NURSING PROCEDURES MANUAL

 

Section

 

INFECTION CONTROL

Policy Title

 

NJ Covid-19 Outbreak Plan- Resumption of Services

Policy Number

OP-036

9-4-2020 Supersedes:

 

Page         of

1            3

 

POLICY:

Infection Control procedures are necessary to prevent the spread of disease causing pathogens, such as viral and bacterial agents.

The intent of this policy is to minimize the number of Covid-19 cases in the facility and to protect the staff, residents, and others during the time of an outbreak.

The definition of an active outbreak of Covid-19, as defined by the Communicable Disease Service is one single case of Covid-19 of resident or staff member in the facility.

Resumption of services requires a phased in approach, based on the facility’s outbreak status and the ability to meet certain criteria, such as, case status in the facility, access to testing materials and labs, adequate staffing, adequate PPE, and other infection control protocols.

The current experiences with Covid-19 has presented lessons learned in the areas of the importance of  active and proficient screening of staff and residents to detect signs and symptoms of Covid-19, early detection of Covid-19 for the asymptomatic individual through routine testing of staff and residents, the importance of universal masking, training and monitoring of proper PPE application and other important infection control procedures, hand hygiene training and monitoring, restriction of visitors to minimize exposure of communal Covid-19, networking importance with Local/State Health Departments, as well as local hospital and EMA agencies, and last but not least the affiliation with State Health Department, CDC, AND CMS for guidance and direction as needed to protect our staff and residents from Covid-19.

PROCEDURE:

A COMMUNICATION STRATEGY has been developed to provide effective and clear communication with staff, residents, and resident representatives/families or responsible party about any infectious disease diagnosis outbreak as required by N.J.S.A 26:2H-12.87. The communication plan includes methods to mitigating actions implemented by the facility to prevent or reduce the risk of transmission, including if normal operations of the facility will be altered. The communication plan will include a dedicated phone line for families to use for urgent COVID-19 related calls that may not be answered through the facility main line. The phone number is 856-275-5659. The dedicated phone line will be promptly displayed on the facility website and/or Social Media so that families, resident representatives, and responsible parties will have a method of communication for these urgent phone calls and concerns or questions to be voiced.

– Cumulative updates for the residents, the resident representatives, and the resident families residing in the facility will be at least once a week thru the facility website.

-Virtual Communication via phone, video-conferencing, or Facetime will be provided in the event of visitation restriction due to an outbreak of infectious disease or in the event of an emergency AND will be scheduled at least weekly through a designated department such as the Activities department. Virtual Communication will be implemented when the facility can’t allow in person visits, in accordance with CMS recommendations for those who would otherwise visit.

-The mailing of letters to the family, posting on Social Media, and facility Website will be      other means of communication as needed.

-The communication plan is to inform residents, resident representatives, and families by   5pm the next calendar day following the occurrence of either: 1) each time a single confirmed infection of Covid-19 is identified OR 2) whenever three or more residents or staff are identified with a new onset of respiratory symptoms that have occurred within seventy-two hours of each other. Notification of confirmed cases or clusters of residents with new respiratory symptoms will be promptly made via the facility website www.eagleviewrehab.com under the Family Notification Page. Facility will display on their website and/or Social Media the phone number and facility contact person for urgent calls or concerns. The appointed contact person will be available for incoming calls and conduct outbound calls, as appropriate. The dedicated phone line with a voice recording that is updated as necessary (could be daily) the facility’s operating status, such as when it is safe to resume visits.

-Facility may host conference calls at set times, where families can log on to a conference call or simply call in and be informed of facility status and happenings and to also ask questions.

– The facility website will be updated, as necessary, and at least weekly to show the status of the facility with regards to testing or outbreak status, facility operations, staffing.

 

STAFFING STRATEGY- in the event of a new outbreak of Covid-19 or any other infectious disease or emergency upon staff will include, if needed, the following:

-Contract services with the local Nursing Agency.

-Administrative Nursing Staff will transition to staff nurse or caregiver role.

-Non Clinical staff will perform those non-clinical duties required to assist in resident care as needed, such as safety provision, answering call lights, and psychosocial needs.

-Facility may consider partnering with local healthcare coalitions and other health care partners to identify and hire additional staff.

-Recruitment of retired healthcare personnel.

-Using nursing students when needed.

-Hire additional staff as needed. Facility may recruit more aggressively than usual by offering hiring bonuses.

– Customize the shifts of work to accommodate employee, such as, working 4 hour shifts, working 12 hour shifts.

-Customize work schedule to accommodate employee as needed.

– Attempt to accommodate the employee, such as, provide transportation to the work place.

– Consider the use of State/Federal waivers to enable the provision of additional staff, such as, Feeding Assistant programs, in-house training for nursing assistants.

– As appropriate, the facility may ask employees to postpone elective time off during an outbreak.

Outbreaks are considered concluded when there are no symptomatic/asymptomatic probable or confirmed Covid-19 cases among employees or residents after 28 days (two incubation periods) have passed since the last cases onset date or specimen collection date (whichever is later) as defined per Covid-19 Communicable Disease Manual Chapter.

The determination of an outbreak conclusion will be made by NJDOH OR LOCAL HEALTH OFFICERS, pursuant N.J.A.C. 8.57-1.10. The facility will submit to the department of health at doh.nj.gov an END OF OUTBREAK ATTESTATION following the end of a Covid-19 outbreak.

The Outbreak Plan shall be posted on the facility website for public view.