Phone monitoring of students with ILI

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Caring for sick Pennsylvania State University (PSU) students in a pandemic meant tracking their illnesses daily by phone or through secure electronic messages. PSU students identified as having influenza-like illness (ILI) were encouraged to go home. If unable to travel home, residence hall students stayed in on-campus housing, while students living off-campus self-isolated in their apartments, homes, or frat houses, said Shelley Haffner, the infection control nurse manager at University Health Service (UHS).

PSU has an electronic health records system, which meant that information technology employees could run daily reports on which students were seen for ILI at the campus health service and local hospital, Haffner said. Students with ILI were notified during their office visits that their condition would be monitored either until they went home or until their symptoms improved. If students went home, they were advised to contact their personal healthcare provider if their symptoms worsened or did not improve. Those who stayed in their residence halls or off-campus housing were monitored via the daily phone calls or secure electronic messages, Haffner added.

PSU used funds from the University Health Services' budget to help pay for what Haffner described as a "tremendous amount of nursing hours" required for the daily patient contacts. The first couple of weeks of fall semester, there were 25-30 sick students per week who needed daily nurse contact. By the third week there were as many as 150 students to contact each week. By week four of the semester and continuing for the next six weeks, an average of 250-300 newly diagnosed students were contacted each week, which translated into approximately 80-100 contacts a day.

"It was a lot of hours and manpower," she said. It was also worthwhile for a few reasons, she added. Students (and parents) often were appreciative of the daily contacts, especially during the first few days of illness when students felt the worst. PSU staff did find quite a few students whose symptoms were worsening. Many of those students were found to have pneumonia. And only two students were hospitalized with influenza-related complications. Haffner attributes the low number to the nurses' early detection of worsening symptoms and their continuous reinforcement of self-care advice.

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