title: Readiness exercise to combat avian influenza.
abstract: OBJECTIVE
  To examine the readiness of our hospital for the potential pandemic threat of avian influenza, we developed and implemented simulation case scenarios in our hospital.
  
  
  METHODS
  Two volunteers, who assumed the identity of 'actual' patients, were trained to simulate acute respiratory symptoms following a visit to an avian influenza-affected area, and their identities and locations were kept confidential prior to the readiness exercise. A team of auditors was stationed at high-risk areas to assess adherence to the use of personal protective equipment (PPE) and infection control procedures.
  
  
  RESULTS
  A total of 324 healthcare workers and 84 administrators participated in this hospital-wide exercise. Following disclosure of their symptoms, the 'patients' were masked and isolated in negative-pressure rooms. A quarantine order was enforced on 38 inpatients and 45 healthcare workers who were present in the affected wards at the time of the exercise, which mandated the use of PPE. Although all affected healthcare workers were competent in the use of PPE, we observed breaches in PPE and isolation procedures in eight medical and nursing students, and 10 healthcare attendants. The exercise concluded after H5N1 tests returned negative.
  
  
  CONCLUSIONS
  We recommend the use of case simulation as an effective means of assessing potential breaches in infection control procedures.
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074. raymond_seet@nus.edu.sg
authors.forename: R C-S
authors.initials: RC
authors.lastname: Seet
authors.forename: E C H
authors.initials: EC
authors.lastname: Lim
authors.forename: V M S
authors.initials: VM
authors.lastname: Oh
authors.forename: B K C
authors.initials: BK
authors.lastname: Ong
authors.forename: K T
authors.initials: KT
authors.lastname: Goh
authors.forename: D A
authors.initials: DA
authors.lastname: Fisher
authors.forename: K Y
authors.initials: KY
authors.lastname: Ho
authors.forename: K G
authors.initials: KG
authors.lastname: Yeoh
mesh_terms: D016358:Contact Tracing; D004196:Disease Outbreaks / Q000517:prevention & control*; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D053124:Influenza A Virus, H5N1 Subtype / Q000302:isolation & purification; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D010356:Patient Isolation / Q000379:methods / Q000458:organization & administration; D016544:Patient Simulation; D011481:Protective Clothing / Q000706:statistics & numerical data; D012846:Singapore / Q000453:epidemiology