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Update: Therapist who treated newborns tests positive for swine flu

Friday, June 19, 2009
(Updated 1:41 pm)

GREENSBORO — Staff at The Women’s Hospital took additional precautions Thursday after learning a respiratory therapist unknowingly exposed 33 babies to the H1N1 virus, or swine flu.

Moses Cone Health System officials learned Thursday night that the therapist tested positive for the virus. The therapist, who is at home recovering, likely became exposed after treating a patient who later tested positive.

Hospital officials said infants in the neonatal intensive care unit, where the therapist was working earlier this week, remain free of flulike symptoms and are still on Tamiflu as a preventive measure. The treatments began Wednesday.

“While we know this may raise concern, we want to reassure everyone that we have acted from the beginning as if this was the case,” said Dr. Timothy Lane, an infectious disease specialist and the director for infection prevention with Moses Cone Health System. “The welfare of these babies remains our top priority, and we are continuing to take every precaution to ensure it.”

Neonatologists at The Women’s Hospital continue to monitor the babies, and the hospital continues to screen or restrict visitors to the unit.

“While we are grateful that this employee is recovering from the illness, we want to emphasize that when she worked in the NICU, she thought she had recovered from a cold,” said Joan Wessman, chief nursing officer of the Moses Cone Health System. “At that time, she also did not know she had been in contact with an H1N1 patient. We do believe she acted in good faith. We are doing everything we can to keep the babies protected.”

The identity of the therapist and patient she treated who exposed her to H1N1 have not been revealed because of medical privacy concerns.

“The hospital has dispensed Tamiflu as a prophylactic measure to 11 family members and visitors and 57 employees,” Wessman said.

“We believe we may dispense it to more family and visitors. We’re not sure how many.”

Concern over exposure began after a patient came to the emergency room on June 6 with symptoms that were believed related to asthma. The patient was treated and released.

According to the hospital, that patient came back twice after experiencing more flu symptoms and was hospitalized on June 10. He was isolated and tested for H1N1, testing positive on Monday.

The hospital looked into all the employees who came into contact with the patient and learned that the respiratory therapist who treated him on an early visit was out sick Tuesday. She had just completed a shift the night before at The Women’s Hospital, where she was treating babies with breathing problems. She was in an area where she was exposed to up to 33 babies, according to the hospital.

“We don’t believe that this respiratory therapist did anything wrong,” said Wessman. “She was unaware that she might have been exposed before she felt any symptoms.”

Wessman said it is common for some employees, especially in specialized fields like respiratory therapy, to work across a number of campuses in the Moses Cone Health System. That policy isn’t likely to change, Wessman said.

“All of our employees are sensitive to this and we’re continuing to educate everyone that if you have symptoms, if you feel sick, don’t come to work.” Wessman said.

In another case, a patient at The Women’s Hospital tested positive for H1N1 Thursday afternoon. The patient, who was sick when she arrived at the hospital, was isolated while at the hospital. She is now recovering at home.

A student on the campus at UNCG tested positive for the virus Thursday afternoon. The case is believed to be unrelated to the first confirmed case at UNCG and is the fifth confirmed case of H1N1 in Guilford County.

Contact Joe Killian at 373-7023 or joe.killian@news-record.com

Accompanying Photos

WE'D LIKE TO HEAR FROM YOU

If you have a baby at The Women’s Hospital or a newborn in the neonatal intensive care unit, we'd like to hear from you. Please send Teresa Prout an e-mail at teresa.prout@news-record.com.
 

Comments

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kikablue

June 17, 2009 - 7:07 pm EDT

This is terrible I hope and pray those babies will be alright. Bless their little hearts, so tiny and already facing a battle.

registerednurse

June 17, 2009 - 7:41 pm EDT

Am I understanding correctly that a Respiratory Therapist was required to work in Neonatal Intensive Care Unit with premature, immunocompromised infants AND also in the Emergency Room where exposure to illness-causing pathogens would be prevalent??? Come on, Cone, how long have your Registered Nurses begged to not be required to float to other units?

Ryan Seals

June 17, 2009 - 7:46 pm EDT

He didn't say that it was required, but that it is a fairly common practice.

bookkeepr

June 17, 2009 - 7:55 pm EDT

Well, having a family member employed by the Health system, I know for a fact that it IS REQUIRED to float to other areas if they want to keep their jobs. It isn't by choice. Now, do you want to have someone working with your immunocompromised premie that has just been in the ER or any other area of the hospital with infectious diseases? Now..... do you really think the patients come first? Nope..These employees are stretched to the max and always in fear of their jobs. Someone should really check into just what does go on and how dangerous it really is with the lack of staffing and floating that is required.

