How to Recognize and Respond to Zika

Blog
Zika: 
Keep Your Patients and Practice Safe 


By Debra A. Cooper, RN, MSN, MBA/HCM, CIC, CPHRM, Coverys Senior Risk Specialist

The following blog post is part one of a three-part comprehensive series on how to keep your patients and practice safe during the Zika outbreak. Be sure to also read part two about what to tell your patients, and part three about how to reduce risk to healthcare workers and stay abreast of the latest Zika news.

Since recent Zika outbreaks have become known, everyone in the healthcare arena has heard much about the virus, its transmission, and its widely variable impact on patients. But hearing about it and doing something about it are two different things. And to halt or slow the outbreak, we must do something. 

Because the clinical symptoms of Zika virus disease are easily overlooked, clinicians and healthcare facilities need to place the potential of a person having Zika virus disease in the forefront of planning and preparations. Putting Zika on the radar in a deliberate and proactive way is the best way to ensure that the patient can be appropriately treated and managed, precautions can be implemented, and potential adverse outcomes associated with Zika infection can be mitigated. 

Where to start? By increasing the index of suspicion when assessing patients and developing a method to screen and identify patients who may have the virus or who may have been exposed to the illness, appropriate interventions and precautions can be implemented.

Office Readiness: Five Tips for Recognizing and Responding to Zika
  1. Go ahead … think zebras. When making a diagnosis, physicians and other healthcare practitioners know that “common things happen commonly.” They know that a headache is usually just a headache and that a rash is often just a contact reaction to an allergen. But when it comes to Zika virus, the tell-tale signs aren’t always that telling, so it’s important that clinicians be connecting the dots. If you have a patient with any of the following symptoms, and they have also been to an area of known Zika outbreak or had sexual contact with someone who has a Zika infection or who has recently visited an outbreak region, consider testing for the virus. Symptoms to look for include a smooth skin rash or redness that is covered with elevated bumps (usually starting on the face and then spreading elsewhere), a fever of 100.4° F or higher, joint pain, muscle pain, conjunctivitis, headache, pain behind the eyes, or vomiting. Also, remember that many Zika patients are asymptomatic, so it’s crucial to screen for risk factors, as outlined below.
  2. Triage with Zika in mind. Screening questions should be a top priority to help you increase the index of suspicion for Zika infection. There are a number of questions that can be asked of patients to determine if they are at risk of having the illness or not. The risk factors for getting infected may be easily converted into a short triage questionnaire. Consider asking the following questions during triage:
    1. Have you recently traveled to an area that is known to have local transmission of Zika virus? (You can download a map of these areas from the CDC. The newest maps should include two areas in Florida.)
    2. Have you recently had sexual contact (protected or unprotected) with a person who has recently traveled to an area that is known to have local transmission of Zika virus? (This could be any type of sex, including genital, anal, or oral sex.)
    3. Have you recently had sexual contact (protected or unprotected) with a person who has recently been diagnosed with Zika virus?
  3. Leave nothing unsaid. Because the incubation period for Zika is approximately two days, you should consider providing – orally and in writing – an inclusive list of signs/symptoms that could be associated with Zika infection that your patients may have experienced. These include the clinical symptoms addressed in Tip #1 above, as well as chills, loss of appetite, sweating, and lethargy. 
  4. Get prepared now for the possibility of diagnostic testing. As of the time of this writing (August 2016), there were four major diagnostic tests available. However, availability of these tests varies widely from state to state and region to region. It’s crucial that clinicians proactively contact their local or state health department now, if they have not already done so, to get specific information about what specimens to collect (e.g., urine, blood), any special requirements for collection or storage of specimens, and where and how the specimens should be sent for testing.
  5. Know how to serve the patient’s health as well as the public’s health. If the results of Zika testing is positive, the infection must be reported to your local health department. In the case of an infected patient who is a pregnant female (for whom an infection could result in microcephaly or other severe brain defects for her baby), a clinician should be aware that the CDC has established the US Zika Pregnancy Registry. A 24/7 consultation service for health officials and healthcare providers caring for pregnant women is available at 770-488-7100. 

Want to know more about how to prepare and respond to Zika? Be sure to read parts two and three of this three-part series on Zika virus.


COPYRIGHTED
No legal or medical advice intended. This post includes general risk management guidelines. Such materials are for informational purposes only and may not reflect the most current legal or medical developments. These informational materials are not intended, and must not be taken, as legal or medical advice on any particular set of facts or circumstances. 

