WELLS NURSING HOME, INC.
PANDEMIC CORONAVIRUS (CO-VID19)
PLAN
HEALTHCARE SETTING-SPECIFIC GUIDANCE
Residents
of nursing homes and other residential facilities will be at particular risk for transmission of pandemic Coronavirus (CO-VID
19) and disease complications. Pandemic coronavirus can be introduced through facility personnel and visitors; once
a pandemic coronavirus virus enters such facilities, controlling its spread is problematic. Therefore, as soon as pandemic
coronavirus has been detected in the region, nursing homes and other residential facilities should implement aggressive measures
to prevent introduction of the virus.
Prevention or Delay of Pandemic Coronavirus into the Facility
1. Control of Visitors
- Post visual alerts at the entrance
to the facility restricting entry by persons who have been exposed to or have symptoms of pandemic coronavirus.
-
Enforce visitor restrictions by assigning personnel to verbally and visually screen visitors for respiratory symptoms at points
of entry to the facility.
- Provide a telephone number where persons can call for information on measures used
to prevent the introduction of pandemic coronavirus.
2. Control
of Personnel
- All personnel will be screened for coronavirus-like symptoms before they come on duty.
Symptomatic personnel will be sent home until they are physically able to return to duty.
Monitoring Residents for Pandemic Coronavirus and Instituting Appropriate Control Measures
Despite aggressive efforts to prevent the introduction of pandemic coronavirus virus, persons in the early stages of pandemic
coronavirus could introduce it to the facility. Residents returning to the facility from a hospital stay outpatient
visit, or family visit could also introduce the virus. Early detection of the presence of pandemic coronavirus in a
facility is critical for ensuring timely implementation of infection control measures.
- Early
in the progress of a pandemic in the region, increase resident surveillance for coronavirus-like symptoms. Notify state
and local health department officials if a case(s) is suspected.
- If symptoms of pandemic coronavirus are apparent,
implement Airborne precautions for the resident, pending confirmation of pandemic coronavirus infection. Residents and
roommates should be separated or moved out of their rooms.
- Cohort residents and staff on units with
known or suspected cases of pandemic coronavirus.
- Limit movement within the facility (i.e. - cancel social
and recreational activities, PT/OT to be done on the unit, etc.).
Pre-hospital
Care (Emergency Medical Services)
Residents with severe pandemic coronavirus or disease complications are
likely to require emergency transport to the hospital. The following information is designed to protect EMS personnel
during transport:
- Screen residents requiring emergency transport for symptoms of coronavirus.
-
Follow standard and Airborne precautions when transporting symptomatic residents.
- Use of surgical or procedure
masks for all resident transport when pandemic coronavirus is in the community.
- If possible, place a surgical
or procedure mask on the resident to contain droplets expelled during coughing. If this is not possible, (i.e. - would
further compromise respiratory status, difficult for the resident to wear), have the resident cover the mouth/nose with tissue
when coughing, or use the most practical alternative to contain respiratory secretions.
- Oxygen delivery with
a non-rebreather face mask can be used to provide oxygen support during transport. If needed, positive-pressure ventilation
should be performed using a resuscitation bag-valve mask.
- Unless medically necessary to support life, aerosol
generating procedures (i.e. - mechanical ventilation) should be avoided during pre-hospital care.
- Optimize
the vehicle's ventilation to increase the volume of air exchange during transport. When possible, use vehicles that
have separate driver and patient compartments that can provide separate ventilation to each area.
- Notify the
receiving facility that a resident with possible pandemic coronavirus is being transported.
- Follow standard
operating procedures for routine cleaning of the emergency vehicle and reusable patient care equipment.
Summary of Infection Control Recommendations for
Care
of Residents with Pandemic Coronavirus
AIRBORNE PRECAUTIONS
-
Hand Hygiene - Perform hand hygiene after touching blood, body fluids, secretions, excretions, and contaminated items; after
removing gloves; and between resident contacts. Hand hygiene includes both handwashing with either plain or antimicrobial
soap and water or use of alcohol-based products (gels, rinses, foams) that contain an emollient and do not require the use
of water. If hands are visibly soiled or contaminated with respiratory secretions, they should be washed with soap and water.
In the absence of visible soiling of hands, approved alcohol-based products for hand disinfection are preferred because of
their superior microbicidal activity, reduced drying of the skin, and convenience.
