COVID-19 and LTCNovember 19, 2020

Guidance and responses were provided based on information known on 11/19/2020 and may become out of date. Guidance is being updated rapidly, so users should look

to CDC and NE DHHS guidance for updates.

Questions and Answer SessionUse the QA box in the webinar platform to type a question. Questions will be read aloud by the moderatorIf your question is not answered during the webinar, please either e-mail it to NE ICAP or call during our office hours to speak with one of our IPs

A transcript of the discussion will be made available on the ICAP website

Panelists today are:Dr. Salman Ashraf, MBBS salman.ashraf@unmc.eduTeri Fitzgerald, RN, BSN, CIC TFitzgerald@nebraskamed.comMargaret Drake, MT(ASCP),CIC Margaret.Drake@Nebraska.gov

Sarah Stream, MPH, CDA sstream@nebraskamed.comKaren Amsberry, MSN, RN kamsberry@nebraskamed.comKate Tyner, RN, BSN, CIC ltyner@nebraskamed.comLacey Pavlovsky, RN, MSN, CIC lpavlovsky@nebraskamed.comDeann Richards, RN, BSN, CIC, CPHQ, CPPS drichards@ncsrcc.org

Moderated by Marissa Chaney

https://icap.nebraskamed.com/coronavirus/https://icap.nebraskamed.com/covid-19-webinars/

Covid-19 and LTC Disclosures1.0 Nursing Contact Hours Awarded for the LIVE viewing of this webinar

In order to obtain nursing contact hours, you must be present for the entire live webinar, complete the attendance poll and post webinar survey

No conflicts of interest were identified for any member of the planning committee, presenters or panelists of the program content

This CE is hosted Nebraska Medicine along with Nebraska ICAP and Nebraska DHHS

Nebraska Medicine is approved as a provider of nursing continuing professional development by the Midwest Multistate Division, an accredited approver by the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation

NE DHHS Last 14 Day Positive Cases

**Updated: 11/18/2020 6am CSThttps://nebraska.maps.arcgis.com/apps/opsdashboard/index.html#/26d5a0dac95449d7813c9323d7a41c36

NE DHHS New Positive Cases by Date Results were Received

**Updated: 11/18/2020 6am CSThttps://nebraska.maps.arcgis.com/apps/opsdashboard/index.html#/26d5a0dac95449d7813c9323d7a41c36

LONG TERM CARE COVID-19 COHORTING

PHYSICAL CONSIDERATIONS –

PUTTING THE PUZZLE TOGETHER

DEANN RICHARDS, RN, BSN, CIC, CPHQ, CPPS DRICHARDS@NCSRCC.ORG NORTH CENTRAL STATES

REGIONAL COUNCIL OF CARPENTERS

Healthcare Isolation Barriers

• Temporary Isolation Barriers Form and Requirements can be found at

https://sfm.nebraska.gov/.../Health%20Care%20Isolation%20Barriers.pdf

• Doug Hohbein is the Assistant State Fire Marshall.

• Addition resources are available on our ICAP website at

https://icap.nebraskamed.com/wp-content/uploads/sites/2/2020/11/Health-Care-Isolation-Barriers.pdf

Staffing Mitigation

Strategies to Mitigate Staffing ShortagesFacilities should activate its contingency staffing plan https://www.cdc.gov/coronavirus/2019-ncov/hcp/mitigating-staff-shortages.html

• Adjust staffing schedules-consider 12 hour shifts instead of 8 hour.

• Consider postponing elective time off from work, adding extra shifts.

• Identify additional HCP in the facility that may be able to support patient care activities.

• Shift or rotate staff positions to support patient care activities.

• Consider administrative or non-clinical licensed personnel to care for patients

• Considered other personnel that may assisted with patient care activities

• Cohort COVID-19 positive residents internally

• Attempt to transfer positive residents of COVID-19 care site

After the facility has activated its contingency staffing plan and has exhausted all options to address staffing needs, consider triggering a crisis level of staffing.

Crisis Staffing StrategiesONLY TO BE implemented in accordance/under the approval of the local health department, or DHHS Health Care Facilities, ICAP AND after notifying regulatory licensures.DHHS contact: DHHS.HealthCareFacilities@nebraska.gov

ICAP Advises facilities against assigning COVID-19 positive asymptomatic staff to work in the yellow or green zones due to the concerns of potential transmission.

1. HCP with confirmed COVID-19 shall only care for Red Zone/Confirmed COVID-19 residents.

2. Cleaning and Disinfection protocols for resident rooms and common areas must be strongly practiced, at least once daily in rooms and communal areas but may be more frequently in areas where people congregate or work.

If allowing asymptomatic or mildly symptomatic COVID-19 positive staff to work in the red zone, facilities should implement strict measures to protect the staff and residents who do not have COVID-19.

