Safety

Stay up-to-date, use available resources to plan as COVID-19 continues to spread

Hospital Safety Insider, March 5, 2020

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As the CDC and international medical community continues to learn how to handle the spread of COVID-19, the latest emerging infectious disease to hit a global scale, use the available resources in your state and online to gear up your readiness plans.

Much like any patient surge involving infectious diseases, such as influenza or measles, make sure your intake staff is prepared with screening questions and knows where to direct potential COVID-19 patients to keep them away from other staff, visitors and patients or facility residents. The mantra is to identify, inform, and isolate, says Ivan Gowe, an infection preventionist at Pardee Hospital in North Carolina.

Primary messaging to healthcare workers should emphasize what they already do during cold and flu season—hand hygiene, cough etiquette, and self-isolation if someone develops a respiratory illness.

Here are some tips from Gowe and other experts who have talked recently with Simplify Compliance partner publications as well as other sources:

? Track developments from the CDC regularly. The online guidance is updated on an almost daily basis. Also, sign up for alerts through the CDC Health Alert Network (HAN).

? Coordinate with local, state and regional healthcare preparedness coalitions and make use of the national Hospital Incident Command System (HICS). HICS is a nationally recognized and notably for smaller facilities a free emergency management resource, including task checklists.

? While there have been some complaints that the CDC is not sharing clinical information fast enough about real-world cases, check sources like the New England Journal of Medicine and the Journal of the American Medical Association, which as been posting information and analysis of the disease as it becomes available.

? If you don’t already have a plan, dig out and update plans your facility used during the H1N1 influenza pandemic that began in 2009. Those plans offered lessons still used today in response to handling severe respiratory viruses.
 

  • ?Focus conversations on how you will handle staffing if employees face quarantine or decline to go to work. “Many hospitals are discussing the challenge of employees who recently returned from China, and work restrictions. These discussions will require several key representatives including physician and nursing leadership, human resources, and potentially even union representatives,” says Judith Guzman-Cottrill, DO, professor of pediatric infectious diseases at Oregon Health & Science University in Portland. She is also the advisory chair for the Society for Healthcare Epidemiology of America (SHEA)/CDC Outbreak Response Training Program, and a member of SHEA’s board of trustees.
  • Gather your representatives or experts on occupational health, infection prevention leaders, and logistics/supply chain to discuss how to manage personal protective equipment. Collaborating with other providers in your healthcare system or community to manage supplies.
  • ?Drill your plan while you can. It can help point out potential problems, says Gowe. During one drill at Pardee Hospital, planners learned that some rooms mentioned in their emergency plan were no longer available for patient use.
  • Communicate. Answer questions from your staff and community as quickly as possible to avoid panic.
  • Work with your suppliers and distributors to determine what you really need if medical supplies, PPE and other materials become more difficult to come by.
  • ? Conserve the PPE you do have as much as you can, as recommended by the CDC. Don’t throw out expired PPE; it can still be used for training. In the event of a dire emergency, some expired PPE such as gowns or other basics might be usable or reusable—but remember never to reuse masks.
  • Especially conserve N95 masks, the supply of which has been particularly impacted by the shutdown of supply lines out of China when the virus was first detected and quarantines put into place. The CDC recommends limiting the personnel who are not directly involved in medical care from entering a patient’s room to conserve N95 or other specialized respiratory masks. That may mean excluding dietary or housekeeping from the room.
  • Consider video monitoring when possible and cohorting healthcare workers to limit the number of people who need to be fit-tested for N95 use as well as limit potential exposures.
  • Clearly define who will need to use the specialized masks and when, and emphasize that the masks do not need to be worn outside the healthcare setting in which COVID-19 patients are being treated.



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