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Sick A&E staff should go home

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A&E nurses who contract viral infections should be sent home at the first sign of illness and not return to work until they have been symptom free for 48 hours, according to Scottish researchers.

Following an outbreak of acute gastroenteritis among A&E staff at Glasgow Royal Infirmary (GRI) in 2006, questionnaires were sent to all 82 members of staff within the emergency department.

The study authors found that, over a 51-day period, almost half of all staff were affected, 56% of whom were nurses.

They said: ‘During this outbreak many staff came to work despite being unwell, as they were aware the department was short staffed.

‘This reflects commendable loyalty but increases the risk of secondary infection
of others.’

Annette Jeanes, director of infection prevention and control at University College London Hospital, said: ‘Staff are difficult to isolate, so the only way to deal with this is to send them home for 48 hours. But often they are reluctant to go, and may even play down symptoms in order to stay and support their colleagues.’

The A&E department at GRI lost nearly 450 working hours during the outbreak, 307.5 of which were nursing hours.

The authors recommended that A&E departments should employ additional staff early on in an outbreak to encourage ill staff to remain at home and prevent understaffing – a major risk factor for the spread of infection.

Martin Kiernan, vice chairperson of the Infection Prevention Society, said A&E staff could also help to control an outbreak of infection by being extra vigilant.

‘Patients will present to A&E with symptoms such as diarrhoea and vomiting for a variety of reasons but because these patients are quickly dispersed an outbreak can be hard to spot,’ he said.

‘Good intelligence of what is happening in the community is vital because, by the time test results have come back, the outbreak may have already taken hold,’ he added.

Emergency Medicine Journal (2007) 24: 699–702

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