Guidance and responses were provided based on information known on 8/12/2021 and may become out of date. Guidance is being updated rapidly, so users should look to CDC and NE DHHS guidance for updates.
COVID-19 and LTC August 12, 2021 Presentation Information: Panelists today are: Dr. Salman Ashraf [email protected] Margaret Drake, MT(ASCP),CIC Margaret.Drake@Nebraska.gov Kate Tyner, RN, BSN, CIC [email protected] Lacey Pavlovsky, RN, MSN, CIC [email protected] Sarah Stream, MPH, CDA, FADAA [email protected] Rebecca Martinez, BSN, BA, RN, CIC [email protected] Daniel Taylor, DHHS [email protected] Becky Wisell, DHHS [email protected] Cindy Kadavy, NHCA [email protected] Debra Sutton, RN, BS, NHA [email protected] Jonathan Figliomeni, DHHS [email protected] Karen Stiles, SM(ASCP)CM [email protected] Melody Malone, PT, CPHQ, MHA, CDP, CADDCT [email protected] Debi Majo, BSN, RN [email protected]
Moderated by Marissa Chaney [email protected]
Slides and a recording of this presentation will be available on the ICAP website: https://icap.nebraskamed.com/covid-19-webinars/
Use the Q&A box in the webinar platform to type a question. Questions will be read aloud by the moderator. If 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. Additional Q&A Support:
In attempt to answer even more questions, ICAP Infection Preventionists and guest panelists are standing by!
Some questions may be answered before the live discussion Q&A session!
Please review the "Answered" tab for already-answered questions.
We appreciate your understanding that all written answers provided during this webinar are based on information known on 7/22/2021 and may become out of date.
Please continue to review questions for up voting. Continuing Education Disclosures
▪1.0 Nursing Contact Hour and 1 NAB Contact Hour is awarded for the LIVE viewing of this webinar ▪In order to obtain nursing contact hours, you must be present for the entire live webinar and complete the 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 Nebraska LTC COVID-19 Cases TMF Health Quality Institute CMS Quality Improvement Organization Melody Malone, PT, CPHQ, MHA Quality Improvement Specialist NHSN COVID Vaccination Questions • We ask that you pay close attention to the following questions in the Vaccine Supply section of the vaccination coverage forms:
4. For the current reporting week, please describe the availability of COVID-19 vaccine(s) for your facility’s residents: › 4.1 Is your facility enrolled as a COVID-19 vaccination provider? [Select Yes or No]
7 NHSN COVID Vaccination Questions • 4.2. Did your facility have a sufficient supply of COVID-19 vaccine(s) to offer all residents the opportunity to receive COVID-19 vaccine(s) from your facility in the current reporting week? [Select Yes or No] • 4.3. Did your facility have other arrangements sufficient to offer all residents the opportunity to receive COVID-19 vaccine(s) in the current reporting week (examples of other arrangements include referring to the health department or pharmacies for vaccination)? [Select Yes or No] 8 NHSN COVID Vaccination Questions • 4.4. Please describe any other COVID-19 vaccination supply-related issue(s) at your facility. [Optional]
• NHSN strongly encourages users to continually review responses to these questions in the NHSN application to ensure the information reported is up-to-date and accurate.
9 Level 3 Access • Current Users: email the NHSN user support [email protected] with “Enhancing Data Security” in the subject line your request.
• Newly added Users: they receive emails from both NHSN and SAMS with directives. › They need to respond promptly or their window for submitting their SAMS Level 3 documents expires. › Check your SPAM/Junk Folders
TIP: See: Increasing LTCF SAMS Level Access to NHSN 10 CMS Targeted COVID-19 Training for Frontline Nursing Home Staff & Management Learning
• Available through the CMS Quality, Safety & Education Portal (QSEP). • Management staff modules: Module 1: Hand Hygiene and PPE • Can be completed on a cell phone Module 2: Screening and Surveillance • Frontline nursing home staff modules: Module 3: Cleaning the Nursing Home Module 1: Hand Hygiene and PPE Module 4: Cohorting Module 5: Caring for Residents with Dementia in a Pandemic Module 2: Screening and Surveillance Module 6: Basic Infection Control Module 3: Cleaning the Nursing Home Module 7: Emergency Preparedness and Surge Capacity Module 4: Cohorting Module 8: Addressing Emotional Health of Residents and Staff Module 9: Telehealth for Nursing Homes Module 5: Caring for Residents with Dementia in a Pandemic Module 10: Getting Your Vaccine Delivery System Ready • 4 hours total training time • 3 hours total training time NHSN Series: • Fast Facts about NHSN - Part 2 • Wednesday, August 18 from 1:30-2 p.m. CT • Register to attend this webinar to learn how a new National Healthcare Safety Network (NHSN) user can apply for a Secure Access Management Services (SAMS) Entrust grid card.
