Good Afternoon Valued Clients and Colleagues! First, I want to thank you for your continued dedication, determination, and sheer COURAGE towards mitigating COVID-19. Please know that at IPCWell, we are with you and dedicated to supporting you during this pandemic. Many of us have worked together long before this pandemic and will CONTINUE our strong efforts towards decreasing infections in your healthcare facilities. We are dedicated to protecting your patients, residents, and healthcare workers from the harms and deaths associated with infectious diseases!
Please find our weekly update and feel free to share and pass along to your colleagues. Please do not hesitate to contact IPCWell for any questions or support.
CMS IPC Requirements:
- Update your emergency preparedness plan with COVID-19 information. You can utilize the CMS COVID-19 focused infection control survey to assist you.
- Review all COVID-19 infection control requirements to ensure that you are appropriately implementing ALL infection control practices (nursing homes and acute and continuing care).
- Contact us if you need any assistance.
- Test, Test, Test! If you suspect a patient or resident to have COVID-19, test and isolate them. This is the most effective way to rapidly detect, isolate, and contain COVID-19 in your facility.
- The CDC Priority testing
- If your local or state lab is unable to test your residents/patients, you can contact Allison Eckebrecht with Target1medical. They are a commercial lab with a 24-hour turn-around.
PPE Updated Recommendations:
- Per the LTCF CMS Guidance released on April 2, “For the duration of the state of emergency, ALL LTCF PERSONNEL should wear a face mask while they are in the facility.”
- Per the LTCF CMS Guidance released on April 2, “When possible, ALL long-term care facility RESIDENTS, whether they have COVID-19 symptoms or not, should cover their noses and mouths when staff are in their room. Residents can use tissues for this. They could also use cloth, non-medical masks when those are available.
- Residents/Patients should not use medical face masks UNLESS they are COVID-19-positive or assumed to be COVID-19-positive.”
- In Long-term Care, when possible, Healthcare PERSONNEL should wear ALL recommended PPE (gown, gloves, eye protection, face mask) for the care of ALL RESIDENTS, regardless of presence of symptoms. Implement protocols for extended use of eye protection and facemasks.
Positive COVID-19 Patients/Residents: Public Health strongly recommends that long-term care facilities and nursing facilities accept their residents back from hospitals after they no longer require acute care. Hospitals are encouraged not to keep patients for isolation because the county will run out of inpatient bed capacity if patients cannot be discharged.
- Please keep all patients/residents with COVID-19 isolated until 7 days after their last positive test AND until they have not had fever or symptoms for 72 hours (without the use of fever-reducing medications).
- Please do NOT require that patients/residents have a negative COVID-19 test before accepting them back into your facility.
- Encourage residents to remain in their room and restrict movement except for medically necessary purposes.
- If residents leave their room, residents should wear a facemask, perform hand hygiene, limit their movement in the facility, and perform social distancing (stay at least 6 feet away from others).
- Room sharing (“cohorting”) might be necessary if there are multiple residents with known or suspected COVID-19 in the facility. As roommates of symptomatic residents might already be exposed, it is generally not recommended to separate them in this scenario.
- If possible, designate a ward or section of the facility for COVID-19 patients with dedicated staff.
- Implement protocols for having dedicated healthcare personnel caring for cohorted residents with COVID-19.
- Please note that the N95 mask should be worn for aerosolizing procedures, but a surgical mask should be worn for all other times.
Positive or Suspected COVID-19 Employees:
- If employees develop any symptoms consistent with COVID-19 (fever or respiratory symptoms) they must:
- Cease contact with residents/patients.
- Put on a facemask immediately (if not already wearing).
- Notify their supervisor or occupational health services prior to leaving work.
- Allow asymptomatic employees to continue to work after consultation with their occupational health program.
- Use your monitoring system to ensure exposed employees are monitored daily for the 14 days after the last exposure.
- If the healthcare facility has a sufficient supply, healthcare personnel who were not wearing recommended PPE during the COVID-19 exposure could be asked to wear a facemask while at work for the 14 days after the exposure.
Prevent the spread of respiratory germs BETWEEN facilities:
- Notify facilities prior to transferring a resident with an acute respiratory illness, including suspected or confirmed COVID-19, to a higher level of care.
- Report any possible COVID-19 illness in residents and employees to the local health department.
- HCP who work in multiple locations may pose higher risk and should be asked about exposure to facilities with recognized COVID-19 cases.
- Consider encouraging staff to work at only one facility.
- When transmission in the community is identified, nursing homes and assisted living facilities may face staffing shortages. Facilities should develop (or review existing) plans to mitigate staffing shortages.
There is an extremely limited Personal Protective Equipment (PPE) available for order. It is very important that you realize that submission of a resource request does not guarantee your order will be filled. Orders will be prioritized based on critical healthcare and current supplies. Before submitting a PPE request you must prove that you have taken the following steps:
- Followed CDC’s guidance on optimizing PPE Supplies
- Reached out to multiple vendors. If vendors cannot supply your order, keep the documentation.
- Reached out to other partners in the area. Many jurisdictions are already sharing with each other.
- Reached out to partners outside of the area. Partners in other states might have extra supplies to help bridge gaps in back orders.
- If you have completed these steps, contact your local or state public health department
- Make sure that EPA-registered, hospital-grade disinfectants are available to allow for frequent cleaning of high-touch surfaces and shared resident care equipment.
- Refer to the EPA list for EPA-registered disinfectants that have qualified under EPA’s emerging viral pathogens program for use against SARS-CoV-2