Get the facts

June 17, 2009 - 9:26 pm EDT

As usual, many assumptions have been made that cannot be substantiated. #1 the nurse is at home with the flu, coincidentally she treated a patient with swine flu. The flu she has acquired has not been determined to be swine flu. #2 Respiratory therapists work all over the health system, there is no dedicated ER respiratory team nor is there a demand to have one. #3 Nurses are NOT REQUIRED to routinely float especially from Moses Cone ED to Women's. It is likely that this RESPIRATORY THERAPIST chooses to work in both places. #4 To say that a reduction in employees floating would reduce the risk of Swine flu transmission is a false sense of security. What about all the parents and family who go through the hospital everyday, what about the children of the hospital employees that can contaminate their homes before they even come to work. #5 No babies have been determined to be infected.

The typical flu kills over 20,000 people in the U.S. every year yet it doesn't make the news because it happens every year and people wouldn't be surprised. The reason the swine flu is so popular is this strain has not been detected before and little is known about it yet, it has not proven to be any more dangerous than any other strain of flu that we have seen. The best way to prevent the spread of the flu is routine hand washing and isolating yourself when symptoms occur which this nurse has done. Moses Cone routinely educates their employees on prevention of infection, promotes handwashing within their hospitals and billboard throughout the city, and provides antiseptic solution on almost every corner. This is not a nurse float problem, a staffing problem, infection control problem, or work demand problem. It is the result of overanxious media and hyperactive ignorance.

bookkeepr

June 18, 2009 - 8:27 pm EDT

So, the fact are in... she does have swine flu. Nurses ARE required to float and it sounds as if you are part of management.

registerednurse

June 19, 2009 - 12:27 am EDT

Right bookkeeper...so far he's only potentially correct about #5 (and I sincerely hope that holds true).

lkirkman5

June 18, 2009 - 12:23 pm EDT

I can't believe that ANY Nurse that had worked in ANY Emerency Room would be assigned to be around ANY babies at ANYTIME! Everyone knows what comes through Emergency Rooms, all kinds of illness.
I am expecting 2 grandchildren in August and all I can say is if this had happened when my grandchild was there, Moses Cone would be looking at a serious lawsuit by endangering their lives.
Get your act together, NOW PLEASE!

DeePeDe

June 18, 2009 - 2:00 pm EDT

Just wish to point out that the hospital worker in question here is a Respiratory Therapist, not an RN. RT's are usually required to work in many different departments of the hospital or hospital system where they are employed. One day they are in the CCU, next the ED and a couple days later the NICU. This is standard practice in many, maybe most hospital systems, unlike RN's who usually work in only one department. Of course, all hospital employees use universal precautions to eliminate the transmission of communicable diseases from patient to patient and from patient to employee. But, there is the risk of hospital workers picking up an airborne respiratory virus from patients who have not yet been diagnosed. So, that brings up the question of hospital employees wearing masks routinely. The CDC recommends fit tested N95 masks for healthcare personnel treating patients who have been diagnosed with certain airborne communicable diseases including this new H1N1 virus. But, I don't believe any hospital is requiring routine wearing of masks for all personnel throughout their whole shift.

bigwill

June 18, 2009 - 3:54 pm EDT

Your chances of getting sick from someone from an ER visit is less likely than going to a public bathroom or touching a shopping cart at Wal-Mart. Also, good luck trying to find a lawyer that would help you with your case of a lawsuit. Just simply being at a hospital that a disease was found to be at would be laughed at in court. Try again there buddy and quit overreacting. More people died today from the regular flu than the H1N1 has totalled since its been found. Get a grip.

keyofa1

June 19, 2009 - 12:12 am EDT

I have to agree to some extent, but wouldn't you want to try to limit as most exposure as possible. At Women's Hospital, they do not have a true ED. The hospital is for WOMEN. They deliver babies, take care of premies and they have a gynocological surgery unit. It would only make sense to limit these employees to this campus, whether it be a nurse, respiratory tech or anyone else in direct patient care. But, I still think floating employees from campus to campus just feeds the spread of any air borne disease, which is how a pandemic would start. I just find it interesting that it seems that someone from Cone administration/management is commenting on this forum. If it is, that just shows their true professionalism.

registerednurse

June 19, 2009 - 12:24 am EDT

keyofa1-
I was wondering the same thing about someone from MCHS commenting! They do have a "public relations specialist". Well....hopefully they are getting paid for all that time & effort they spent on the post this am!!

