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White Earth agencies collaborate on H1N1 emergency plan

In March 2003, the White Earth Home Health Agency and the White Earth Indian Health Service (IHS) started collaborating on Emergency Management and Pandemic Flu plans. The collaboration has led to a team effort working together on H1N1.

According to the "Anishinaabeg Today," in September both agencies started working to update their present pandemic flu plans. With H1N1 hovering, the discussions led to how to handle pandemic flu and H1N1 when it arrived at the White Earth Reservation. The goal was to continue to provide patient care to chronically ill and well patients within the clinic setting, while taking care of patients with Influenza Like Illness (ILI) symptoms.

The team looked at the White Earth Community Center as a site to provide alternative care to patients with ILI. A walk through of this site was done and plans developed to offer an ILI clinic, to help keep the sick people separated from the generally healthy people.

This clinic would have nursing staff to triage and screen patients, providers to evaluate, pharmacy staff to provide home care medications, and mental health services to patients as well. However, it was determined that due to lack of provider staff at the IHS, the Tribal Mobile Clinic Unit would be a better option to open a mobile flu clinic.

The Tribal Health Department has a mobile clinic unit that is set up to screen and exam patients. This mobile clinic unit is primarily used by a podiatrist who goes to the different communities on the reservation to evaluate, examine and treat patients.

The White Earth Home Health Agency offered to staff this mobile clinic with Public Health Nurses (PHNs) to screen, triage and offer home measures to patients with ILI symptoms.

The first week, the PHN staff averaged evaluating 10-15 patients per day in the mobile clinic unit. During the second and third weeks, approximately 15-20 patients were seen and evaluated per day in the mobile clinic unit. Entering the fourth week, there was a drop in the number of patients with ILL, and the PHN staff was able to reduce their force in the mobile clinic unit to one nurse (previously, it had been staffed by two nurses at all times).

In mid-October, the HINI vaccine was received and direct patient care staff was vaccinated at both IHS and Tribal Heath Programs. With the plan that was developed in September, the White Earth Home Health Agency, which is also the Public Health authority for the reservation, would begin mass vaccination in the communities.

Because of the amount of vaccine received, initially only pregnant women and young children ages 6 months to 4 years old were vaccinated. As more vaccinations were received, they began to open up community clinics throughout the reservation. In late November, approximately 900 people have been vaccinated thus far.

Without this collaborative effort, this endeavor would not have taken place. Both agencies have worked very well together to provide patient education and care to the patients of the White Earth Reservation.

(Submitted by nurses Mina Spall and Deanna Pepper.)