Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
MICHAEL D. CREWS SECRETARY PROCEDURE NUMBER: 401.003 PROCEDURE TITLE: MANAGEMENT OF APPARENT FOODBORNE OUTBREAKS RESPONSIBLE AUTHORITY: OFFICE OF HEALTH SERVICES EFFECTIVE DATE: JULY 21, 2014 INITIAL ISSUE DATE: APRIL 14, 2000 SUPERSEDES: HEALTH SERVICES ADMINISTRATIVE MEMORANDUM NO. 97-1 RELEVANT DC FORMS: DC4-539A, DC4-543, DC4-544C, AND DC4-672 OTHER RELEVANT FORMS: DH 1847 ________________________________________________________________________________ ACA/CAC STANDARDS: 4-4354 STATE/FEDERAL STATUTES: SECTIONS 381.006 AND 381.0072(2), F.S. FLORIDA ADMINISTRATIVE CODE: CHAPTER 64E-11, F.A.C. Procedure 401.003 PURPOSE: To provide administrative and operational guidelines to manage foodborne outbreaks. DEFINITIONS: (1) Comprehensive Health Care Contractor (CHCC) refers to contracted staff that has been designated by the Department to provide medical, dental, and mental health services at designated institutions within a particular region. (2) Clinical Contract Monitor-Public Health refers to the employee located in the Office of Health Services in the central office who oversees all Department infection control issues. (3) Foodborne Illness refers to a disease acquired by consumption of contaminated food. The contaminants can be bacteria, viruses, parasites, toxins produced by microorganisms, other toxins or chemicals. (4) Foodborne Outbreak refers to an incident in which two (2) or more persons experience a similar illness after ingestion of a common food, and epidemiologic analysis implicates the food as the source of the illness. The only exceptions are a single case of botulism or a single illness caused by a chemical might be said to constitute an outbreak. ________________________________________________________________________________ SPECIFIC PROCEDURES: These standards and responsibilities apply to both Department staff and Comprehensive Health Care Contractor (CHCC) staff. (1) The institution Infection Control Nurse or designee will initiate the “Checklist for Management of Possible Foodborne Outbreaks,” DC4-672, when an outbreak is suspected. The DC4-672s will be kept on file by the institution’s Infection Control Nurse for three (3) years. The DC4-672s will not be filed as a part of the medical record or with any committee minutes. (2) During regular day hours, the Chief Health Officer/Insitutional Medical Director or designee will notify the appropriate staff below: (a) the Warden, the facility Environmental Health and Safety Officer, Food Service Director, and all institutional personnel with a need to know; (b) the Assistant Secretary of Institutions (Contract Manager); (c) the Regional Director of Institutions; (d) the local Department of Health office (if there is no response, the Department of Health, Bureau of Environmental Epidemiology Administrator in Tallahassee will be called at [850] 245-4401; if there is no answer, medical staff will call the Administrator’s pager or the other telephone numbers provided for this purpose); (e) the Regional Medical Director; 2 Procedure 401.003 (f) the central office Clinical Contract Monitor-Public Health or designee ; and (g) The CHCC Regional Infection Control Coordinator will notify the regional Epidemiologist for foodborne illness at (850) 653-2111 extension 108 or 109 Monday through Friday 8 a.m. to 5 p.m. After hours, holidays, or emergencies at (850) 653-5980 or (850) 370-0803. (3) During off duty hours, the Regional Medical Director will notify the Department of Health at the number listed in section (2)(d) of this procedure. (4) Health services staff will refer to “Movement Restrictions During Communicable Disease Outbreaks,” Procedure 401.001, for the additional staff to be notified. (5) The institution’s Infection Control Nurse will arrange with food service staff to: (a) keep all leftover foods clearly marked and refrigerated (the food service staff will keep the leftover food preserved until the Department of Health Investigator determines if there is a need to culture), (b) acquire a list of all menus for the previous three (3) days (the institution’s Infection Control Nurse and the Department of Health Investigators will use these menus to help determine what food is the suspected cause of the illness), and (c) acquire food temperature logs for the previous three (3) days. (6) If contraband food is involved, the institution’s Infection Control Nurse will obtain assistance from security staff to determine if any contraband food is still available. Staff will place this food in a clearly marked package and refrigerate it for possible investigation by the Department of Health. (7) Health services staff will: (a) collect stool culture(s) for enteric pathogens and viral organisms (viral stool cultures may be collected in a sterile urine cup without any preservatives if the proper specimen containers cannot be obtained from the Department of Health immediately, and follow the example of Department of Health “Laboratory Form,” DH 1847) on the first ten (10) to twelve (12) inmates who are ill with gastrointestinal symptoms, including fever, nausea, vomiting, diarrhea, etc.; and (b) consult with the local Department of Health staff for lab recommendations regarding delivering the specimens. (8) The institution’s Infection Control Nurse will: (a) start the “Infectious Disease Outbreak Worksheet,” DC4-544C, and (b) collect the following information from anyone who seems ill (inmates and staff): 1. signs and symptoms of illness, 2. onset date and time (as accurate as possible), 3 Procedure 401.003 3. 4. current housing location, and work assignments. (9) Health services staff will collect a food history, including beverages and ice. The food history will include answers to the following questions: (a) “What did they eat or drink?” (b) “Where did they eat or drink?” (c) “When did they eat or drink?” (10) The food history should cover the seventy-two (72) hours prior to the onset of the illness. The Department of Health may assist in collecting food histories. (11) The Chief Health Officer/Insitutional Medical Director will determine if any food handlers have been ill from the week before the first case until the present. (12) Health services staff will submit a DC4-544C daily to the CHCC Regional Infection Control Coordinator or designee who will forward it to the Central Office Clinical Contract MonitorPublic Health. This form should be submitted to Central Office by 10 a.m. every morning. Inmate information on this form is required to compile the Movement Restriction list needed by the Population Management Section within the Bureau of Classification Management. (13) The institution’s nursing supervisor or Infection Control Nurse will submit the “Summary of Infection Control Investigation – Table V,” DC4-539A, to the CHCC Regional Infection Control Coordinator or designee upon the conclusion of the outbreak within one(1) week and the CHCC Regional Infection Control Coordinator will forward the form to the central office Clinical Contract Monitor Public Health. Private facilities will submit this form directly to the central office Clinical Contract Monior-Public Health. (14) CHCC and private facilities are to submit a daily “Daily Infectious Disease Outbreak Report,” DC4-543, to Department of Health Epidemiologist, excluding weekends and holidays. __/S/_________________________ Secretary 4