a. Upon identification of symptoms such as fever of more than or equal to 100.4F, cough, sore throat, difficulty in breathing and runny nose, resident/patient will be tested for Covid (rapid test and PCR) if the outcome is positive, the Resident will be immediately placed on transmission-based precautions and will be transferred to the designated Covid unit.
b. Notify the attending physician about the affected resident and carry out specific orders including discharge instructions (if given) and the Medical Director.
c. If another resident with similar symptoms is observed, that resident will be cohorted with another resident with similar symptoms.
d. Designated Isolation carts with PPEs, trash bins and personal hygiene kits will be in placed in the room including the designated BP, thermometer and O2 saturation device.
e. Communication to FNS via Dietary - Nursing Communication Form to provide disposables during mealtimes.
- aides/nurse are responsible for disposing the disposable utensils used during mealtimes in the room of the affected resident.
- restrict group dining indoor and outdoor activities.
f. Visitation will be based on CDC guidelines.
g. Line listing investigation will be initiated by infection preventionist. Notify infectious disease MD or nurse practitioner.
h. Notify the medical director, local department of health (973-448-2028), county officials and local hospital about the outbreak.
i. Notify family members of the affected residents via email, telephone call or text.
j. Entire staff of the facility will be notified via email, PointClickCare Conversation and Facility Bulletin Board, OnShift Messages, phone call, and text message.
k. Specimen will be sent to designated laboratory.
l. All employees and visitors (compassionate visits) will be screened for symptoms using the respiratory screening form before they start to work or see patients/residents. Staff will screen at the time clock and visitors and vendors will be screened at concierge.
m. All visitors who have the symptoms will not be allowed to enter the facility stated in the screening form. Offer rapid tests to visitors and vendors.
n. All employees who are sick with symptoms will not report to work, notify staffing and respective department heads.
o. No building tours will be scheduled or provided during the outbreak.
p. All admissions will be place in the designated floors during the outbreak. All anticipated discharges will be monitored and assessed prior to discharge from the facility, including performing rapid tests. If quarantine is necessary, MD, DON, IP and family should be informed.
q. All rehab and recreational activities will be in the room.
r. Increased frequency of housekeeping services 3x (7:30am, 3pm and 7pm) for disinfecting high traffic areas.
s. Cross staffing should be limited.
t. All vendors like X-ray techs, pharmacy delivery drivers will be screened at the concierge.
u. Proper ventilation of all rooms will be always maintained.
v. During outbreak, the cloths of covid positive residents are placed in separate plastic bag, tied, and sprayed with electrostatic sprayer disinfectant EPA-approved prior to leaving the patient room. This bag is labelled “covid resident” and brought down to laundry chute
Merry Heart Health Care Center
Merry Heart Assisted Living
Beverwyck House of Merry Heart
Lessons learned from the Covid-19 pandemic:
1. The Covid-19 infection is extremely lethal and contagious.
2. The Personal Protective Equipment (PPE) has been identified as one of the most precious resources in our facility. It is very important that our frontline staff are equipped with appropriate PPE during this pandemic.
3. We learned the disease process and how to prevent the spread of infection.
4. Our residents while they were more vulnerable, are also among the resilient people who endured this pandemic. Despite the lack of visitation from loved ones and abrupt cessation of communal activities, most of them were able to comprehend the necessity of the measures we implemented. Additionally, our residents were able to adapt and focus on the skilled care services and the innovative therapy programs to make the most of their time with us.
5. As a health care facility, we took our social freedom for granted. This pandemic gave us a broad perspective about the value of freedom and inspired us to be creative in executing the procedure which is required to maintain our sanity, mental health, and socialization of our residents.
6. Handwashing and all infection control procedures are extremely important in maintaining an infection-free environment.
7. We realized the importance data management which includes:
a. Our PPE burn rate
b. Data on staff member quarantine
c. Covid testing of residents and staff
d. Quarantine schedules
e. Data of symptoms monitoring
f. Visitors and employee screening data
8. The importance of continuing education and training that we provide and its value during the pandemic cannot be understated. All continued and updated training helped our staff to combat difficult situations during this pandemic.
9. We learned the importance of unity, team building, camaraderie that helped us to move forward in unison and a positive spirit and never give up attitude.
10. From a sanitization perspective we learned that all disinfectants are not effective against the Covid-19 virus. The importance of EPA approved disinfectant was understood very well by the staff.
Our outbreak response plan includes but is not limited to the following:
a. A policy on isolating and cohorting patients and residents in the event of an outbreak.
b. To establish a scientific procedure to investigate the outbreak of the disease.
c. Covid-19 infection prevention and control.
d. Covid-19 emergency preparedness management.
e. Isolation - categories transmission-based precautions.
f. Testing procedure and frequency of staff and residents.
g. Policies on mitigating personnel staffing shortage.
a. Daily communication to family members via email blast.
b. Daily communication to employees via text message.
c. Reporting data to NJHA daily.
d. Reporting data to DOH daily.
e. Reporting data to NHSN CDC twice a week.
Lab testing and lab data communication:
a. Policy on staff authorization for testing.
b. Policy on Resident authorization for testing.
Surveillance for infection:
a. Policy on limitation and visitation
b. Employee infection and vaccination status
c. Planning for additional staffing needs.
d. Backup plan for a potential second wave Covid-19 outbreak.
e. Flu vaccine administration.
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