12 LTC Connect: NHSN Data Reports • Thursday, August 19 from 1:30-2:30 p.m. CT • Register to attend this LTC Connect call to learn more about accurate data reporting, and how to generate data sets and explain the value of running the data reports for quality improvement, such as establishing vaccination goals, monitoring these goals and verifying data entry
13 Reach out to us at: [email protected] to submit requests for assistance with NHSN reporting problems or quality improvement assistance. NPHL-ICAP Confirmation Testing Protocol
Karen Stiles 402-559-3590 [email protected]
Jonathan Figliomeni 402-890-1094 [email protected]
Helping People Live Better Lives.
15 Outline
Contact with ICAP or Local Health Department (LHD) Contact NPHL Collections Ordering a Test Send Specimens to NPHL Results and Further Action
Helping People Live Better Lives.
16 Contact with ICAP or LHD
ICAP or the LHD will contact you • You will be told the number of tests you need • You will be told isolation strategies • You will be told your facility’s testing strategy
• You should work with your LHD for testing equipment • Swabs • Transport media • Biohazard bags • Category B boxes • Gel cooler packs
Helping People Live Better Lives.
17 Contact NPHL
ICAP will get you in touch with NPHL • NPHL will work with you to get testing kits • Jon Figliomeni ([email protected]) will help you
• If you don’t have one, you will get a NUlirt Account • RPS Interface Support ([email protected]) will help • Support will need: • Account Name • Address • City/State/Zip • Phone • Fax (where you’d like results faxed to) • A complete new user form for each user needing access to order tests • Here
Helping People Live Better Lives.
18 Collections
Once Collection Kits Have Arrived • Follow collection protocol • Order tests in NUlirt
Helping People Live Better Lives.
19 Collections, cont.
While wearing appropriate PPE, collect specimen with nasopharyngeal (NP) swab.
Helping People Live Better Lives.
20 Collections, cont.
While wearing appropriate PPE, place specimen into vial, break at score and seal tube.
Helping People Live Better Lives.
21 Collections, cont.
BEFORE specimen goes into the specimen bag, vial MUST have 2 identifiers on it (Name, DOB, etc).
Helping People Live Better Lives.
22 Collections, cont.
Deposit specimen into specimen bag. (Note: Bag must have absorbent material.)
Helping People Live Better Lives.
23 Collections, cont.
Multiple specimen bags can be gathered into a larger specimen bag and refrigerated until sent to NPHL.
Helping People Live Better Lives.
24 Collections, cont.
Keep specimens refrigerated in a NON-FOOD refrigerator/freezer until specimens are picked up.
Helping People Live Better Lives.
25 Ordering a Test
Once you have a NULirt account, go to https://nulirt.nebraskamed.com/login
Helping People Live Better Lives.
26 Ordering a Test, cont.
NPHL COVID-19 test code: • [NCOVFL]
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27 Ordering a Test, cont.
Upper left corner for Covid-19 test ordering
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28 Ordering a Test, cont.
Complete all test ordering questions. • If you have any questions, please reach out for help. • Client Services/Regional Pathology Services (RPS) • 866-290-1406 (24-hour line) • Karen Stiles • 402-559-3590 (during normal business hours) • Jonathan Figliomeni • 402-890-1094 (during normal business hours)
Helping People Live Better Lives.
29 Ordering a Test, cont.
Once all questions are complete, review and submit the order.
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30 Ordering a Test, cont.
If information looks good, submit the order.
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31 Ordering a Test, cont.
If information looks good, submit the order.
Helping People Live Better Lives.
32 Return Specimens to NPHL
To return specimens, contact Client Services to arrange courier services. • Client Services: (866) 290-1406 (24-hour line)
• You will either • Deliver the specimens to a nearby hospital for courier pick up; or, • Give specimens directly to a courier
Helping People Live Better Lives.
33 Return Specimens to NPHL, cont.
Delivering specimens to a hospital for courier pick up • Client Services should inform you of WHEN and WHERE to go • Contact the place you are dropping them off • You are most likely going to a local hospital lab • The lab may have a protocol for delivering outside specimens
• If you have any questions, please reach out for help • Client Services/Regional Pathology Services (RPS) • (866) 290-1406 (24-hour line) • Karen Stiles • 402-559-3590 (during normal business hours) • Jonathan Figliomeni • 402-890-1094
Helping People Live Better Lives.
34 Return Specimens to NPHL, cont.
For courier pick up • Client Services should inform you of WHEN the courier should arrive
• Packaging of specimens is important • Extensive packaging information here • Category B shipping checklist • Courier label here • If you have any questions, please reach out for help • Client Services/Regional Pathology Services (RPS) • (866) 290-1406 (24-hour line) • Karen Stiles • 402-559-3590 (during normal business hours) • Jonathan Figliomeni • 402-890-1094
Helping People Live Better Lives.
