COVID-19 Education Property of Genesis HealthCare, Inc.

COVID-19 Education Property of Genesis HealthCare, Inc.

The pandemic has (as usual) brought out the best. Opportunities have been consumed by many. As we continue to follow the path and guidelines laid before us by the CDC and CMS, recommendations and direction will change. Staying flexible will help meet the goal of ensuring the safety of the residents, families and staff. This education on COVID19 will answer some of your questions and provide valuable information to help to protect you and the residents we serve Property of Genesis HealthCare, Inc.

What is COVID-19? Coronavirus disease (COVD-19) is an infectious disease caused by a new strain of a virus. The disease causes respiratory illness. Property of Genesis HealthCare, Inc.

Respiratory Illness Symptoms Fever Cough Severe Casesdifficulty breathing NonRespiratory Illness Symptoms Vomiting and Diarrhea Headache Loss of Taste and Smell Property of Genesis HealthCare, Inc.

How can YOU protect yourself? Use an alcohol-based hand rub or washing your hands frequently. Avoid touching your face. Avoid close contact (6 feet) with people. Property of Genesis HealthCare, Inc.

PPE What does PPE stand for? 3 types of PPE Masks (2 types) Personal Protective Equipment PPE should be worn consistently and used appropriately through the COVID pandemic. Gown s Face/Eye Protection (3 types) Property of Genesis HealthCare, Inc.

Mask Type: Surgical Mask Positioning: over nose and mouth - DO NOT hang over neck or ear. Wear Time: use for single shift only. Re-use: NO - Staff may use multiple standard face masks in a single shift. Staff should don a new facemask each shift when entering the facility, remove and replace the facemask with a new one after breaks, and dispose of their facemask at the end of the shift All staff MUST wear a mask for the entire time they are in the building. This includes ALL areas of the building at ALL times Property of Genesis HealthCare, Inc.

Mask Type: Respirator Requirements: Respirators should be worn by persons entering the room of a patient suspected or diagnosed with COVID-19, a patient under observation status on or off of the AOU, or working on a unit with a COVID outbreak. This includes units with outbreaks, AOU, & memory units. Storage: During break times, the respirator may be placed on a clean, dry paper towel and then reapplied at the end of the break. Wear time: Respirator should be worn as universal mask for the entire shift and then discarded. The respirator should additionally be discarded and replaced following aerosolized generating procedures or if the respirator becomes soiled or excessively moist, and if a seal cannot be obtained when donning. Re-use: YES, for the duration of a shift then discarded. Anytime the respirator is worn it is worn as the universal mask Property of Genesis HealthCare, Inc.

Face/Eye Protection Types Face Shield Positioning: Band across forehead - Face shields must be worn over a respirator when caring for a patient that is suspected or diagnosed with COVID-19. Due to the close exposure of front-entry screeners to large numbers of people entering the building from the community, you should wear face shields, not safety glasses. Staff may choose to continue wearing the face shield after disinfecting throughout the shift or switch to wearing goggles. REUSE: YES Cleaning: 1) If protective eyewear is to be removed, always remove outside of the patient’s room. 2) Remove and disinfect protective eyewear anytime the protective device becomes potentially soiled/contaminated. 3) It is not necessary to remove, clean/disinfect protective eyewear between every patient encounter. Face shield must be cleaned and disinfected after coming out of the room suspected or diagnosed with COVID-19. Follow the guidance/steps for disinfecting and storing eye protection. Property of Genesis HealthCare, Inc.

Face/Eye Protection Types Goggles Positioning: Can be worn over glasses with a strap mid back of head. Also to be worn on patient care units with an outbreak and on Admission Observation Units/Rooms and AOU status. REUSE: YES Cleaning: 1) If protective eyewear is to be removed, always remove outside of the patient’s room. 2) Remove and disinfect protective eyewear anytime the protective device becomes potentially soiled/contaminated. 3) It is not necessary to remove, clean/disinfect protective eyewear between every patient encounter. Face shield must be cleaned and disinfected after coming out of the room suspected or diagnosed with COVID-19. Follow the guidance/steps for disinfecting and storing eye protection. Property of Genesis HealthCare, Inc.

Face/Eye Protection Types Safety Glasses Positioning: Can be worn over glasses. Must have side coverage. May be worn on units without an outbreak. REUSE: YES Cleaning: Cleaning and disinfecting needs to be done if splashes or sprays occurs and is done upon exiting the room using an EPA-approved List N product. Follow the guidance/steps for disinfecting and storing eye protection. Property of Genesis HealthCare, Inc.

Are eyeglasses considered protective? NO! Prescription glasses are NOT considered protective unless goggles are worn over them Property of Genesis HealthCare, Inc.

When should you wear a gown? The same gown is worn by the same HCW when caring for more than one patient known to be infected with the same infectious disease, when these patients are housed on the same unit (e.g. COVID-19 patients on the same unit). Extended use of gowns is only considered if there are no additional co-infectious diagnoses (e.g. C. diff)) among patients. Staff must remove and replace the gown if it becomes visibly soiled. Gown is changed between each patient cared for when the patient is in patient specific precautions Use proper donning and doffing (or putting on and taking off) of gown to ensure you do not contaminate it or yourself. For extended gown use, when an employee takes a restroom or meal break, removes the gown, performs HH, and dons a clean gown prior to entering a patient room. Staff should not wear a gown into any clean area (e.g. nurses' station, med room, etc. Property of Genesis HealthCare, Inc.

