing into the facility any number of contagious conditions including lice, skin infections like MRSA, and flu virus. Reduce the chances of an outbreak at intake by performing a thorough health screening. Consider including a hand washing requirement at intake where the detainee is viewed washing their hands for 20 seconds including under the nails. Hand transfer and mouth/nose/eye contact with contaminated hands are a primary means of virus transmission.
Include simple information on respiratory hygiene and cough etiquette during inmate orientation and provide the information in the common languages of your geographic region. CDC materials, available in English and Spanish, can be modified to meet the needs of your facility. Posters on coughing and hand-washing are available in a variety of languages (like the example here).
Scenario #2: Sneaking in with the Kids
Another way the swine flu (H1N1) virus can enter your facility is through the visitor process, especially on kid’s day. Children are notoriously poor at hygiene. Screen all visitors for flu symptoms and have all visitors wash their hands while in the waiting area. Alcohol gel is acceptable and convenient. If your facility limits these gels due to alcohol content, a non-alcohol based formulation is still a better option than no visitor hand-washing.
Provide clear visitor information such as posters used in the California system. Once again, consider ways to provide the information in all common languages spoken in your geographic region.
Scenario #3: Your Buddy is a Carrier
It’s not only the inmates and their families that can bring virus into the facility. Your work buddies (and you!) can be a major problem. Most folks think they wash their hands regularly and correctly but studies show that the majority of us are not thorough hand-washers. Flu virus can live on surfaces for 2-8 hours (http://www.cdc.gov/h1n1flu/qa.htm). That can mean a lot of opportunity for hand transmission and then mouth/nose/eye contact.
You or your work buddies could be carrying in flu virus from a variety of sources such as poorly disinfected gym equipment, ketchup bottles at the diner, or dropping off the children at school or daycare. Facilities consistently enforce security checks for staff entering the security perimeter at the start of their shift. Consideration should be given to enforcing a thorough hand-washing on entry, as well.
If your work mate considers it a sign of team spirit to always show up for duty, she or he may come to work with flu-like symptoms. Make it a practice to send any sick officers home. They are not doing you a favor by bringing a flu virus within the walls of the facility. The CDC is now recommending that anyone with an influenza-like condition be fever-free (without the use of fever-reducing medication) for at least 24 hours before returning to work. This is likely to be from 3-5 days away from work - http://www.cdc.gov/h1n1flu/guidance/exclusion.htm.
Have a contingency work plan in place to account for situations where up to 10 percent of the workforce is unable to be at work - http://www.hhs.gov/pandemicflu/plan/appendixd.html.
Scenario #4: The Nacho Problem
This is the real clincher for a potential outbreak — too many staff members think it is not their problem. When the prevailing mindset is that a flu outbreak is “Nacho (as in, not your) problem”...there definitely is a problem. Staff members must be ever alert to potential transmission of virus through cough droplets and/or skin contamination (followed by entry through mouth/nose/eyes). Continue to keep staff alert to the potential of flu outbreak through briefings at roll call, rounding and observing hygiene behaviors and continuous awareness posters. Just these three actions consistently followed could save you:
1. Wash hands correctly: Be sure all staff members know how to correctly and effectively wash their hands. It sounds simple but plenty of people do not follow all the steps. The most common areas missed are the thumbs, under the nails, and the backs of the hands. Wash thoroughly for 20 seconds by singing the Happy Birthday song through twice.
2. Cover your mouth: Use a shoulder or crook-of-elbow rather than hands when you cough or sneeze — this can reduce the spread to contact objects.
3. Don’t touch yourself: Practice not touching your mouth/nose/eyes with your hands unless you have washed them first. This may be the single most important habit for reducing the spread of flu virus.
If you take the position that swine flu (H1N1) virus is contraband to keep out of your facility, you will be on your way toward preventing an outbreak during this flu season.