mickey

June 18, 2009 - 11:42 pm EDT

What I want to know is, did the resperitory therapist wear a mask when she was in the NicU? Did she wear gloves? I would think that if she was wearing a mask and gloves that the risk of transmission would be low. But then again, when this person was in the ER working with the "asthma " patient, was she wearing gloves then? I would think that health care professionals would be well-schooled in universal precautions and to some degree would assume that the patients with whom they are working MAY have a communicable disease. I think that something was not done, or some procedure was not followed somewhere along the way.

registerednurse

June 19, 2009 - 12:31 am EDT

Nurses & Respiratory Therapists are WELL aware that handwashing is the single most important means of preventing the spread of infection. I feel sure the RT was an excellent RT who followed necessary precautions.

mickey

June 19, 2009 - 8:40 am EDT

Was she wearing a mask when she worked in the NicU? Is that the protocol?

nicurn

June 19, 2009 - 6:01 pm EDT

I worked as an RN in Women's Hospital NICU in the recent past. I found some of the best RNs and RTs that I've ever had the pleasure of working with there. I would not hesitate to recommend that NICU or its staff. As in most other hospitals, RTs at Women's do cover several units. Every place that I have worked, including Womens Hospital, has standards in place for isolating pts who exhibit any suspicious symptoms. From what I understand, this adult pt was treated by this RT for what was initially diagnosed as asthma-like symptoms. This pt did not qualify for any isolation at that time, and the RT would have had no reason to believe otherwise. IF the pt had exhibited flu-like symptoms at the time the RT had treated him, she would have been wearing a mask and gloves. She would also not have been allowed into the NICU after exposure to the pt. The fact that the pt was initially discharged home is indicative that no one believed he was contagious. Also, we do not know the circumstances behind the RT working in the adult ED at Moses Cone--perhaps she was picking up extra hours over there of her own accord, or maybe she was in fact required to work in that unit during that shift. Floating is a very unpleasant fact of life for many healthcare personnel; RNs in particular despise the practice of floating to different units; but as mentioned before, RTs routinely cover multiple areas. And to the questions about wearing gloves/ masks routinely--I have never worked anywhere where the staff routinely wear gloves and masks with all of the pts. I do not know of anyplace where this is the case. A set of guidelines was put in place in hospitals many years ago called "Standard Precautions", which mandates hand hygiene before and after pt care as the most effective way to prevent disease transmission. Gowns, gloves, and masks are only to be worn as indicated by the pt's condition and your likelihood of coming into contact with bodily fluids. During routine care of the normal NICU pt, gowns and masks are almost never indicated. The nurses, RTs, neonatal nurse practitioners, and neonatologists at Womens Hospital are a very professional group of people, and I wish them all the best through this.

bookkeepr

June 19, 2009 - 6:17 pm EDT

You're right.. the nurses, techs, therapists, etc are all so good about handwashing, etc. I think the focus has gotten a little off course. The point I was making earlier was that if floating were't required.. then there would be a little less cross contamination. Newborns (and especially premies) basically have no immune system anyway. Hats off to the staff that work so hard at their jobs and do try so hard given the sad, sad situation that management has put them in.

nicurn

June 19, 2009 - 8:33 pm EDT

I agree with you--I hate the practice of floating. As an RN, I feel it just furthers the mistaken idea that administration has that "a nurse is a nurse is a nurse..."; basically that any nurse should be able to work anywhere at any time. Anybody in healthcare these days knows how specialized it is, and nurses are specialized as well. As a NICU RN, I don't want to be taking care of congestive heart failure patients, and you don't want a cardiac nurse taking care of a 24-weeker. And cross-contamination of pts is a real issue. During my time at Womens, the nurses were not required to float outside of Womens' Hospital, with the possible exception of NICU nurses to pediatrics at Moses Cone. And if you were in contact with a contagious pt, you did not come back to the NICU for the remainder of that shift. The RTs at Womens are based out of the NICU, but cover the entire hospital as needed. There are many different reasons why that RT might have been at Moses Cone that night, but you're right--if she's really an employee of Womens Hospital, and was required to float to Cone ED the night she was exposed, I think some policies need to be re-analyzed in this new light.

babysis

June 19, 2009 - 4:05 pm EDT

Well it would also be nice if Cone would not give an occurence to employees who call in sick and have doctors notes to back it up. Then maybe when they are sick and running fevers they can stay home without fear of being written up or fired and keep from spreading whatever virus they have. Like bookeeper said, do the patients really come first???

bookkeepr

June 19, 2009 - 6:19 pm EDT

AMEN! You are expected not to pass your illness on to patients and babies, but yet when you are sick.. you are given an "write up" when you are out. Too bad that the staff can't pick and choose when they get sick.. oh yea... and DON'T EVER GET SICK ON THE WEEKENDS!

nicurn

June 19, 2009 - 8:21 pm EDT

You are 100% correct--you're punished for calling in sick.

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