When is a gown not necessary? Staff on patient units that will not be entering rooms SHOULD NOT wear a gown. Instead practice social distancing. Remember, no gowns are needed in NONPATIENT areas. Property of Genesis HealthCare, Inc.

Different PPE is used depending on patient/resident health status and unit type. Please click on the link below to view the poster What PPE Should I Use Property of Genesis HealthCare, Inc.

Donning and Doffing PPE Video Donning and Doffing refers to the proper technique to put on and take off PPE properly. The following video will demonstrate the correct procedure to follow. Please click on the link to view the Donning and Doffing PPE Video Donning and Doffing PPE Property of Genesis HealthCare, Inc.

Prevention Prevent the Spread In order to prevent the spread of illness always institute standard precautions and use the following: 1 Hand hygiene BEFORE and AFTER going in a room. 2 Gloves if touching patient or surfaces. Property of Genesis HealthCare, Inc.

6 moments for hand hygiene 1 3 5 Before patient contact 2 Before aseptic task 4 After patient contact After contact with body fluid After contact with patient surroundings 6 Every time you remove your gloves or other pieces of PPE, (e.g. eye protection) Property of Genesis HealthCare, Inc.

Isolation Contact Droplet Isolation To prevent the spread of a patient's illness from droplets through speaking, sneezing, or coughing use: 1. GOWN 2. GLOVES 3. DEDICATED OR DISPOSABLE SINGLE-USE EQUIPMENT 4. SURGICAL MASK 5. EYE PROTECTION Will also be implemented during a center outbreak such as influenza. Contact Airborne Implemented for patients who receive medically necessary out-patient care (e.g. dialysis, chemotherapy), patients under observation status residing on or off the AOU, and patients who reside on outbreak units. Contact plus airborne precautions are also implemented when providing aerosolized generating procedures to patients. 1. GOWN 2. GLOVES 3. RESPIRATORS FOR SUSPECTED, PRESUMED AND CONFIRMED COVID-19 PATIENTS 4. FACE SHIELD 5. DEDICATED OR DISPOSABLE SINGLE-USE EQUIPMENT Will be used with patient's that are suspected/presumed or confirmed with COVID19. Property of Genesis HealthCare, Inc.

Aerosolized Generating Treatments vs MDI Aerosolized Treatment Dangers: Disease transmission through droplet nuclei. Potentially generates a high volume of respiratory aerosols that may be carried long distance from the source. Consideration to decrease risk: When clinically appropriate convert to a pMDI with a spacer. All PPE needed (respirator, eye protection, gown, gloves) while delivering aerosolized treatment. A respirator must be worn with face shield-disinfect face shield after treatment and may continue to wear respirator. Door must be closed during treatment. pMDI-pressurized metered dose inhaler Assess patient ability to “use” pMDI correctly. Contraindications for use of MDI: S&S of severe or impending respiratory failure. Sensitivity to propellant used in pMDI. Patient is unable to follow commands. Property of Genesis HealthCare, Inc.

Center Protocol Daily Screen and Review of Screens Have a trained screener to screen visitors and employees. Have a back-up plan in case a screener is not available. Process for daily review of the log for completion and compliance with screening guidelines. Property of Genesis HealthCare, Inc.

Infection Preventionist (IP) Designee There is an appointed IP person for each shift. The IP will: Respond to questions. Staff observations: direct daily visual observation of staff donning and doffing of PPE, proper use of PPE & hand hygiene and ensure process of review of screening log for trends. Education of staff: on the spot coaching and feedback to correct practice. Property of Genesis HealthCare, Inc.

Testing and Cohorting If a "suspected COVID" resident is tested, any roommate(s) should be tested at the same time even if asymptomatic. All room changes related to coronavirus MUST be done in consultation with the Center's CQS. Property of Genesis HealthCare, Inc.

Compassionate Care Continue to imbed compassion with care everyday!hc Meet the resident, families and your coworkers where they are by: be an active listener despite the chaos and acknowledge their emotions and feelings Explore goals of care: understand what is important to the resident or family regarding care and discuss treatment options in light of COVID-19. Ensure frequent daily communication with patients and families. DON'T FORGDON'T FORGET YOUET YOU YOU are an important part of the equation. Please take time for yourself. Stress and fatigue can really impact the way you respond and perceive the situation. It is hard to take good care of those entrusted to us if we are too emotionally and physically strained ourselves. Property of Genesis HealthCare, Inc.

THANK YOU! Thank you for everything you do everyday to take care of our patients in the fashion they deserve. You all live and breath compassion as you search and find new ways to persevere and overcome so that our patients find comfort and safety in our care. We have learned that the definition of a true hero is a person that has given his or her life to something bigger than themselves. Property of Genesis HealthCare, Inc.