The new coronavirus behind COVID-19 has added new levels of complexity to an already complicated field. As a facility, you’re already trying to keep your shifts filled with enough qualified staff to provide the best patient care. And now you’re also trying to find the best ways to protect them and your patients and visitors from a virus we still are learning more about every day.
What steps you decide to take to protect your staff, patients, and visitors are up to you, and likely, your facility is already using many of the best practice guidelines and recommendations from the Centers for Disease Control and Prevention (CDC). The CDC’s guidelines outline general recommendations for infection control and PPE use as well as specific guidelines that are targeted to different types of facilities, so you can find the best guideline for your needs.
As we learn more about the coronavirus and as state restrictions change, be vigilant about regularly assessing the number of positive cases and community transmissions in your area and be ready to adjust your policies as needed.
Your staff are some of the people who can help your facility the most with risk mitigation. Staff can be consistently trained and educated on how to use PPE correctly, proper handwashing practices, and new cleaning and disinfecting policies. They know the basics of transmission-based precautions and can help patients, visitors, and other staff follow the policies in place to keep one another safe.
Many facilities in hard-hit areas with rising coronavirus cases have considered various policies for their staff:
- Establish screenings at employee entrances for temperature and symptoms
- Set a strict stay home policy if staff are sick
- Require staff to wear face coverings during their shift if there are no positive cases of COVID-19 in your facility
- Require staff to wear face masks or respirator if your facility has positive cases of COVID-19
- Limit reuse of PPE as supplies allow
- Post handwashing guidelines and reminders near sinks and in common areas
- Maintain cleaning supplies, PPE equipment, and hand sanitizer around the facility so it is always easy to access
- Provide barriers between staff and visitors when applicable, like at registration desks
Although screenings at each entrance when staff, patients, and visitors arrive can rule out some COVID-19 cases, some cases may be asymptomatic or pre-symptomatic. Because we’re still learning about how the virus spreads at those stages, the CDC encourages that facilities require everyone to wear a face-covering while inside the facility.
Visitors are common for many facilities and often a necessary part of a patient’s treatment. They are also an important participant in protecting your facilities and your staff and patients. Many facilities have adopted some or all of the following recommended policies:
- A single designated entrance for visitors
- Temperature checks at the entrance
- Screening questions about symptoms and possible exposure at the entrance
- Visitor limits, especially for high-risk patients
- Signs and posters describing symptoms and asking visitors with symptoms to stay home and wear masks before entering the building
- Masks and hand sanitizer available at the entrance and throughout the facility
- A policy requiring all visitors to wear masks when inside the building
- Proper teaching on mask usage and handwashing — if you touch your mask or face, wash your hands
- Remote communication of patients and family members or other visitors through cell phones, tablets, or computers
Staff should be trained on how to properly educate visitors with any new policies. Some facilities have dedicated staff to specific tasks, like taking temperatures and screening visitors at the door.
Many patients have conditions that put them at high risk for COVID-19 complications. You can protect patients before they even come to a facility in several ways:
- Use telehealth whenever possible
- Limit how many patients can come into your facility (if applicable)
- Have masks and hand sanitizer available at entrances
Once patients are within our facilities, the next goal is to reduce the opportunities for them, your staff, and any future patients and visitors from catching the virus. That means minimizing the opportunities for the potential spread of infection, either through limiting contact with different people, equipment, and areas. If a test or procedure can be performed in the room, do it there instead of taking the patient out. Equipment can be wiped down later.
For patients who are in long-term or acute care, or who are recovering at home, there are many policies that can help protect them and their caregivers:
- Require patients to wear face coverings when not in their rooms (as tolerated)
- Restrict how many people can gather in one place at a time and how often, or cancel group activities
- Limit any patient room changes or transfers between units or floors
- Disinfect rooms and any furniture or equipment after each patient
Testing & Reporting
COVID-19 can spread quickly through units and facilities. Knowing if and when a possible infection is introduced into your facility can help you move quickly to prevent it from spreading to too many people.
If staff have symptoms, they should get tested as soon as possible and not work until results come back. For negative results, they should still stay home until their symptoms have resolved.
With positive results, you will need procedures in place on who will contact the local health department and how. Your facility will also need to contact and alert other staff, patients, and patient families of the possible exposure.
Whether or not you may have patients with positive COVID-19 tests will depend on your facility type. Most outpatient clinics use telehealth options for patients who are high risk or who have symptoms of the coronavirus.
For acute or long-term care, facilities need to stay vigilant on patient symptoms and get any patients with possible symptoms tested as soon as possible. If any tests come back positive and the patient doesn’t need hospitalized care, your facility will need a quarantine plan to keep the patient(s) separated from the rest of the community in a separate wing or room with dedicated staff.
In the event that COVID-19 affects your staffing abilities, or if you have questions about how per diem staffing works in the event your facility has positive COVID-19 cases, contact Clipboard Health at any time.