May 12 , 2009
As of May 12, 2009, 30 Countries have reported 5251 confirmed cases of influenza A (H1N1) infection. These numbers include the 53 confirmed cases in Alberta. Of the Alberta cases 18 are from theCalgary area, 15 from the Edmonton area, 13 from central Alberta and 7 from northern Alberta.
Risk Assessment for HINI Influenza Virus
The Canadian Federation of Nurses Unions released a policy directive: H1N1 Outbreak and Personal Protective Equipment (PPE) on May 7, 2009. As part of that directive CFNU encourages it's members to work with their Joint Occupational Health and Safety Committees to conduct risk assessment to identify healthcare workers at risk and develop prevention measures that include engineering controls (single bed rooms, plexiglass partitions), administrative controls (policies, procedures, education and training) and personal protective equipment (N95 respirators, eye protection, gloves, gown).
The requirement to perform risk assessments is part of Alberta's Occupation Health and Safety Legislation. Part 2: Hazard Assessment, Elimination and Control of the Occupational Health and Safety (OHS) Code states that “employers are required to assess a worksite and identify existing or potential hazards before work begins”. The purpose of the hazard assessment process is to eliminate or control workplace hazards before they cause injury and illness. Employers are required to eliminate the hazard or implement the most effective method of control available.
In Part 35: Health Care and Industries with Biological Hazards of the OHS Code “an employer must ensure that worker exposure to biohazardous materials is kept as low as reasonably practicable” Biohazardous materials include virus, fungi, bacteria, parasites, mould, blood and body fluid and biological waste. Employers must include biological hazard when they perform hazard assessments.
Providing care to patients, clients or residents with suspected or confirmed influenza A H1N1 infections clearly poses a health risk to health care workers. Therefore, AHS should be performing hazard (risk) assessment to identify staff at risk of infection and job duties and aspects of the work environment that contribute to that risk.
In addition, nurses need to rely on their own assessment skills to determine if they need to be wearing a N95 respirator, eye protection, gloves, and gown when providing care to their patients. If the patient, client or resident is exhibiting the symptoms of an influenza A H1N1 infection then you should be erring on the side of caution and don the appropriate personal protective equipment (PPE). You need to protect yourself at the highest level available until it is confirmed that a lower level of protection is required.
If the appropriate PPE is not available then you are required by law to refuse to perform unsafe work until your employer provides you with that equipment.
Recommended precautions for health workers remain
It is the position of United Nurses of Alberta that until such time as there is scientific certainty regarding the mode of transmission of Swine Influenza A (H1N1) all Employees covered by the Multi-Employer/UNA Collective Agreement that are required to provide patient care for suspected or confirmed swine influenza A cases must be provided with an appropriate supply of fit-tested N95 respirators and mandatory education regarding the care of procedures for donning and doffing N95 respirators.
Along with respiratory protection until the manner of causation is known, in addition to routine practices, infection control measures for suspected and confirmed cases of the swine influenza should include contact precautions, respiratory hygiene, accommodation, eye protection, surveillance and reporting.
What You Need to Know:
Get Fit Tested! - The Multi-Employer/UNA Joint Committee has reached an agreement regarding N95 Respirator Provision and Fit Testing, which requires the employer to provide N95 respirator fit-testing to all employees covered by the Multi-Employer/UNA Collective Agreement. Fit-Testing is mandatory as per Article 35.02 (a)
Ensure you have enough N95 respirators - The Joint Committee agreement obligates the Employer to ensure that an appropriate supply of N95 respirators is available.
You may be temporarily transferred - In the event of an emergency Article 44: Mobility (44.05 (e)) allows the Employer to reassign Employees from any site to perform work at any other site in emergency circumstances. An emergency is defined as “an unforeseen combination of circumstances or the resulting state that calls for immediate action”. Contact you Local representative or Labour Relations Office for additional information regarding emergency transfers.
Do not report to work if you are sick - Nurses should not be reporting to work if they have influenza like illness (fever and respiratory symptoms). Nurses who do report to work are putting patients and their co-workers at risk of infection and illness. The Alberta Government is asking that individuals with flu like symptoms stay home from work and avoid public places when ill.
You do not have to put your health at risk - The agreement between the parties states that employees who have not been fit-tested for an N95 respirator or are unable to achieve an effective facial seal shall not be expected to enter or provide services in an area where a suspected or confirmed case of swine influenza A has been identified. These Employees may be deployed to another area.
You need to assess whether you believe that you need to provided with N95 respirators (fit-tested), gown and eye protection. If your employer refuses then ask to be reassigned.
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