35 Return Specimens to NPHL, cont.
For courier pick up • Packaging of specimens is important • Bagged specimens go into cooler with ice packs
Helping People Live Better Lives.
36 Return Specimens to NPHL, cont.
For courier pick up • Packaging of specimens is important • Cooler is placed into Category B box and labeled.
Helping People Live Better Lives.
37 Return Specimens to NPHL, cont.
For courier pick up • Packaging of specimens is important • Once Category B box is sealed and labeled, courier can transport it safely.
• If you have any questions, please reach out for help • Client Services/Regional Pathology Services (RPS) • (866) 290-1406 (24-hour line) • Karen Stiles • 402-559-3590 (during normal business hours)
Helping People Live Better Lives.
38 Return Specimens to NPHL, cont.
Delivery to Omaha • Specimens generally arrive within ~1-8 hours after pick up
• Specimens are received by RPS and given to NPHL
• Once NPHL accepts the specimens, results can be expected within 24-48 hours
• Estimated time between collection and results: ~24-72 hours
Helping People Live Better Lives.
39 Results and Further Action
Releasing results • Results are released to the account holder via fax
• If the account holder does not have a fax line, results are released to the LHD
• ICAP will advise you on how to adjust testing, isolation, etc
Helping People Live Better Lives.
40 Results and Further Action, cont.
Released results • If you have questions about what the results mean, contact Client Services • (866) 290-1406 (24-hour line)
• Your ICAP Team representative can help understand the results
Helping People Live Better Lives.
41 Questions?
• If you have any questions, please reach out for help • Client Services/Regional Pathology Services (RPS) • (866) 290-1406 (24-hour line)
• Karen Stiles • 402-559-3590 • [email protected]
• Jonathan Figliomeni • 402-890-1094 • [email protected]
Helping People Live Better Lives.
42 Jonathan Figliomeni Public Health Lab Surveillance Coordinator [email protected]
402-890-1094
dhhs.ne.gov
@NEDHH NebraskaDHHS @NEDHH S S Helping People Live Better Lives.
43 COVID-19 Vaccine Mandate News Vaccine Mandate News
• Several leading health care systems in Nebraska announced Thursday that they will require all employees to be vaccinated against COVID-19. • The announcement was in a joint statement signed by the heads of: • Boys Town National Research Hospital • Madonna Rehabilitation Hospitals • Bryan Health • Methodist • CHI Health • Midwest Surgical Hospital • Children’s Hospital & Medical Center • Nebraska Medicine • The leaders say the vaccine is safe and effective ad protecting against serious infection and hospitalization. • Unvaccinated employees and physicians will be allowed to apply to their employer for a medical or religious exemption.
Nebraska health care systems to require vaccinations (wowt.com) Encouraging Face Masks Encouraging Face Masks
• Some fully vaccinated individuals can still become infected with COVID-19
• Fully vaccinated, infected individuals can have a higher viral load with the Delta variant and may pass COVID-19 on to others
• Encourage masking for visitors and residents along with staff Examples of when to encourage mask use (again)
• Team meetings with fully vaccinated staff • Resident/ visitor meetings, even when fully vaccinated • Residents going on a community outings, even when fully vaccinated as recommended by the CDC guidance • Residents returning from higher risk** community outings (at least for the 14 days after returning from outing)
**Determine risk by conducting a risk assessment prior to resident outings Outing Risk Assessment Template: link here
ICAP Suggested Plan for Managing New Admissions, Readmissions and Return from Community Outings link here Nebraska Medicine Updates Universal PPE Guidelines and FAQs On August 2nd, Nebraska Medicine updated their Universal PPE Guidelines and FAQs document. The links and summary of key changes are shared for informational purposes in response to audience requests and with permission from the Nebraska Medicine Infection Control & Epidemiology Department. https://www.nebraskamed.com/sites/default/files/documents/covid- 19/universal-ppe-policy-and-faq.pdf
https://www.nebraskamed.com/for-providers/covid19 LTC Testing and PPE Testing BinaxNOW Testing (federal resource--not through the state) • Facilities looking to secure additional BinaxNOW™ tests, may now use the HHS COVID-19 Supply Exchange (http://tiny.cc/SupplyExchange [gcc02.safelinks.protection.outlook.com]). • The HHS COVID-19 Supply Exchange was created in March 2021 to allow states or facilities to donate/request surplus tests or supplies and facilitates matching of donors to recipients. • Associated shipping costs are the responsibility of donors and recipients. • Millions of BinaxNOW™ tests are currently available on the HHS COVID-19 Supply Exchange Deadline - Order by August 18th Image by rawpixel.com • The below are reminders from Angela Ling, Incident Commander, Nebraska DHHS.
