Wednesday, March 16, 2022 |
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EPIC Newsletter
For Arizona SNFs - Emergency Preparedness Infection Control
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Registration Open for the Disaster Ready Summit!
Featured presentations will include an overview of a first-of-its-kind program developed by the Disaster Ready Team focused on training front-line staff to manage emergencies and disasters followed by another session addressing the sensitive topic of PTSD and how it impacts health care professionals.
Two guest speakers from Colorado will share their experiences on evacuating their respective LTC campuses during the fast-moving Marshall Fire north of Denver in late December 2021. An interesting infection control session will spot-light the importance of developing and maintaining a comprehensive Water Management Plan. The Disaster Ready Summit will be anchored by a keynote presentation from ADHS reviewing common Emergency Preparedness deficiencies (E-Tags) and strategies for compliance. Registration is filling up fast so be sure to sign up soon.
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Disaster Ready Tabletop Exercise Training Coming to Flagstaff.
AHCA will be hosting a TTX in the (AzCHER Northern Region) in Flagstaff, at the Coconino County Health and Human Services building, 2625 N. King Street, Flagstaff, AZ 86004. The exercise is scheduled for Wednesday, April 6, 2022, from 10am-2pm in the Ponderosa Conference Room. This exercise will meet the communitywide exercise annual requirement. Please click here to register for the session, lunch will be provided.
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2022 AzCHER Full-Scale Exercise Jumanji in July
Date: Thursday, April 21, 2022
Time: 8:30 a.m. – 12:30 p.m.
AzCHER Full Scale Exercise requires the exercise planners/designers to create a Master Scenario Events List (MSEL). The Master Scenario Events List is a chronological timeline of expected actions and scripted events to be injected into the exercise play by facilitators/controllers to generate or prompt player activity. It ensures necessary events happen so that all exercise/facility's objectives can be met. The Full-Scale Exercise will be held on April 21st and run by a MESL, however, each participating facility may create a MESL as well. Creating a MESL will help drive actions based on the facility-specific objective(s). The participating facility's Master Scenario Events List should align with the AzCHER MSEL and scenario. Participating facilities will assign a facilitator/controller to implement the injects at the appropriate time. See the sample MESL here as well as a blank MESL template for use by those intending to utilize this tool. Notice the partially completed MSEL health care provider types on the right are highlighted in different colors. Three possible injects (in turquois) have been included to address the objectives of: supply chain issues, lock down procedures/policies and non-compliant resident procedures. Controllers/evaluators should focus on the time the inject is to be introduced, who generated the action, who should receive it, the written or verbal inject and what is the expected/intended action.
This exercise is intended to assist participating facilities to identify gaps in their EOP and to take the necessary steps to strengthen it. Questions? contact Gil Damiani gild@azhca.org or call him at 480-682-7760.
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Registration Deadline: March 25, 2022 |
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AzCHER Annual Conference
Collaboration, Coordination and Cooperation
Teaming up with AzCHER to bring you two days of emergency preparedness education – the first is the Disaster Ready Summit (see previous article). Reserve your seat at the upcoming AzCHER (separate registration and fee from the Disaster Ready Summit) annual conference March 24, 2022, from 8:30 a.m. to 4 p.m. in Phoenix.
The one-day conference theme is Collaboration, Coordination, and Cooperation. The agenda features a range of topics including partner integration, healthcare workforce, supply chain integrity, resiliency and more. Attendees will hear from and directly interact with speakers from real-world events such as Colorado’s New Year wildfire. For more information and to register, visit the conference webpage here.
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DR EPIC Infection Control Training (FREE)
The Disaster Ready Emergency Preparedness Infection Control (EPIC) program is offering two FREE infection control training courses.
- The Infection Preventionist Specialized Training (IPCO) is a specialized course of study for healthcare professionals who desire to serve as Infection Preventionists (IPs) this program. Individuals taking this course will be specially trained to effectively implement and manage an Infection Prevention and Control Program in a nursing center.
- The Infection Prevention & Control in the Post-COVID-19 World provides a review the basics of infection prevention and control practices and will look at the future of infection prevention and control. This course also describes the process for cohorting practices and will look at how to conduct self-assessment processes to continually evaluate and improve the infection prevention and control program in long term care.
These two courses can either be taken by one person or you can separate them out and allow two individuals from one facility to each take one training. If you are interested in taking one or both trainings, click on the links below to complete the interest forms. Once we have your contact information from the forms, you will receive an email from us (AHCA) with further instructions on how to register. There will be no fees associated with these two trainings because they are grant funded.
