Department | Policy # | Date Issued | Date Reviewed | Date Revised |
NURSING | | 3/2020 | 9/25/2020 | 5-2020 |
Subject: | COVID 19 | Dept Head: | Jennifer Sacks RN, MSN, DON | Date: | 09-2020 |
| Outbreak Management | Approved: | | Date: | |
| | | | | | | | | |
Policy:
Imperial Healthcare will develop a comprehensive response plan to address the global pandemic due to COVID 19. The plan will be in place to protect the resident, staff and visitor from respiratory infections including COVID-19.
Procedure:
The facility will create a COVID-19 Committee team consisting of the following:
Medical Director | Isaac Dweck |
Administrator | Lior Benisti |
Director of Nursing | Jennifer Sacks |
Asst. Director of Nursing | Erika Cheavers |
Facility Educator | Erika Cheavers |
MDS Coordinator | Cheryl Gold |
Rehab Director | Tzippi Cohen |
Social Service Director | Lauren Braxton |
Admissions Director | Cris Brown |
Maintenance Director | Willie Reyes |
Housekeeping | David Grant |
Dietary Director | Bob Davis |
Dietician | Roseanne Dugas |
Pharmacy Representative | Varnie Elyze-Vital |
The facility’s COVID 19 response coordinator will be: Lior Benisti, Administrator.
Communication with Residents and Families:
Policy:
It is the policy of this facility to inform residents, their representatives, and families of the residents by 5pm the next calendar day following the subsequent occurrence of either: each time a single confirmed infection of covid-19 is identified or whenever three or more residents or staff with new-onset of respiratory symptoms occurs within 72 hours of each other.
Procedure:
- Nursing Administration will notify the Administrative Staff if the facility meets either of the criteria listed above. The Administrative Staff will gather all required information as directed in CMS rule: 42 CFR 483.80(g) and with CMS guidance at https://www.cms.gov/files/documents/gso-20-29-nh.pdf.
- Administrative Staff will send required information out via email and posted on Imperial website on the COVID-19 page to all residents, their representatives, and families of the residents by 5pm the next calendar day following the subsequent occurrence of either: each time a single confirmed infection of covid-19 is identified or whenever three or more residents or staff with new-onset of respiratory symptoms occurs within 72 hours of each other.
- Residents will be notified of a new outbreak via our closed circuit television system which will be posted by 5pm the next calendar day following the subsequent occurrence of either: each time a single confirmed infection of covid-19 is identified or whenever three or more residents or staff with new-onset of respiratory symptoms occurs within 72 hours of each other.
- The required information along with an emergency number for urgent calls and complaints will be posted on our website.
Communication with Employees:
Policy:
It is the policy of this facility to inform all employees by 5pm the next calendar day following the subsequent occurrence of either: each time a single confirmed infection of covid-19 is identified or whenever three or more residents or staff with new-onset of respiratory symptoms occurs within 72 hours of each other.
Procedure:
- Nursing Administration will notify the Administrative Staff if the facility meets either of the criteria listed above. The Administrative Staff will gather all required information as directed in CMS rule: 42 CFR 483.80(g) and with CMS guidance at https://www.cms.gov/files/documents/gso-20-29-nh.pdf.
- Administrative Staff will send required information out via email and posted on Imperial website on the COVID-19 page by 5pm the next calendar day following the subsequent occurrence of either: each time a single confirmed infection of covid-19 is identified or whenever three or more residents or staff with new-onset of respiratory symptoms occurs within 72 hours of each other.
- Should an employee refuse to provide the facility with a means to contact them via email it is the responsibility of the employee to reference the website where the information will be posted by 5 PM the next calendar day.
- The required information along with an emergency number for urgent calls and complaints will be posted on our website.
General Facility Control Measures
Establish testing capacity to identify SARS-CoV2 through Monmouth Medical Center Laboratory to conduct test, and provide appropriate specimen collection materials.
Ensure sufficient supply of Hand Hygiene resources in the facility.
Evaluate personal protective equipment (PPE) and report level to corresponding agency/OEM/LDOH/NJDOH.
Educate staff on infection prevention practices, control measures for COVID-19.
Facility will implement Universal Source control by providing facemask to person in the facility. As an alternative, cloth mask will be provided in the event of supply shortage for staff that does not provide direct care to the residents.
Daily Reporting
Complete line listing for residents / staff.
Submit line listing to Monmouth County DOH per instruction. Monmouth County representative Enrico Cabredo.
Admission, Transfer and Readmission
Consider closing to new admissions if the facility is unable to appropriately cohort. This does not include readmission back to the facility.
Close the unit affected to new admissions except as needed to cohort individuals and staff.
The facility will coordinate with the transport company if a presumptive or confirmed COVID-19 is going to be transported. Face mask will be provided to the resident for transport to protect the transport staff and receiving facility staff.
The facility physician will coordinate with the receiving facility’s physician to ensure report is accurately communicated and precaution is in place.
Dedicate equipment in isolation rooms. If not possible, clean and disinfect equipment using the EPA-registered disinfectant before use with another resident within the cohort.
Conduct routine cleaning and disinfection of high touch surfaces and shared medical equipment using EPA-registered disinfectant.
