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QJM Advance Access originally published online on December 10, 2008
QJM 2009 102(2):133-137; doi:10.1093/qjmed/hcn159
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© The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Readiness exercise to combat avian influenza

R.C.-S. Seet1,2, E.C.H. Lim1,2, V.M.S. Oh1,2, B.K.C. Ong1,2, K.T. Goh3, D.A. Fisher1,2, K.Y. Ho1,2 and K.G. Yeoh1,2

From the 1Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 2Department of Medicine and 3Medical Affairs, National University Hospital, Singapore

Address correspondence to Dr R.C.-S. Seet, Yong Loo Lin School of Medicine, National University of Singapore, c/o Department of Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074. email: raymond_seet{at}nus.edu.sg

Received 29 May 2008 and in revised form 15 November 2008


  Abstract

Aim: To examine the readiness of our hospital for the potential pandemic threat of avian influenza, we developed and implemented simulation case scenarios in our hospital.

Methods: Two volunteers, who assumed the identity of ‘actual’ patients, were trained to simulate acute respiratory symptoms following a visit to an avian influenza-affected area, and their identities and locations were kept confidential prior to the readiness exercise. A team of auditors was stationed at high-risk areas to assess adherence to the use of personal protective equipment (PPE) and infection control procedures.

Results: A total of 324 healthcare workers and 84 administrators participated in this hospital-wide exercise. Following disclosure of their symptoms, the ‘patients’ were masked and isolated in negative-pressure rooms. A quarantine order was enforced on 38 inpatients and 45 healthcare workers who were present in the affected wards at the time of the exercise, which mandated the use of PPE. Although all affected healthcare workers were competent in the use of PPE, we observed breaches in PPE and isolation procedures in eight medical and nursing students, and 10 healthcare attendants. The exercise concluded after H5N1 tests returned negative.

Conclusions: We recommend the use of case simulation as an effective means of assessing potential breaches in infection control procedures.


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