AMA Journal Says Most Nursing Homes Don't Have Pandemic Flu Plan

If influenza pandemic hits the United States, acute care hospitals are likely to be overwhelmed. Nursing homes may then be expected to assist with the patient overflow, but a new study in the Journal of the American Medical Association suggests that many are not prepared for such a task.

Of the more than 400 nursing homes in the study, just 23 percent had a specific pandemic influenza plan. Another quarter of the nursing homes had a pandemic response incorporated into an overall disaster response plan. And more than half--52 percent--did not have any pandemic plan.

"If nursing homes are called upon to serve as alternative care centers for patients who can't be treated in overcrowded hospitals, the impact on the nursing homes could be vast. Nursing homes serve a vulnerable population prone to dire consequences from an emergency," said lead author Philip W. Smith, M.D., professor and chief, Section of Infectious Diseases, University of Nebraska Medical Center. "While most facilities felt that nursing homes were being counted on to take hospital overflow patients in a pandemic, in reality few homes would be able to do so."

"Nursing homes may not be equipped to handle an influx of influenza as well as non-influenza patients. They may also be unwilling to accept overflow patients, if it means displacing their current residents," added senior author Lona Mody, M.D., M.Sc, assistant professor of internal medicine at the University of Michigan Health System and research scientist, Geriatric Research, Education, and Clinical Center at the Veterans Affairs Ann Arbor Healthcare System. "Nursing homes run a high occupancy rate, making it logistically difficult to accept a lot of patients if there is a time crunch."

"Specific areas for improvement include communication with nearby health departments and hospitals at planning stage and exercising formulated plans. Planning for staff shortages is also critical," Mody said.

Half of the nursing homes in the study had stockpiled some commonly used supplies such as gloves and hand hygiene products. Less than half had provided pandemic education to staff members. Just 6 percent had conducted pandemic influenza outbreak exercises.

In more optimistic findings, more than three-quarters--77 percent--of all Michigan and Nebraska nursing homes had a person or staff position designated as being responsible for pandemic preparedness. Access to laboratory facilities for the detection of influenza was available at 84 percent of these nursing homes. Another 71 percent provide mental health and/or faith-based services.

The researchers sent a questionnaire to all 656 state health department or Centers for Medicare and Medicaid-registered nursing homes in Nebraska and Michigan to assess their preparedness. The response rate was 69 percent.

For access the federal government's information about pandemic influenza preparedness, visit: www.ready.gov/america/beinformed/influenza.html. For state-by-state information about pandemic preparedness, visit www.pandemicflu.gov/whereyoulive/index.html.

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