Introduction The purpose of this survey is to assess and improve our respiratory infection control practices in Canada. As an infection control team member, your expertise and opinions are essential to this work. The following survey will take approximately 10-15 minutes of your time. Once the survey is complete, you can choose to enter your e-mail address for a chance to win one of forty honoraria as a token of thanks for your participation. Please note that this survey requires some expertise in Infection Control and knowledge of hospital policies and resources allocated to this service. We wish to collect only one response per institution. Are you the most appropriate person to answer this survey on infection control? * *This survey requires some expertise in Infection Control and knowledge of hospital policies and resources allocated to this service. If this is not you, please forward this e-mail to the person most responsible for the day to day activities of the Infection Control program of your institution. Section 1 Hospital Information 1.1 - What is the name of your hospital (e.g. The Ottawa Hospital)? 1.2 - If applicable, what is the name of your hospital campus (e.g. Civic campus)? 1.3 Where is your hospital located (city, province or territory)? 1.4 - Is your hospital a University Academic Center (teaching center)? 1.5 - How many acute care beds does your hospital have (all campuses combined)? <100 101-499 500-999 Page 1 of 10
>1000 1.6 - How many people live in your hospital's catchment area? <5000 5001-100,000 100,000-500,000 >500,001 unsure 1.7 - Which clinical services are offered in your hospital? Check all that apply. Acute Cardiac Care (Coronary Care Unit - CCU) Acute Stroke Care (Neurology unit) Ambulatory Care (Outpatient clinics) Cancer Care (Oncology) Emergency Department Inpatient General Medicine Care Intensive Care Unit Long Term Care Residence Mental Health Unit Neonatal Intensive Care Unit (NICU) Operating Rooms Palliative Care/ Hospice Pediatric Care Quarantine Ward (for isolation patients only) Rehabilitation Solid Organ Transplant or Bone Marrow Transplant Ward Section 2 Infection Control Program Resources 2.1 - Does your hospital have a dedicated Infection Prevention and Control program? Page 2 of 10
2.2 - What is the level of training for the person responsible for the day-to-day operations of the Infection Control Program? This person could be a corporate manager, infection control practitioner (ICP), or physician responsible for infection control. Check all that apply. Epidemiologist (MSc or PhD) Infection Control Professional (accredited course or program) Physician (MD) Public Health (MSc or PhD) Registered Nurse (RN) Other (please specify): 2.3 - How many full-time infection control practitioners (ICP's) work in your hospital? 0 1 2-5 6-10 11 2.4 - In your hospital, how many ICPs are certified with CIC (Certification in Infection Control)? 0-25% 26-50% 51-75% 76-100% 2.5 - Are ICPs assigned specifically to any of the following clinical areas in your hospital? Check all that apply. Emergency Room Intensive Care Unit Neonatal Intensive Care Unit Neonatal Intensive Care Unit Transplant Unit, ICPs cover all areas Other (please specify): 2.6 - Does your institution use a dedicated database for infection surveillance (e.g. commercial database purchased by hospital)? Page 3 of 10
2.7 - What is the annual operating budget (including salaries) for your hospital's Infection Control program? 100,000 $ 100,001-500,000$ 500,000$ Prefer not to answer OR do not know Section 3 Respiratory Infection Control Policies 3.1 - Does your hospital have a policy for respiratory infection control in the following clinical areas? Check all that apply. Emergency Department Inpatient Wards Intensive Care Unit All Hospital Areas ne 3.2 - Does your hospital have a program in place to teach clinical and non-clinical staff members about respiratory infection control policies and practices? 3.3 - Does your hospital use Symptom Screening Questionnaires to identify patients with febrile respiratory illness (FRI) in the emergency department? 3.3.1 If yes, does your hospital change the Symptom Screening Questionnaire depending on new or emerging infectious diseases or provincial health directives? 3.4 - Are febrile respiratory illness (FRI) screening tools administered to patients during all months of the year? Page 4 of 10
3.4.1 If no, when are FRI screening tools administered to patients? Flu season only Flu season and outbreaks Outbreaks only Never 3.5 - Are signs posted at the hospital entrances to inform patients and visitors to take precautions with hand washing and use of masks if they have respiratory symptoms (e.g. fever or cough)? 3.6 - Is it routine practice at your hospital to order a nasopharyngeal swab (or aspirate) on a patient with febrile respiratory symptoms (e.g. a patient who screened positive on the Symptom Screening Questionnaire)? 3.7 - Who is responsible for ordering a nasopharyngeal swab (or aspirate) for patients with febrile respiratory symptoms? Check all that apply. Infection Control Practionners (ICP) Nurse (RN) Physician (MD) Other (please specify) : 3.8 - Is there a medical directive in place to perform the nasopharyngeal swab (or aspirate) on a patient without a direct order from a physician? 3.9 -How are nasophraryngeal swab specimens processed at your hospital? Select the most common method. DFA (Direct Fluorescent Antibody) PCR (Polymerase Chain Reaction) Viral Culture Unsure Page 5 of 10