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Mark Your Calendars for Upcoming EPIC Events
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Wednesday, March 23 - Annual Disaster Ready Summit | Phoenix | Register Here
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Wednesday, April 6 - Disaster Ready NHICS Training and Tabletop Exercise | Flagstaff | Register Here
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Thursday, May 10 - EPIC Infection Control Emergency Preparedness Tabletop Exercise| Phoenix| Register Here
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Wednesday, May 25 - EPIC Training: Antibiotic Stewardship Training | Flagstaff
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Thursday, June 9 - EPIC Antibiotic Stewardship Training | Tucson
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Wednesday, June 22 - EPIC Infection Control Emergency Preparedness Tabletop Exercise | Kingman
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Thursday, August 25 - EPIC Water Management Training | Phoenix
For more information or to register for any of these events contact Krysten Dobson.
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ADHS Moving to Weekly COVID-19 Dashboard Updates
ADHS has made an important change their COVID-19 Data Dashboard. As of February 26th, there are no more daily updates to the Dashboard. Weekly updates began on Wednesday, March 2. Updating weekly is consistent with other infectious disease reporting and how public health uses data to make decisions and recommendations. It also will provide a clearer view of COVID-19 trends by smoothing the variability in daily reporting by labs and other sources. While all dashboard measures have fallen since the spike fueled by the Omicron variant, this change shouldn’t be taken as a sign that COVID-19 is on the way out. There is still a great deal of transmission throughout Arizona, and ADHS continues to strongly recommend that everyone take steps to reduce the risk for themselves and others.
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Laundry Rooms Need a Little Extra TLC During Infectious Disease Outbreaks
Since your teams having been fighting the "good fight" on matters pertaining to infection control since the start of the pandemic, it is likely that your laundry department has been working overtime to keep items clean and sanitized. An extremely vulnerable element of laundry department operations is your commercial clothes dryer. In recent months, these appliances have been the cause of several fires in long term care facilities and senior living communities. Your dryers must always be maintained in accordance with manufacturer's guidelines. This means regularly cleaning lint traps (more frequently is better than less frequently) as well as cleaning areas behind and inside of the dryers to eliminate the build-up of combustible lint and dust. Additionally, it is essential that items that should not be dried in a commercial dryer like micro-fiber mops as well as rags that may have been exposed to hazardous substances like grease or chemicals are never placed in the dryer barrel. Towels and rags that have been exposed to these flammable chemicals are often the cause of fires that start in the dryer barrel. Applying a little extra TLC to your building's laundry equipment will go a long way in preventing fires. If you have questions, call EPIC consultant, Stan Szpytek at 708-707-6363 or email him at Stan@azhca.org.
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COVID-19 Tools Available
More tools than ever before are available to prevent COVID-19 from placing strain on communities and health care systems. On February 25th, the Center for Disease Control and Prevention (CDC) announced new measurements for COVID-19 levels based on county statists. Rather than focusing only on the number of cases, the new tool also uses the number of hospitalizations and available hospital beds to determine a community’s COVID-19 level. The new community levels are updated weekly on the CDC COVID Data Tracker website. Community levels are broken down into three categories, low, medium, and high. Each level comes with more recommended layers of protection for people living in that community.
Low: Stay up to date with COVID-19 vaccines and get tested if you have symptoms.
Medium: If you are at high risk for severe illness, talk to your healthcare provider about whether you need to wear a mask, stay up to date with COVID-19 vaccines and get tested if you have symptoms.
High: Wear a mask indoors in public, stay up to date with COVID-19 vaccines, get tested if you have symptoms, additional precautions may be needed for people at high risk for severe illness.
People may choose to mask at any time. People with symptoms, a positive test, or exposure to someone with COVID-19 should wear a mask.
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F888 COVID-19 Vaccination of Facility Staff
F888, the federal tag related to Vaccination of Facility Staff states that it applies to facility staff who provide any care, treatment, or other services for the facility and/or its residents, under contract or by other arrangement, regardless of their clinical responsibility or resident contact. Facility staff in this requirement includes facility employees, licensed practitioners, students, trainees, and volunteers. Contracted staff includes hospice and dialysis staff, therapists, mental health professionals, and licensed practitioners. Case managers would also be included in facility staff according to Dr. Gifford from AHCA NCAL. Ad hoc non-healthcare services are addressed by this requirement, as F888 says facilities are not required to “ensure the vaccination of individuals who very infrequently provide ad hoc non-healthcare services (such as annual elevator inspection), or services that are performed exclusively off-site.” Facility staff would not include anyone who provides only telemedicine services or support services outside of the facility and who does not have any direct contact with residents and other staff
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Visitation Guidance: Dos and Don’ts
Do...
- Follow the Core Principles of COVID-19 Infection Prevention
- Require visitors to wear masks.
- Offer visitors surgical masks or KN95 masks.
