PANDEMIC CORONAVIRUS (COVID 19) PLAN
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Pandemic Coronavirus Plan

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

 

 

 

 




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