Increase frequency of routine cleaning and disinfection.
Prioritize rounding in a “well to ill’ flow to minimize cross-contamination.
New admissions and readmission will be monitored for signs of COVID 19 for 14 days and will be cared for by staff using COVID-19 PPE according to CDC guidelines. They will be placed in private rooms (if available). If feasible, a cohort will be created for this population.
Emergency Staffing Strategies:
POLICY:
In the event of an emergency, the Administrator or DON will make the decision to utilize emergency staffing strategies as necessary to provide for care and treatment of residents. There is a staffing contingence in place. Please refer to the policy and procedure during an emergency.
Virtual Communication:
Policy:
To continue to provide the vital opportunity for family members to interact with their loved ones while minimizing the chance of the spread of COVID-19.
Procedure:
- Scheduling for all video chats will be done by the Activity Department.
- All family members were notified to send an email for all virtual visitation requests to Imperialnjcommunications@gmail.com at least 24 hours prior to requested video chat time.
- Email addresses for new admissions are obtained by Admissions and/or Receptionist.
- Chats are scheduled daily from 11 am to 4:30 pm and are limited to 10 minutes.
- A daily schedule will be printed and distributed to each unit and Activity Supervisor so everyone knows what chats are scheduled for the day.
- Activity Director and/or Activity Supervisors will coordinate who will be assigned to carry out each video chat scheduled.
- On units with suspected or confirmed COVID-19 or 14-day quarantine, the Activity Supervisor or Director will coordinate with Unit Managers to identify any residents that could done by Nursing staff while in the rooms.
- When video session is complete, staff is to log the results and notify Activity Director or Supervisor of any issues during the call.
- All tablets and iPads will be wiped down with disinfecting wipes before and after each use.
Infection Prevention and Control
Restrict visitors and non-essential healthcare personnel, except in certain compassionate-care situation.
Evaluate all persons who enter the facility for signs of COVID-19. Temperature checks at entry point. Temperature checks at the start of each shift for all employees.
The facility will monitor any visitors/vendors/physician for temperature and any signs of respiratory symptoms. The following will also be assessed: history of international travel with 14 days, history of exposure to a presumptive or positive COVID-19.
Visitors with respiratory symptoms will not be permitted to enter the facility at any time.
Facility will require visitor who are cleared to enter the facility will be asked to perform hand hygiene and use of facemask and restrict visitation to resident’s room.
Signage for visitation, cough etiquette and hand hygiene will be posted in several location within the facility.
Visitation restriction will be communicated through email, website and posting of signage
Active screening for residents for fever and other COVID-19 symptoms every shift.
Any supply delivery will be dropped off by the loading dock and/or right by the reception area.
Alcohol-based hand sanitizers for hand hygiene will be provided in the hallways, in each resident’s room, medication carts and throughout the building.
PPE needed will be made available outside the doors for easy access to the staff.
Facility will provide EPA disinfectants to allow for frequent cleaning of high touched surfaces and shared resident equipment.
Suspend communal dining and all group activities.
Residents are encouraged to remain in their rooms. If the resident leaves their room, they should wear a face covering or face mask; perform hand hygiene, limit movement in the facility and perform social distancing.
Waste receptacles will be provided for PPE
Implement Standard and Transmission-Based Precaution including use of N95 mask.
Signs posted for direction of PPE to use in residents on Transmission Based Precaution
Resident Management / Cohorting
Implement cohorting plan that allows for separation of residents, dedicating staff and medical equipment to each of these cohort and allowing necessary space to do so at the onset of an outbreak.
In the event staffing cannot be designated specifically in the COVID-19 unit, Staff will work from clean unit to COVID Unit., Staff will cluster work load from clean resident to COVID residents.
Staff will don COVID-19 recommended PPE according the CDC guidelines.
Laboratory confirmed COVID-19 positive residents will be relocated to designated cohort. Private rooms will be provided if feasible. Cohort with another COVID-19 resident maybe done when private room is not possible.
Person Under investigation will not be moved to COVID-19 cohort until results are confirmed.
Roommates of COVID-19 residents is considered exposed and should not share a rooms with others unless they have tested negative and has been asymptomatic for 14 days from last exposure.
Facility will adhere to the CDC guideline for the discontinuation of Transmission-Based Precaution.
Symptom-based strategy
At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
At least 10 days have passed since symptoms first appeared
Staff Management
All residents will be provided mask and instructed to cover their nose and mouth when around others, as tolerated.
Enforce use of universal facemask (source control)for staff while in the facility in addition to active screening of symptomatic staff.
Staff will be screened by getting their temperature taken and completing a screening tool at the start of their shift
Any staffs that shows symptoms consistent with COVID-19 will be asked to put on mask and leave the facility. Such staff would require clearance from IP before returning to work.
Identify staff who maybe at higher risk for severe COVID-19 and attempt to assign to unaffected units.
Educate and reinforce sick leave policy including not to report to work when sick.
Assess staff competency on infection prevention and control measure including putting on and taking off PPE.
Conserve use of PPE using CDC guidance for PPE contingency strategies.
Consider staffing contingency for shortage (refer to separate policy).
