Report Outlines Policy Changes After 11 Kids Died At NJ Facility

PASSAIC COUNTY, NJ — State health officials are recommending drastic changes to how nursing homes handle infectious outbreaks months after 11 children died and 36 were sickened after a viral outbreak occurred at a Wanaque facility last fall.

One recommendation is that parents and guardians be notified immediately following "an event of significance" at a facility, including an infectious diseases outbreak, the report by the New Jersey Department of Health states.

There were reports following the outbreak that some parents were not immediately notified of the outbreak.

The report also recommends:

• Requiring facilities to have an "outbreak plan," which would address clear policies for notifying staff and patients of an outbreak, assessing if visitors are sick, requiring sick staff to stay home, and separating ill and well patients following the onset of an outbreak, a process known as "cohorting"
• Having facilities hire a full-time infection control professional who is responsible for assessing, developing, implementing, monitoring, and managing an Infection Prevention and Control Plan
• Training staff every six months on infection control policies specific to their facility
• Implementing stronger infection control policies, including ones covering hand-washing and separating clean and used medical equipment
• Making protective equipment available to staff members in patient rooms, including disinfectants and sterilizers, to help prevent the spread of infections

"There is much that our healthcare system can learn to make long-term care more prepared and responsive to outbreaks when they occur," said state Health Commissioner Dr. Shereef Elnahal. "Ensuring that all staff are regularly trained in proper handwashing protocols and other infection control procedures is the best way to prevent the spread of respiratory viruses in long-term care facilities."

The report also recommended annual training for municipal health departments in outbreak preparedness and response. Governor Phil Murphy's proposed budget includes $2.5 million in grant funds to help fund this initiative.

"Local assessment and response are better when possible, and when local public health infrastructures have the appropriate staffing and infrastructure, as these health department are more facility with facilities in their jurisdiction and are physically closer to sites of care," the report stated.

Also, the health department's Communicable Disease Service will develop a respiratory virus outbreak preparedness checklist to help facilities prepare for outbreaks.

The department receives no funding to track respiratory virus outbreaks, other than for influenza, the report states. Officials recommended creating a new state-run Respiratory Virus Surveillance Team to monitor such outbreaks. The team would consist of three research scientists and a health data specialist at a cost of $380,000 annually.

"At this time, any non-influence respiratory virus surveillance or response is cobbled together from non-dedicated resources that have other primary responsibilities," the report states.

Eleven children who were patients at the Wanaque Center for Nursing and Rehabilitation died and 36 patients were sickened after an adenovirus outbreak occurred there last fall.

The facility "needed substantial assistance from the state" to help manage the outbreak, officials said in the state report.

Federal and state officials inspected the facility during the outbreak and noted several deficiencies. In one instance, a licensed nurse touched a patient's tracheotomy tube and a ventilator machine without gloves, according to a report by NorthJersey.com. The nurse then left the room, opened a window in another resident's room without washing her hands, and went to her medication cart, an inspection report said.

In another incident, a respiratory therapist put a gown and gloves on and put a breathing mask on a resident. She took her gloves and mask off and touched her hair without washing her hands. She then went to another resident's room, attached a pulse monitor to their foot, left without washing her hands, and went to another resident's room.

The federal government fined the facility $600,000 following the inspections, NorthJersey.com reported.

Adenoviruses are typically a family of viruses that often cause mild illness, particularly in young children. But the strain of adenovirus at Wanaque affected medically fragile children with severely compromised immune systems.

Adenoviruses can cause mild to severe illness, though serious illness is less common. People with weakened immune systems, or existing respiratory or cardiac disease, are at higher risk of developing severe illness from an adenovirus infection, according to the U.S. Centers for Disease Control and Prevention.

To view the state report, click here.

Related:

• Parents, Officials, Blast Response To Deadly Adenovirus Outbreak
• Families Would Be Notified Quickly Of Outbreaks If Bill Passes
• Report Details Lapses In Care At Wanaque Facility Where 9 Kids Died

Email: daniel.hubbard@patch.com