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Doctor’s Notes for Absenteeism; Lab Confirmation for H1N1

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October 14, 2009

Illness and "Fit to Work" 

If you become ill with influenza like illness (new or worse cough, with or without fever, plus other common symptoms of fatigue, muscle aches, sore throat, headache, decreased appetite, runny nose, and sometimes nausea, vomiting and diarrhea) you are required to stay off work for 7 days after onset of symptoms or once symptoms are resolved whichever is shorter. Staff providing direct care in NICU, Oncology and other similar units should stay away the full 7 days.

  • If you are ill, report it using normal call-in procedures established by your supervisor/manager. Access to your accumulated sick bank is not changed.
  • You do not need a doctor’s note (proof of illness) for this type of absence or to allow you to return to work. If you have other types of illness, please discuss proof of illness requirements with your Manager
  • There is no need to prove that you did or did not have H1N1 to access your sick bank. There are no requirements to be "swabbed" to prove or disprove whether you have H1N1.
  • We are only recommending the swabbing of hospitalized patients at this time, or those where the doctor determines that it is necessary to know about for the medical management/treatment of the illness.
  • Even if you previously have been sick with influenza-like illness, H1N1 vaccination for health care workers is recommended as you may have been infected by a different influenza strain which would not provide immunity to H1N1.
  • Influenza is primarily acquired in the community. If a healthcare worker contracts influenza and decides to file a WorkSafe BC claim, WorkSafe BC will determine on a case by case basis whether or not the influenza was acquired at work. WorkSafe will decide this, not FH. This is consistent with their law and policy regarding occupational diseases.
  • Routine reassignment of health care workers based on their pregnancy, medical conditions or immune status is not necessary. However, individual requests for reassignment should be reviewed on a case-by-case basis with your Manager. All health care workers, regardless of pregnancy or medical status must abide by current infection control guidelines during the care of patients, clients and residents.
  • There is no special paid H1N1 leave for pregnant healthcare workers in British Columbia. Federal government employees may be eligible for this, but the leave is not applicable for workplaces that are provincially regulated, like Fraser Health.

N95 Respirators and Personal Protective Equipment

  • Procedure mask and protective eye wear for all routine care
  • Gloves for contact with the patient and the patient’s environment
  • Gowns if splash or spray is anticipated;
  • N95 and protective eye wear if performing aerosol generating procedures (AGMP) *
    *AGMP is any procedure carried out on a patient that can induce the production of aerosols of various sizes, including droplet nuclei. Examples include: non-invasive positive pressure ventilation (BIPAP, CPAP); endotrachial intubation; respiratory/airway suctioning; high-frequency oscillatory ventilation; tracheostomy care; chest physiotherapy; aerosolized or nebulized medication administration; diagnostic sputum induction; bronchoscopy procedure; autopsy of lung tissue.
  • Prior to any patient interaction, all health care workers (HCWs) have a responsibility to always assess the infectious risk posed to themselves and to other patients, visitors, and HCWs. This risk assessment is based on professional judgment about the clinical situation and up-to-date information on how the specific healthcare organization has designed and implemented engineering and administrative controls, along with the availability and use of Personal Protective Equipment (PPE).
    • This is called a Point of Care Risk Assessment (PCRA). PCRA is not a new concept, but one that is already performed regularly by professional Healthcare Workers many times a day for their safety and the safety of patients and others in the healthcare environment.
    • Professional judgment will dictate that in certain circumstances the minimum level of protection ought to be increased. If for example healthcare workers are providing care in an open ICU with a high number of acutely ill patients with influenza then it may be appropriate to wear a N95 respirator along with eye protection, gloves and hand hygiene all the time and not only while performing aerosol generating medical procedures (AGMP).

Fit-testing information and FH’s staff Respiratory Protection Program can be found on the Fraser Health intranet (you must be logged onto the Fraser Health network to view this page).

Health Care Worker Immunization Clinics

Health care workers will be provided with free H1N1 vaccination at site drop-in clinics and through peer nurse immunizers. Watch for the posted schedule on the intranet – coming soon.

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