Infection Control Practices and Norovirus Knowledge

Ashley Dorenkamp, Megan Evans, Rachel Force, Taylor FortuneBenjamin Kimball, Tiffany Linares, Lyndsey Martin, and Makenze Nugen

Wichita State University

Overview (Taylor)

Service Learning Project with Sedgwick County Health Department

Norovirus and Adult Care Homes

Met with our mentor Chris Steward, MPH to learn what we would be doing.

Created an online survey with provided questions.

Overview Continued…

Prepared paper surveys for mail out to sixty-four Adult Care facilities in Sedgwick county.

Entered returned surveys in our online survey for data analyses.

Wrote a research paper and created charts and tables.

What we were investigating. (Tiffany)

How often each facility monitored disease trends.

What measures each facility was taking to stop spread and future outbreaks of Norovirus in their facilities.

Did they offer infection control training to their employees?

Did they provide written clean-up and disinfection procedures for vomiting and/or diarrhea?

What we were investigating, Continued…

Was there a return to work policy in place after an employee had symptoms of vomiting and/or diarrhea?

Would facilities be interested in learning more about Norovirus from educational materials provided by Sedgwick County Health Department.

What is Norovirus? (Megan)

Norovirus is a highly infectious and contagious disease.

Sometimes called the “stomach flu”, no relation to Influenza.

It is the leading cause of acute gastroenteritis and foodborne disease in the United States.

1 in 15 U.S. residents become ill each year.

Along with 56,000 – 71,000 hospitalizations.

570 – 800 deaths per year.

Predominantly affects young children and elderly.

How do you get it? (Megan)

CDC lists several ways you can contract Norovirus:1) Contaminated food or water

2) Contact with infected person

3) Touching a contaminated surface

Symptoms include:o Fever, body aches, headaches, nausea, vomiting, and diarrhea

Symptoms develop within 24 – 48 hours of exposure

Concerns: Severe Dehydration, continued exposure to others

Recovery can take one to three days.

Ways to prevent at: http://www.cdc.gov/Features/Norovirus/index.html

Method (Makenze)

Created an online survey with provided questions from Sedgwick County Health Department.

Survey consisted of eight questions, some yes/no, others gave the opportunity to give more detail.

Reached out to facilities by phone, and mail.

Entered information from paper surveys into online version.

Analyzed survey data.

Results (Ben)

24 of 64 adult care homes provided responses to our surveys, which gave a response rate of 37.5%

13 were part of a larger network10 monitored disease trends daily1 monitored less frequently2 did not monitor

11 were part of smaller network 4 monitored daily1 monitored weekly1 monitored monthly2 monitored less frequently3 did not monitor

Results Continued…

19 facilities had multiple levels of care:Of the 19 with multiple levels of care:

5 offered infection control training more than three times per year.

7 offered training two to three times per year.6 offered training once per year.1 had never offered this type of training.

Facilities part of a larger network were more likely to offer this type of training.

Results Continued...

92% of the larger network facilities had return to work policies in place.

64% of non-network facilities also had return to work policies.

75% of the facilities involved in the study were interested in receiving educational materials from Sedgwick County Health Department.

Materials that were offered included:Posters, brochures, fact sheets, and in-house presentations for staff

and residents.

Charts and Tables (Ashley)

n=10

n=10

n=4

Number of Responding Facilities by Res-ident Population (n=24)

1-50 Residents

51-100 Res-idents

More Than 100

Charts and Tables Continued…

11

8

22

9

3

Level of Care

Memory CareSkilled NursingAssisted LivingIndependent LivingOther (Home Plus)

Charts and Tables Continued…

100+ Residents 51-100 Residents 1-50 Residents0

2

4

6

8

10

12

Memory CareSkilled NursingAssisted LivingIndependent LivingOther (Home Plus)

Level of Care by Size of Facility

Charts and Tables Continued…

Facilities Part of A Larger Network:

Charts and Tables Continued…

Facilities NOT Part of a Larger Network:

Charts and Tables Continued…

Monitoring Disease Trends by Resident Population

Discussion (Lyndsey)

Focus of research was adult care homes within Sedgwick County.

Investigated the measures adult care homes are taking to monitor Norovirus outbreaks and disease trends in their facilities.

Examined infection control policies and procedures each facility had in place for employees.

Discussion Continued…

Ended up with a good variety of facilities that responded to the survey but sample size was small.

Limitations included: Small sample size.

Follow-up calls to facilities – wrong numbers or disconnected numbers.

Some administrators did not have time to do the survey.

Time management: Allowed more time? Maybe more facilities could have responded?

Improved knowledge of what some adult care home are doing to monitor and prevent outbreaks in their facilities.

The Future of Norovirus Control (Rachel)

There was a positive response overall from facilities about

receiving educational materials from the Sedgwick County Health

Department to enhance their knowledge, and understand the

dangers of infectious diseases such as Norovirus.

By providing this education to facilities we hope to make

administrators, staff, and residents more aware of preventative

measures in order to limit spread and outbreaks.

THE END

For more information on the continuing effort to stop the spread of infectious diseases, visit the Centers for Disease Control and Prevention at:

www.cdc.gov

References

• Bitler, E. J., Matthews, J. E., Dickey, B. W., Eisenberg, J. S., & Leon, J. S. (2013). Norovirus outbreaks: a systematic review of commonly implicated transmission routes and vehicles. Epidemiology And Infection, 141(8), 1563-1571. doi:10.1017/S095026881300006X

• Hall, A. J., Wikswo, M. E., Pringle, K., Gould, L. H., & Parashar, U. D. (2014). Vital signs: foodborne norovirus outbreaks - United States, 2009-2012. MMWR. Morbidity And Mortality Weekly Report, 63(22), 491-495.

• Norovirus. (June 3, 2014). 2014, from http://www.cdc.gov/norovirus/about/index.html