- Restrict the visitor’s movement in the facility to only the location of the visit.
- Increase air-flow and improve ventilation and air quality.
- Have dedicated areas for visitation.
- Clean and sanitize the visitation area after each visit.
- Provide reminders in common areas (e.g., signage) to maintain physical distancing, perform hand-hygiene, and wear well-fitting masks.
Don’t...
- Conduct visits in common areas (unless it is a dedicated area for visitation).
- Allow large gatherings, where large number of visitors are in the same space and unable to physically distance.
- Require testing or vaccination or show proof of such as a condition of visitation.
- Restrict visitation without reasonable clinical or safety cause.
Core Principles of COVID-19 Infection Prevention
- Visitors who have a positive viral test for COVID-19, symptoms of COVID-19, or currently meet the criteria for quarantine, should not enter the facility. Facilities should screen all who enter for these visitation exclusions.
- Hand hygiene (use of alcohol-based hand rub is preferred)
- Face covering or mask (covering mouth and nose) and physical distancing at least six feet between people, in accordance with CDC guidance
- Instructional signage throughout the facility and proper visitor education on COVID-19 signs and symptoms, infection control precautions, other applicable facility practices (e.g., use of face covering or mask, specified entries, exits and routes to designated areas, hand hygiene)
- Cleaning and disinfecting high-frequency touched surfaces in the facility often, and designated visitation areas after each visit
- Appropriate staff use of Personal Protective Equipment (PPE)
- Effective cohorting of residents (e.g., separate areas dedicated to COVID-19 care)
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Resident and staff testing conducted as required at 42 CFR § 483.80(h) (see QSO-20-39-NH Revised).
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Join the Infection Preventionist Call - 3/24/22
Each month EPIC hosts a Zoom call targeted to infection preventionists in skilled nursing facilities. If you are interested in participating please send your contact information to Kay Huff and we will send you a link to the call. The call will be held Thursday, March 24th at 1:00 pm.
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Common Sources of Formaldehyde in the Environment and Ways to Prevent Exposure Risks
The National Toxicology Program has listed formaldehyde as known to be a human carcinogen. The National Cancer Institute at the National Institutes of Health reports that studies of workers exposed to high levels of formaldehyde, such as industrial workers and embalmers, have found formaldehyde causes myeloid leukemia and rare cancers, including cancers of the paranasal sinuses, nasal cavity and nasopharynx. Unfortunately, the widespread use of formaldehyde also means people may be exposed to this chemical in SNFs due to its use in so many products found in the facilities.
According to the Agency for Toxic Substances and Disease Registry, while there are small amounts of formaldehyde in nearly all buildings, levels are higher in:
- Buildings with smokers. Tobacco smoke contains formaldehyde. If someone at the site smokes tobacco products, the smoke may be the greatest source of formaldehyde.
- Buildings with new products or new construction. Formaldehyde levels are higher in various new manufactured wood products.
New products listed by ATSDR that often contain high levels of formaldehyde include:
- Some manufactured wood products such as cabinets, furniture, plywood, particleboard and laminate flooring.
- Permanent press fabrics (like those used for curtains and drapes or on furniture).
- Common products such as glues, paints, caulks, pesticides, cosmetics and detergents.
“It is important to limit exposure to formaldehyde and other pollutants in the indoor environment,” Derrick A. Denis, EPIC Consultant, Industrial Hygienist ,and Senior Vice President with Clark Seif Clark (CSC). “In addition to the long-term risk of cancer, the health effects of overexposure to formaldehyde can include nose, throat and eye irritation as well as and labored breathing and wheezing. Sensitive individuals may also experience fatigue, headache or nausea. Formaldehyde can trigger asthma symptoms in some asthmatics. Therefore, where possible SNFs should choose products free of formaldehyde or with low formaldehyde off-gassing emissions. And, SNFs should consider testing their air for formaldehyde preemptively or when concerns of complaints about the indoor environmental quality arise.”
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Check out our DR EPIC Helpline!
To submit questions, email the DR EPIC online helpline at EPIC@azhca.org. You can also call the DR EPIC phone Helpline at 602-241-4644 and we will assist you. or valuable infection prevention resources! Go to: EPIC.DisasterReadyaz.org to explore these tools.
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Questions? Contact EPIC@azhca.org |This program is funded by ADHS
The Disaster Ready Emergency Preparedness Infection Control (DR EPIC) program provides education and technical assistance for skilled nursing providers throughout the state. Individual providers will need to exercise their independent discretion in how to apply this information and technical assistance to the unique operation of each facility. For that reason, a facility’s of its professional judgment and due diligence in utilizing the program for infection control and risk management practices is solely within the facility’s control for which it is entirely responsible.
Copyright 2022.
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