Things to consider include:• Try to staff the red zone with all positive staff (who meets the criteria

to work) in all shifts to avoid any exposures to the staff without COVID illness• Identifying separate break and restroom areas and nursing stations for

those who have COVID-19 versus those who do not.• Focusing on cleaning and disinfection efforts between shifts in all

common areas used by the staff.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/return-to-work.htmlhttps://www.cdc.gov/coronavirus/2019-ncov/hcp/mitigating-staff-shortages.html

Bamlanivimab EUAUpdates

Bamlanivimab Infusion

• Monoclonal antibody infusion given over 60 minutes

• Residents must be monitored for 60 minutes after infusion

• Any questions can be directed to the Ne ASAP Pharmacist, Andrew Watkins, PharmD

• Call Ne ICAP at (402)552-2881 to be connected with Andrew

Webinar CE Offerings

Webinar CE Process1 Nursing Contact Hours is offered for attending this LIVE webinar

1. A poll will be put out during the Q&A to collect attendance for your participation in the live webinar, you must verify your attendance with this poll to receive CE

2. A survey will open upon completion of the webinar, you must complete the survey to get your CE credits. Please note: Your web browser makes a difference. Google Chrome is the suggested browser.

3. BOTH the attendance poll and post webinar survey must be completed to receive Nursing Credit hours (No exceptions will be granted)

4. Nursing Credit hours will include the entire month of verified CE on one certificate (Ex: You attended 2 webinars during the month of November, your certificate will reflect the 2 webinar dates and 2 credit hours earned)

5. Certificates will be emailed to you by the 15th of the following month

Direct any CE questions to Sarah Stream, MPH, CDA at sstream@nebraskamed.com

Webinar CE Announcement!

• We have been approved for Nursing Home Administrator Credit through NAB!

• We will start issuing NAB for live attendance of our Thursday Webinar on Dec. 3, 2020

• In order to issue NAB credit, you need to provide your NAB number during the post webinar survey

• Attendance will be posted in the NAB system and you will download your attendance records directly from their system.

Project Firstline is launching!• Follow us on FB for updates and

launch information

• Project Firstline is Infection Prevention and Control (IPC) training for ALL healthcare providers

• Infection Control Needs Assessment survey:

• https://redcap.nebraskamed.com/surveys/?s=K3Y4XYJPKR

Additional Project ECHO Opportunity if Unable to Join UNMC ID or UNMC College of Public Health Cohort

Tele-ICAR-COVID-19 Response TeamsThe ICAP Team is proud to announce they have Infection Prevention and Control support for Acute and Outpatient Clinics and Facilities in Nebraska (Dental and Dialysis Center option coming soon)

Tele-ICAR-COVID-19 (Infection Assessment and Response Program)

•Voluntary program for acute and outpatient settings in Nebraska

•Assesses facility response to and preparation for different elements related toCOVID-19

•Performed remotely via zoom: Approximately 90 minutes

•Feedback/recommendations will be provided in narrative form and through a follow up meeting-approximately 30 minutes

•Contact: NebraskaICAP@nebraskamed.com or (402-552-2881) to schedule an assessment

Participants understand and agree that project findings will be shared with the CDC and others in a de-identified and aggregate format.

IP Contact ProceduresDo not call IP's directly to report additional cases- email that information to the IP you worked with and Dan German dgerman@nebraskamed.com

Consider looking first at the ICAP website for tools to answer your questions

For urgent needs, use the 402-552-2881 number

Especially after hours, please be considerate and only call IPs for questions that cannot wait.

When to contact ICAP-specific questions that are not answered on website.

What constitutes an after-hours emergency?

• New suspected or confirmed COVID-19 outbreak

• Facility needing to request resident transfer to COVID-19 unit because of inability to isolate properly

• Need to move residents between units due to isolation and/or zoning

Infection Prevention and ControlOffice Hours

Monday – Friday 8:00 AM – 10:00 AM Central Time

2:00 PM -4:00 PM Central TimeCall 402-552-2881

After Hours ProtocolAfter hours phone protocol

• Call State HAI Epidemiologist on-call phone number at: 531-207-4053

• Call between 8 am and 8 pm

•Also work with the Local Health Department regarding new outbreaks

What constitutes an after-hours emergency?

• New suspected or confirmed COVID-19 outbreak

• Facility needing to request resident transfer to COVID-19 unit because of inability to isolate properly

• Need to move residents between units due to isolation and/or zoning

Office Hours review

• General contact tracing questions (email ok)

• General infection control questions (email ok)

• General PPE questions (email ok)

• Review or updates of existing cases (email ok)

Questions and Answer Session

Use the QA box in the webinar platform to type a question. Questions will be read aloud by the moderator, in the order they are received

A transcript of the discussion will be made available on the ICAP website

Panelists:• Dr. Salman Ashraf, MBBS• Kate Tyner, RN, BSN, CIC• Teri Fitzgerald, RN, BSN, CIC• Margaret Drake MT (ASCP), CIC• Sarah Stream, MPH, CDA• Karen Amsberry, MSN, RN

• Lacey Pavlovsky, RN, MSN, CIC

• Deann Richards, RN, BSN, CIC, CPHQ, CPPS

• Moderated by Marissa Chaney

• Supported by Margaret Deacy

• Slide support from Karen Amsberry, MSN,

RN

https://icap.nebraskamed.com/resources/

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