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Influenza A (H1N1) update

Geneva, Switzerland, 12 June 2009 – WHO has been carefully monitoring the spread of influenza A (H1N1) and has now raised the alert level to level 6. Raising the alert to level 6 is a measure of geographical spread of the virus and not a measure of its severity.   
At this time, WHO considers the overall severity of the situation to be moderate. This assessment is based on scientific evidence as well as input from countries on the impact of the pandemic on their health systems, and their social and economic functioning.
The current assessment reflects that:

1. Most people recover from infection without the need for hospitalization or medical care.
2. Overall, national levels of severe illness from influenza A (H1N1) appear similar to levels seen during local seasonal influenza periods, although high levels of disease have occurred in some local areas and institutions.
3. Overall, hospitals and health care systems in most countries have been able to cope with the numbers of people seeking care, although some facilities and systems have been stressed in some localities.

What you can do to protect yourself and others from catching influenza A (H1N1)  
The main route of transmission of the new influenza A (H1N1) virus seems to be similar to seasonal influenza, via droplets that are expelled by speaking, sneezing or coughing. You can prevent getting infected by avoiding close contact with people who show influenza-like symptoms and by taking the following measures:

• avoid touching your mouth and nose;
• clean hands thoroughly with soap and water, or cleanse them with an alcohol-based hand rub on a regular basis (especially if touching the mouth and nose, or surfaces that are potentially contaminated);
• avoid close contact with people who might be ill;
• reduce the time spent in crowded settings if possible;
• improve airflow in your living space by opening windows;
• practise good health habits including adequate sleep, eating nutritious food, and keeping physically active.

Do I need to use a mask?

If you are not sick you do not have to wear a mask. If you are caring for a sick person, you can wear a mask when you are in close contact with the ill person and dispose of it immediately after contact, and cleanse your hands thoroughly afterwards. If you are sick and must travel or be around others, cover your mouth and nose.  More information is available at the WHO web site: www.who.int
ICN is carefully monitoring the situation and we have put in place a system for early detection, comprehensive assessment and referral to a health facility during the CNR and Congress in Durban, South Africa.  WHO is not recommending travel restrictions.

Nurses Survey: Patients Pay the Price for Insufficient Staff, High Workloads

Global survey of nurses highlights views of profession, health care environments

July 1, 2009 – DURBAN, SOUTH AFRICA – Nurses believe that heavy workloads and insufficient staff are impacting patient care and health outcomes around the world, according to research presented today at the International Council of Nurses (ICN) 24th Quadrennial Congress. The results are part of an extensive global attitudinal survey, which asked more than 2,000 nurses about the challenges and opportunities that face nurses.

“Nurses represent the largest group of healthcare providers in the world,” said ICN Chief Executive Officer, David Benton. “We are keen to better understand nurses’ views of their work and the environments in which they practice across the world. These results will inform the Positive Practice Environment campaign ICN and partners are implementing to improve the practice environment and with it the quality of care.”

An estimated 13 million nurses form the backbone of health care systems, working in hospitals, clinics, communities and other settings around the world. ICN and Pfizer Inc. External Medical Affairs collaborated on a global representative survey of 2,203 nurses in eleven countries, including Brazil, Canada, Colombia, Japan, Kenya, Portugal, South Africa, Taiwan, Uganda, the UK, and the U.S. The survey was conducted by APCO Insight. Collated global results and methodology can be viewed at http://www.icn.ch/Workplace_survey2009.htm.

The survey finds that nine in ten (92%) nurses face time constraints that prevent them spending enough time with individual patients as they think necessary. Nearly all nurses surveyed (96%) say that spending more time with individual patients would have a significant impact on patient health.

“Nurses are key patient advocates and have always been patient-focused. The research shows that for nurses, the most favourable aspect of their profession is indeed patient contact,” said Paula DeCola, R.N., M.Sc., from the office of the Chief Medical Officer at Pfizer, Inc. External Medical Affairs. “This survey supports the research of Dr. Linda Aiken at the University of Pennsylvania – nurses perceive that inadequate staffing and high workloads are having a negative impact on the quality of care patients receive.”

Other key findings from the research provide a glimpse into the challenges nurses face, and opportunities for improvements:

• Nearly half of nurses (46%) say their workload is worse today compared to five years ago, potentially impacting the quality of patient care.
  
  
• Nurses are most concerned with heavy workloads (42%), insufficient pay and benefits (22%), a lack of recognition for their work (15%) and too much bureaucracy (13%). The best part of their profession is helping patients; nurses are most likely to say that patient contact (37%) is the most favorable aspect of their work experience.
  
  
• Nursing as a career is viewed as worse today than it was five years ago in Canada (52%), the U.S. (46%), Taiwan (45%), and the UK (39%); however nurses in Kenya (71%), Brazil (64%) and South Africa (63%) are more likely to see their roles improving over this time.
  
  
• When asked to rate the likelihood they will still be practicing nursing in five years, 53% say it is ‘very likely.’ However, the commitment varies significantly by country. Nurses in Portugal (77%), Brazil (75%), Canada (71%), and the U.S. (68%) say they are very likely to stay in nursing for the next five years, while nurses in countries with severe health human resource shortages and heavy disease burdens such as Kenya (38%), South Africa (33%), Taiwan (33%), and Uganda (32%), say they are less likely to do so.
  
  
• Nurses favor expanding their health care responsibilities, including the authority to prescribe medicines to patients. Eight in ten (83%) nurses surveyed say they currently do not have the authority to prescribe medicines to patients. Nevertheless, seven in ten (70%) say they favour nurses having this authority. Nurses in Colombia (61%), the U.S. (59%) and Taiwan (57%) are most likely to oppose nurses having this authority, while those in Kenya (94%), the UK (87%), Canada (87%), Uganda (84%) and South Africa (83%) are most in favour of it.
  
  
• The research shows that having greater independence and control over their practice area, sufficient staff, greater involvement in decisions impacting their work and patient care, and improved work-life balance have a significant impact on nurses’ likelihood to remain in nursing.
  
  
• Nurses around the world see their professional associations as effective in advancing their interests (64%) and supportive of their needs (76%).

“Nurses globally are thinking about leaving the profession, which will further impact already burdened healthcare systems, including in countries such as Kenya, Uganda and South Africa. It is urgent to respond to their needs with adequate staffing, greater independence and greater involvement in decision-making. Nurses must be involved in crucial policy conversations as healthcare systems are growing, developing and changing,” added Mr. Benton.