Related Resources:

A Dose of Insight — Maternal/Fetal Risks: Using Claims Analysis to Improve Outcomes

Report - 1/8/2019
Each year in the United States, there are nearly 4 million births, and every birth has a story. This special report is the story of what can go wrong — the real data about maternal/fetal risk, why poor outcomes related to childbirth trigger malpractice claims, and what can be done to improve outcomes and reduce liability. Read More »

Behavioral Health Risks in Surgical Environments

10/23/2018
Learn how to manage behavioral health issues in surgical environments and some nuances to consider for the surgical process. Read More »

Managing Behavioral Health Risks in the Emergency Department

Blog - 10/15/2018
Psychiatric admissions in EDs have reached an all-time high as the number of beds available for psychiatric inpatient services has dwindled due to changes in reimbursement for these services and other funding cutbacks. Learn how EDs can maximize safety and minimize exposures. Read More »

Seven Common Electronic Health Record Mistakes

Article - 1/10/2018
Improper use of electronic medical records may create a challenge in defending a healthcare provider’s treatment due to a perceived carelessness in documentation. Learn about seven common mistakes and how to avoid them. Read More »

Pennsylvania Supreme Court: Informed Consent Is a Non-delegable Duty

Blog - 8/30/2017
Pennsylvania Supreme Court opinion could significantly change the way physicians and surgeons address informed consent. Read More »

Telemedicine: Reducing the Risks

Article - 6/6/2017
An overview of the opportunities and risks of telemedicine for physicians and healthcare providers. Read More »

Surgical Claims Data: Inpatient/Outpatient Comparison

Blog - 5/26/2017
Key insights into the risks of inpatient vs. outpatient surgery from Coverys claims data. Read More »

Mitigating Surgical Risks in the Outpatient Setting

Blog - 5/26/2017
Tips to mitigate surgical risks in the outpatient setting, based on Coverys claims data. Read More »

Preventing Infection in the Outpatient Setting

Article - 5/22/2017
Many services traditionally provided in acute care and inpatient settings have moved to outpatient settings, such as surgery centers and physician offices. This article provides insight into what healthcare providers can do to prevent infection and improve patient safety in the outpatient setting. Read More »

Pediatric Lead Testing

Article - 4/4/2017
Tips to help healthcare providers enhance their pediatric lead screening and testing protocols. Read More »

Testing & Screening Tips for Pediatric Lead Poisoning

Blog - 4/4/2017
Lead toxicity among children in the United States has been a public health issue for decades and statistics show the problem is widespread. This article provides tips top help healthcare providers improve their lead screening and testing protocols. Read More »

Fragmented Intelligence Breeds Fragmented Care

News - 3/1/2017
Article highlights the importance of data analytics in uncovering the root causes of medical malpractice claims. Read More »

Medication Errors: The Risks We Must Reduce

Blog - 2/14/2017
A root-cause analysis of 11,000 medication-related claims reveals top areas of concern. Read More »

Legal Concerns Regarding Medical Record Alteration

Article - 12/19/2016
An actual case study is used to illustrate how altering electronic medical records after the fact can damage the defensibility of a malpractice lawsuit. Read More »

Shared Decision-Making & Patient Engagement

Blog - 12/15/2016
An overview of why patient engagement and shared decision-making is essential to successful patient-centered care. Read More »

Seven Tips to Increase Patient Engagement

Blog - 12/15/2016
Tips to help physicians and healthcare providers improve care through patient engagement. Read More »

Language to Encourage Patient Engagement

Blog - 12/15/2016
Insight into how the language you use when communicating with patients can help or hinder patient engagement. Read More »

Medical Assistant Scope of Practice

Article - 12/5/2016
To help ensure medical assistants are used safely and effectively in your office or organization you must clearly define their scope of practice. This article provides tips on how to do so. Read More »

Pros and Cons of Dispensing Medication Samples

Article - 11/21/2016
Outlines the pros and cons of dispensing medication samples and steps you can take to help ensure patient safety. Read More »

Tips for Responding to Negative Online Reviews

Blog - 11/15/2016
Tips to help you develop and implement a response plan to negative online reviews. Read More »

Preventing Healthcare Worker Fatigue

Article - 11/7/2016
Extended work hours bring up concerns of worker fatigue and its effects on patient safety. Learn strategies to help prevent worker fatigue and mitigate risk. Read More »

A Guide to Purchasing MPL Insurance

Guidelines
This guide provides important information about medical professional liability insurance coverage and points to consider when selecting an insurance provider. Read More »

Communicating With Patients About Zika

Blog - 9/2/2016
How and what to communicate to patients regarding the Zika virus. Read More »

Reducing Zika Risk for Healthcare Providers

Blog - 9/2/2016
Identify and reduce risks to physicians and healthcare workers who treat patients with the Zika virus. Read More »

Addressing Patient Non-Compliance

Article - 8/18/2016
This article evaluates an actual non-compliance case study to illustrate why patients fail to follow treatment plans and how physicians and healthcare providers can work to promote compliance, improve patient safety, and reduce malpractice risk. Read More »

Exploring the Benefits of Root-Cause Analysis of Medical Professional Liability Claims

Article - 8/18/2016
The analysis of medical professional liability (MPL) data can offer a unique lens into a number of perspectives that are important to physicians and health systems. Most notably, it can provide intelligence to make the delivery of healthcare safer and ultimately reduce malpractice exposure for physicians and hospitals. Read More »