Personal Protective
Equipment (PPE)
- Gloves - For touching blood, body fluids, secretions, excretions,
and contaminated items; for touching mucous membranes and nonintact skin. During resident care activities.
- Gown -
During procedures and resident care activities.
- Face/eye protection - During procedures and resident care activities.
-
Safe work Practices - Avoid touching eyes, nose, mouth, or exposed skin with contaminated hands (gloved or ungloved); avoid
touching surfaces with contaminated gloves and/or other PPE that are not directly related to resident care (i.e. - door knobs,
keys, light switches).
- Patient Resuscitation - Avoid unnecessary mouth-to-mouth contact; use mouth piece, resuscitation
bag, or other ventilation devices to prevent contact with mouth and oral secretions.
- Soiled Resident Care Equipment
- Handle in a manner that prevents transfer of micro-organisms to oneself, others, and environmental surfaces; wear gloves
if visibly contaminated; perform hand hygiene after handling equipment.
- Soiled Linen and Laundry - Handle in a manner
that prevents transfer of microorganisms to oneself, others, and environmental surfaces; wear gloves if visibly contaminated;
perform hand hygiene after handling equipment.
- Needles and Other Sharps - Use devices with safety features when available;
do not recap, bend, break or hand-manipulate used needles; if recapping is necessary, use a one-hand scoop technique; place
used sharps in a puncture-resistance container.
- Environmental Cleaning and Disinfection - Use EPA registered hospital
detergent-disinfectant; follow standard facility procedures for cleaning and disinfection of environmental surfaces; emphasize
cleaning/disinfection of frequently touched surfaces (i.e. - bed rails, phones, lavatory surfaces).
- Disposal of Solid
Waste - Contain and dispose of solid waste (medical and non-medical) in accordance with facility procedures and/or local or
state regulations; wear gloves when handling waste; wear gloves when handling waste containers; perform hand hygiene.
-
Respiratory Hygiene/Cough Etiquette - Source control measures for persons with symptoms of a respiratory infection; implement
at first point of encounter within a healthcare setting. Cover the mouth/nose when sneezing/coughing; use tissues and dispose
in no-touch receptacles; perform hand hygiene after contact with respiratory secretions; wear a mask (surgical or procedure)
if tolerated; sit or stand as far away as possible (more than 3 feet) from persons who are not ill.
- Airborne Precautions
- Place residents with coronavirus in a private room or cohort with other residents who have coronavirus. Keep door closed;
maintain room assignments of residents in nursing homes and other residential settings; apply Airborne precautions to all
persons in the room.
- Resident Placement - During the early stages of a pandemic, infection with coronavirus should
be laboratory confirmed. PPE - wear a surgical or procedure mask for entry into resident room; wear other PPE as recommended
for standard precautions.
- Resident Transport - Limit resident movement outside of room to medically necessary purposes;
have resident wear a procedure or surgical mask when outside the room.
- Other - Follow standard precautions and facility
procedures for handling linen and laundry and dishes and eating utensils, and for cleaning/disinfection of environmental surfaces
and resident care equipment, disposal of solid waste, and post-mortem care.
- Other (continued) - Healthcare facilities
should ensure the availability of materials (i.e. - tissues waste baskets, etc.) for adhering to respiratory hygiene/cough
etiquette in waiting/lounge areas for residents/visitors
- Aerosol-Generating Procedures - During procedures that may
generate small particles of respiratory secretions (i.e. - nebulizer treatments, suctioning), healthcare personnel should
wear gloves, gowns, face/eye protection.
WELLS
NURSING HOME, INC.
PANDEMIC CORONAVIRUS PLAN
STRUCTURE
FOR PLANNING AND DECISION MAKING
Pandemic Coronavirus preparedness planning
is done from an ad hoc committee from the Safety Committee. It includes:
- Administrator
Neal VanSlyke
- Director of Nursing Services
Renee Swartz
- Medical Director
Dr. Jonathan Waldman
- Infection Control Nurse
MaryAnn Ovitt
- Director of Plant Operations
Michael Frasier
- Food Service Director
Bridgett Darrow
The Pandemic Coronavirus response
coordinator is:
- Administrator
Neal VanSlyke
Local Health Department Contact - 518-736-5720
NYS DOH contact - Peter Drabkin - 518-408-5396
NYS DOH Regional Office: business
hours - 518-408-5300
off hours - 1-866-881-2809
CDRO pager - 518-484-7181
County Civil Defense
Coordinator - Steven Santa Maria - 518-736-5858
Area Hospitals:
Nathan Littauer - Sally Clemente - 518-725-8621
St. Mary's Hospital - Patricia Streeter - 518-842-1900
WELLS
NURSING HOME, INC.
