ahrq echo national nursing home covid-19 action network

AHRQ ECHO National Nursing Home COVID-19 Action Network

AHRQ ECHO National Nursing Home COVID-19 Action NetworkPre-Launch Webinar: Strategies to Prevent the Spread of COVID-19

October 23, 2020

‹#›AHRQ ECHO National NursingHome COVID-19 Action Network

Dr. Matt BouchonvilleAssociate Director

Project ECHO

Sue LaGrangeDirector of Education

Pathway Health

Lisa ThomsonChief Strategy Officer

Pathway Health

Today’s Speakers


Identify key strategies leaders can take to mitigate the spread of COVID-19 in the long-term care facility

Describe 2 examples of process surveillance audits that can be used to identify employee compliance with procedures

Verbalize where to find guidance on PPE optimization for direction on use when supplies are running low

Objectives


Segment 1

Prevention Strategies


It’s Up to YOU……and Your Team


https://www.cdc.gov/coronavirus/2019-ncov/downloads/hcp/assessment-tool-nursing-homes.pdf

https://www.cdc.gov/coronavirus/2019-ncov/downloads/novel-coronavirus-2019-Nursing-Homes-Preparedness-Checklist_3_13.pdf


ScreeningPPE

• Universal Source ControlSocial DistancingHand HygieneEquipment and SuppliesCommunication

Policies and Procedures - Examples

VisitationTestingEducationCleaning and DisinfectionEmployee Scheduling

• Dedicated Staff• Essential Staff• Employee Sick Leave


Education

How often?• Orientation• Initial• Ongoing-frequently

What topics?

How are we verifying competency?


Active Screening


• Gloves

• Gowns

• Eye Protection

• Face Masks

• N95 Respirators

• Other

Personal Protective Equipment


Admissions and Readmissions

Quarantine

COVID-19 Positive

*Dedicated and Essential Workers

Resident Placement


Alcohol-Based Hand Rub (ABHR)

Hand Washing-Soap and Water

Hand Hygiene


Cleaning

Disinfecting

Products• EPA Registered List N against

SARS-CoV-2 (COVID-19)

Cleaning and Disinfection

https://www.epa.gov/pesticide-registration/list-n-disinfectants-coronavirus-covid-19


• Diagnostic Testing

• Screening Testing

Testing

https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antigen-tests-guidelines.html#table1


Process Surveillance is a system that will review employee practices to determine if they are following policies and procedures.

Audits

Observations

Process Surveillance


Screening LogsSignagePPE donning and doffingHand HygieneEmployee SchedulesLine ListsNew AdmissionsAudit Reviews

Ongoing Monitoring


Summary


Segment 2

Personal Protective Equipment (PPE)


Inventory ManagementIdentification of Sources for PPE AcquisitionMonitor UseDesignation of Staff to Replenish SupplyPlacing trash container near room exitStrategies to OptimizeAnd more!

Guidance - CDC


Guidance from CMS

https://www.cms.gov/files/document/qso-20-38-nh.pdf


Planning


Inventory

Burn Rate Monitor -Who Replenish Monitor

Usage

https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/burn-calculator.html

Personal Protective Equipment (PPE) Burn Rate Calculator-CDC


Types of PPE

When Used

Donning and Doffing

Signage

Policies and Procedures


https://www.cdc.gov/coronavirus/2019-ncov/downloads/A_FS_HCP_COVID19_PPE_11x17.pdf

CDC


Gloves

Gown

Eye Protection• Face Shield• Goggles

N95 or higher Respirator • Facemask if N95 not available

Types of PPE


Cloth face coverings

Bandanas

Scarfs

Rain Ponchos

Disposable or reusable lab coats

Aprons

Patient Gowns

Items that are NOT Considered PPE


https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/strategies-optimize-ppe-shortages.html

Optimizing PPE


Education

Education

Verification

All Departments


PPE Audits

Choosing

When

Donning and Doffing

Do’s and Don’ts

Discarding

Optimizing

Process Surveillance


Special Considerations with PPE


Summary


Thank You


Centers for Disease Control and Prevention. Preparing for COVID-19 in Nursing Homes. June 25, 2020: https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html

Centers for Disease Control and Prevention. Infection Prevention and Control Assessment Tool for Nursing Homes Preparing for COVID-19. May 8, 2020: https://www.cdc.gov/coronavirus/2019-ncov/hcp/assessment-tool-for-nursing-homes.html

Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19). Optimizing Personal Protective Equipment (PPE) Supplies, July 16, 2020: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html

References and Resources


Centers for Disease Control and Prevention. Information for Healthcare Professionals about Coronavirus (COVID-19). August 25, 2020: https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html

Centers for Medicare & Medicaid Services. Interim Final Rule (IFC), CMS-3401-IFC, Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency related to Long-Term Care (LTC) Facility Testing Requirements and Revised COVID19 Focused Survey Tool. August 26, 2020: https://www.cms.gov/files/document/qso-20-38-nh.pdf

Centers for Medicare & Medicaid Services (CMS). COVID-19 Long-Term Care Facility Guidance. April 2, 2020: https://www.cms.gov/files/document/4220-covid-19-long-term-care-facility-guidance.pdf



Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) Preparedness Checklist for Nursing Homes and other Long-Term Care Settings: https://www.cdc.gov/coronavirus/2019-ncov/downloads/novel-coronavirus-2019-Nursing-Homes-Preparedness-Checklist_3_13.pdf

Centers for Medicare & Medicaid Services. State Operations Manual. Appendix PP –Guidance to Surveyors for Long Term Care Facilities: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf

Centers for Medicare & Medicaid Services. Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) In Nursing Homes (REVISED). March 13, 2020: https://www.cms.gov/files/document/3-13-2020-nursing-home-guidance-covid-19.pdf



Centers for Disease Control and Prevention. Using Personal Protective Equipment (PPE). August 19, 2020: https://www.cdc.gov/coronavirus/2019-ncov/hcp/using-ppe.html

Learn more and sign up at https://hsc.unm.edu/echo/nursing-home

Resources and Next Steps


Thank You

ahrq echo national nursing home covid-19 action network

Documents