Name of Activity:Testing of communicable diseases for patients presenting to ER when sent from Physician’s office Role performing Activity:Emergency RN or LPN Location: FHHR Department:ER WORK STANDARD Document Owner: Lisa Parker Date Prepared: Jun 5/2014 Region/Organization where this Work Standard originated: FHHR Last Revision: Date Approved: Work Standard Summary: Essential Tasks: 1. OP Physician requests testing for communicable disease (eg.Viral exanthema, mumps) or emerging respiratory illness (Avian Flu, Mers-CoV,Viral Hemmorhagic Fever (EBOLA)) to be completed in ER. OP Physician to consult with MHO to discuss the specifics of the case. Patient directed to present to Ambulance entrance of Emergency department by OP physician. ER doors will be closed as usual and patient will have to pick up red phone to talk to ER staff member or staff member will meet them at Ambulance entrance. 2. ER staff will don surgical/procedural mask if droplet transmission ( eg. ILI, Mers-CoV, mumps, Viral Hemmorhagic Fever (EBOLA)) is suspected. Staff will don N95 respirator if airborne transmission ( measles,chickenpox,TB,) is suspected. 3. ER staff member will have patient and visitors wear a surgical/procedural mask prior to entering ER department from supply of masks kept in Ambulance entrance.( if have not received a mask from doctors office). If no masks present in back entrance, patient and visitors will be left in Ambulance entrance until staff member obtains appropriate masks. 4. Patient and visitors will be escorted into the nearest private room to the Ambulance entrance available. Ensure isolation cart and signage in place. For Viral Hemmorhagic Fever (EBOLA) use red isolation cart. 5. ER staff member will obtain health information from patient and register the patient. Ensure all staff involved in patient care are wearing appropriate isolation PPE( gowns, gloves, eye protection, surgical/procedural mask / N95 respirators) based on symptom presentation/procedure. Rev 2013042 Copyright 2013 John Black and Associates, LLC 6. Lab will be called and notified that the patient is present in the ER. Communicate isolation status of patient to lab. Make out lab requisition and place in phlebotomy hotbox. Mark status of test(Stat,ASAP). Indicate on requisition a copy of lab testing to be sent to family physician and MHO. Severe/specific cases may require stat testing at SDCL based on physician discussion with MHO prior to patient being sent to ER department. Notify lab staff if stat transport is required. No lab work or IV’s to be initiated on Viral Hemmorhagic Fever patients unless specifically ordered by MHO. 7. Nurse will collect any other samples ordered such as nasopharyngeal swabs, auger suctions, urinalysis 8. Requisitions for above testing will be sent to laboratory along with samples. Indicate on requisition ordering physician with copy to MHO. 9. Upon discharge, patient and visitors will ensure that masks are still on (should be on for entire procedure if possible) and will be instructed to exit ER through Ambulance entrance to minimize traffic through the ER department. 10. ER staff will notify housekeeping to isolation clean the room. Housekeeping staff should wear appropriate isolation PPE based on signage on the door. N95 respirator would be required when cleaning for cases where airborne precautions are in effect (signage would be on door to direct this). Supplies: Rev 2013042 Copyright 2013 John Black and Associates, LLC