Having a plan for the outbreak is paramount for the success of your nursing center.
Preparation For Outbreak
Prepare Your Staff
Turnover and employee call-outs will increase during the outbreak. Speak to your team about the importance of their role and prepare your leadership team for the staffing challenges that they will face.
Who will be ready to help on your quarantine unit?
CNAs, LPNs, RNs, maintenance, house keeping, and dietary will be needed.
Who will be your runner?
Identify the staff that can provide supplies to the isolated area.
Prepare Your Facility:
You must dedicate a clean, COVID-free area for your staff to rest and eat in each type of unit. If possible, create 6 feet of separation between tables or sitting areas and consider a separate entrance for symptomatic patients, if possible. Additionally, implementing safety measures like temperature tests, symptoms questionnaires, and n95 mask fitting can help keep your facility safe.
Identify Positive Patients:
It is crucial to ask questions such as: Who will be tested for COVID? What other tests will need to be obtained? Who will perform the testing? Consider patients with symptoms as positive and treat accordingly, likely with a mandatory quarantine.
How will we quarantine patients?
Some patients will need to be isolated in room with the door closed. However, there will be patients who attempt to leave isolation room and access other parts of your center. Therefore, it is paramount for your staff to know which patients require in room isolation to avoid cross- contamination. Also, be mindful of cross-over of staff from COVID-free areas.
Supplies that should be ready in the quarantine unit:
- Face Masks & n95s
- Face shields
- Protective gowns
- Gloves
- Hand washing station at entrance and exit
- Cleaning supplies and disinfectant
- Isolation bins/trash
- Linen cart
- Med cart
- Housekeeping cart
- Disposable meal service items
Treatment Plan
Supportive Care
Per CDC recommendations, our goal will be to provide supportive care to the patients while in the facility. Provide o2, IV, Tylenol, Nebs for “symptomatic” patients.
Treatment
We can consider antibiotics, o2, IVs, and nebulizer treatments. We will discontinue any non-vital medications.
Hydration & Vitals
It will be important to increase water supply to your quarantined patients as they tend to become more dehydrated. We will also need to obtain vitals more often.
Advance Care Planning
DNR:
- This will be paramount to reduce and prevent hospital transfers.
- We will need to know immediately the type of end of life care the family and patient desires.