PANDEMIC CORONAVIRUS PLAN
ELEMENTS
OF A CORONAVIURUS PANDEMIC PLAN
The Infection Control Nurse (ICN) has been assigned responsibility
for monitoring public health advisories (federal and state) and updating the pandemic response coordinator and members of
the pandemic coronavirus planning committee when pandemic coronavirus has been reported in the United States and is nearing
the geographic area.
The ICN will monitor daily/weekly for coronavirus -like illness in residents and staff.
ADMISSIONS - please refer to Section I - Admissions - in the Infection Control Manual.
In the
event there are residents/staff with symptoms of pandemic coronavirus, the following would be initiated:
- Institute
all actions necessary to control infections within the facility.
- Notify the county and state health departments
of reportable diseases (as appropriate).
- Initiate isolation barriers.
- Obtain lab specimens.
-
Close the facility to admissions.
- Restrict visitation.
- Other as necessary to prevent and control the spread
of infection within the facility.
WELLS NURSING HOME, INC.
PANDEMIC CORONAVIRUS PLAN
FACILITY COMMUNICATIONS PLAN
The following employees will be notified of a pandemic coronavirus:
- Administrator
Neal VanSlyke
- Director of Nursing Services
Renee Swartz
- Medical Director
Dr. Jonathan Waldman
- Infection Control Nurse
MaryAnn Ovitt
- Director of Plant Operations
Michael Frasier
- Food Service Director
Bridgett Darrow
The Pandemic Coronavirus response
coordinator is:
- Administrator
Neal VanSlyke
Local Health Department Contact - 518-736-5720
NYS DOH contact - Peter Drabkin 518-408-5396
The
ICN will be responsible for communications with Public Health authorities during a pandemic.
The
Administrator or designee will be responsible for communications with staff, residents and their families regarding the status
and impact of pandemic coronavirus in the facility.
Contact information for family members
or guardians of facility residents' is up-to-date.
Communication plans include how signs,
phone trees, and other methods of communication will be used to inform staff, family members, visitors and other persons entering
the facility (i.e. - sales and delivery people) about the status of pandemic coronavirus in the facility.
Please refer to the Fire/Disaster manual - pages 51-52 for other health care entities and their points of contact.
WELLS NURSING HOME, INC.
PANDEMIC CORONAVIRUS PLAN
EDUCATION
& TRAINING OF BASIC PREVENTION &
CONTROL MEASURES FOR PANDEMIC CORONAVIRUS
A plan is in place to provide education and training to ensure that all employees, residents, and family
members of residents understand the implications of, and basic prevention and control measures for pandemic coronavirus.
See "Section I - Admissions" in the Infection Control Manual.
The ICN is responsible for coordinating education
and training on pandemic coronavirus.
WELLS NURSING HOME,
INC.
PANDEMIC CORONAVIRUS PLAN
ISSUES RELATED
TO SURGE CAPACITY
A contingency staffing plan has been developed that identifies the minimum
staffing needed and prioritizes critical and non-essential services based on residents' health status, functional limitations,
disabilities, and essential facility operations.
The Scheduling Coordinator has been assigned responsibility for conducting
a daily assessment of staffing status and needs during an coronavirus pandemic. In lieu of the Scheduling Coordinator,
the Nursing Supervisor is responsible.
This facility can only accommodate residents who require skilled nursing care,
adult home care, and/or assisted living care. THIS FACILITY CANNOT ACCEPT ACUTE CARE PATIENTS.
The Administrator
will respond to all requests for information by Local and State agencies and community partners.
Comprehensive Surge
Plan - this facility can accommodate up to 25 residents (2 from the community):
* Day Care - 5
* PT - 5
* Activities - 10
* 2nd floor West lounge - 2
* 2nd floor East lounge - 3