• All organizations can order PPE through the normal process until August 18, 2021.
• After August 18th, facilities will need to work through their local health department (LHD) as the have built stockpiles. As many LHDs already have stockpiles, consider ordering from them first before using the NE DHHS PPE Needs Form. When the local health department is low, they will work directly with the state.
• For questions or barriers, please contact Angela Ling at [email protected] or Brian Madison at [email protected] and they will assist.
• The below link to the NE DHHS PPE Needs Form can be used until August 18th: o https://form.jotform.com/NebraskaDHHS/PPERequestForm o Order as much PPE as you can appropriately store before Aug 18th. Accepting New Admissions from Acute Care Reminder
There are no vaccine requirements for a resident to be admitted to LTC.
These are suggestions that we have provided for managing admissions of all types: ICAP-Suggested-Plan-for-Managing- New-Admissions-Readmissions-and- Return-from-Community-Outings.pdf (nebraskamed.com) ICAP Updates 2 Respiratory Protection Webinars The Future of Respiratory Protection and other Personal Protective Equipment Date: Tuesday September 7 Time: Noon – 1:00 PM CST Registration for webinar [cdc.zoomgov.com] • Speakers from the National Institute for Occupational Safety and Health’s (NIOSH) National Personal Protective Technology Laboratory (NPPTL) will provide an overview of how novel and emerging technologies may be applied to respiratory protection and other types of personal protective equipment (PPE), the new role of PPE in non-traditional settings, and closing PPE gaps for underserved populations. Authorities Associated with Respiratory Protection - The Role of NIOSH, the FDA, and OSHA Date: Thursday, September 9 Time: 2:00 - 3:00 PM CST Registration for webinar [cdc.zoomgov.com] • NIOSH and NPPTL will clarify information regarding the U.S. Respiratory Protection authorities. Do you know what each federal agency (NIOSH, OSHA, and FDA) are responsible for when it comes to respiratory protection? They all work together with a common goal of keeping workers safe from workplace hazards, each agency has its own specific purpose. COVID-19 Tele-ICAR Reviews
• ICAP is offering COVID-19 focused virtual ICAR reviews to LTC, outpatient and acute care facilities
• The review will assess the status of COVID-19 policies and procedures and offer a summary of recommendations from ICAP
• Home Health Agencies fall under the outpatient umbrella and ICAP has developed a HH focused review to support our HH partners
• Contact NE ICAP at 402.552.2881 to be connected with the IP responsible for the facility Webinar CE Process
1 Nursing Contact Hour and 1 NAB Contact Hour is offered for attending this LIVE webinar A separate survey must be completed for each attendee. Nursing Contact Hours: NAB: ➢ Completion of survey is required. ➢ Completion of survey is required. ➢ The survey must be specific ➢ The survey must be specific to to the individual obtaining the individual obtaining credit. credit. (i.e.: 2 people cannot (i.e.: 2 people cannot be listed be listed on the same survey) on the same survey) ➢ One certificate is issued monthly ➢ You must have a NAB membership for all webinars attended ➢ Credit is retrieved by you ➢ Certificate comes directly from ➢ Any issues or ICAP via email questions regarding your credit must ➢ Certificate is mailed by/on the 15th be directed to NAB customer service. of the next month ➢ ICAP can verify survey completion and check the roster list
Contact Marissa with questions: [email protected] 402-552-2881 Infection Prevention and Control Hotline Number: Call 402-552-2881 Office Hours are Monday – Friday 8:00 AM - 4:00 PM Central Time
On-call hours are available for emergencies only Weekends and Holidays from 8:00 AM- 4:00 PM **Please call the main hotline number only during on-call hours** Questions and Answer Session Use the QA box in the webinar platform to type a question. Questions will be read aloud by the moderator.
Panelists: • Dr. Salman Ashraf • Kate Tyner, RN, BSN, CIC • Margaret Drake, MT(ASCP),CIC • Lacey Pavlovsky, RN, MSN, CIC • Sarah Stream, MPH, CDA, FADAA • Rebecca Martinez, BSN, BA, RN, CIC https://icap.nebraskamed.com/resources/ • Daniel Taylor, DHHS • Becky Wisell, DHHS • Cindy Kadavy, NHCA • Debra Sutton, RN, BS, NHA Don’t forget to Like us on Facebook • Karen Stiles, SM(ASCP)CM for important updates! • Jonathan Figliomeni, DHHS • Melody Malone, PT, CPHQ, MHA, CDP, CADDCT • Debi Majo, BSN, RN
• Moderated by Marissa Chaney • Supported by Margaret Deacy • Slide support from Lacey Pavlovsky, RN, MSN, CIC