Other, please specify: 3.10 - On average, how long does it take for the nasopharyngeal swab (or aspirate) results to return? <24 hours 25-48 hours 49-72 hours >73 hours Unsure 3.11 - According to hospital protocol, what type of isolation precautions are used for patients with febrile respiratory symptoms during a standard influenza season? Airborne precautions alone Droplet precautions alone Droplet and airborne precautions Droplet and contact precautions Droplet, airborne, and contact precautions 3.12 - Based on the hospital's policy, are private rooms used for patients under droplet precautions the majority of the time? 3.13 - What is the standard duration for droplet isolation precautions in your hospital? 2 days 3-4 days 5 days 3.14 - Who can discontinue droplet precautions at your hospital? Check all that apply. Any Nurse (RN) Any Physician (MD) Infection Control Professional (ICP) Infectious Disease Physician Other, please specify: 3.15 - How does the ICP at your hospital decide to discontinue droplet isolation precautions? Check all that apply. Page 6 of 10
Afebrile for >48 hours Alternative diagnosis is established, droplet precautions not required) Negative viral test (nasopharyngeal swab or aspirate) Resolution or improvement of patients respiratory symptoms Other, please specify: 3.16 - What personal protective equipment is used at your hospital by staff caring for patients under droplet isolation precautions? Check all that apply. Eye protection Gloves Gowns N95 Respirator Surgical Masks ne of the above 3.17 - How often do you feel the hospital clinical staff adheres to the respiratory infection control policy? 50% 51-75% 76% 3.18 - Does your hospital cohort patients with febrile respiratory symptoms to a designated area of the hospital? Section 4 Respiratory Infection Control Surveillance 4.1 - How does your hospital find cases of nosocomial respiratory infections during non-outbreak periods? Check all that apply. Surveillance by tracking nasopharyngeal swab (or aspirate) results Surveillance by monitoring patient clinical symptoms 4.2 - How does your hospital find cases of nosocomial respiratory infections during outbreak periods? Check all that apply. Surveillance by tracking nasopharyngeal swab (or aspirate) results Page 7 of 10
Surveillance by monitoring patient clinical symptoms 4.3 - Do ICP's or other personnel conduct regular surveillance of personal protective equipment used by MD's and RN's working in the hospital? 4.4 - Do ICP's record the duration of isolation precautions (in number of days) at your hospital? 4.5 - Do ICP's at your hospital collect data on respiratory infection rates? 4.5.1 If yes, during this past influenza season (2015-2016), how many nosocomial influenza cases were confirmed (# of cases)? 4.6 - Do ICP's conduct daily clinical surveillance on patients who are under isolation precautions? 4.7 - Does the hospital have a policy during outbreak periods to notify or screen visitors upon entrance to the hospital for possible respiratory symptoms? Check all that apply. Signage for hand washing and wearing masks FRI screening questionnaires administered by staff Nasopharyngeal Swabs (or aspirates) Other (please specify) : Section 5 Antiviral Medication & Staff Influenza Vaccination Practices 5.1 - Is annual influenza vaccination mandatory for health care workers at your hospital? 5.2 - Is the influenza vaccination mandatory for health care workers during an outbreak? Page 8 of 10
5.3 - During an influenza outbreak, are non-immunized staff working with patients in the affected ward(s) of the hospital required to take oseltamivir (Tamiflu ) prophylaxis? 5.3.1 - If no, please select all that apply Staff continue to work in the outbreak affected area Staff are re-assigned to non-outbreak affected area Staff are put on leave for duration of outbreak Other (please specify) 5.4 - Is it a standard policy during a respiratory viral outbreak for inpatients to receive oseltamivir (Tamiflu ) as prophylaxis if they come into contact with another patient with confirmed influenza in the hospital? 5.5 - In 2015/16, what was the overall influenza vaccination rate for all health care workers at the hospital? 0-25% 26-50% 51-75% 76-100% Unsure 5.5.1 - In 2015/16, what was the influenza vaccination rate for each of the following groups at the hospital? 0-25% 26-50% 51-75% 76-100% Unsure Physicians Nurses Hospital Staff (e.g.clerical, porters, housekeeping) Other Health Professionals (e.g. allied health professionals) Page 9 of 10
Section 6 Additional information 6.1 - Is your hospital planning any upcoming changes to your infection control practice or policy?, please specify If you wish to enter the draw for one of forty 100$ honoraria, please enter your e-mail address below. Please note that your e-mail will be used solely for the draw., I do not want to provide my e-mail address., I would like to enter the draw for a chance to win 1 of 40 100$ honoraria. Please enter your e-mail here Thank you kindly for your participation in this survey. Please sent your completed survey to judiotte@ohri.ca Thank you The Infection Control and Respiratory Research team, The Ottawa Hospital. Page 10 of 10