New! National CMS/CDC Nursing Home COVID-19 Training
Through the Quality Improvement Organization (QIO) Program, the Centers for Medicare & Medicaid Services (CMS) hosts a weekly webinar series (every Thursday, 4-5 pm ET) to provide training for infection control processes in nursing homes. To review a list of archived trainings and recordings, as well as view and register for upcoming trainings, please visit https://qioprogram.org/nursing-home-trainingsexternal icon.
The Centers for Disease Control and Prevention (CDC) have updated their Personal Protective Equipment (PPE) recommendations for health care workers involved in the care of patients with known or suspected COVID-19. At this time, these recommendations will be considered by CMS surveyors to determine if Medicare and Medicaid providers and suppliers are complying with infection control protocols:
• Based on local and regional situational analysis of PPE supplies, facemasks are an acceptable temporary alternative when the supply chain of respirators cannot meet the demand. During this time, available respirators should be prioritized for procedures that Memorandum Summary
• The Centers for Medicare & Medicaid Services (CMS) CMS is committed to taking critical steps to ensure America’s health care facilities are prepared to respond to the threat of the Coronavirus Disease 2019 (COVID-19) and other respiratory illnesses.
• The memo clarifies the application of CMS policies in light of recent Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) guidance expanding the types of facemasks healthcare workers may use in situations involving COVID-19 and other respiratory infections. Page 2 of 4 are likely to generate respiratory aerosols, which would pose the highest exposure risk to Health Care Providers (HCP). o Facemasks protect the wearer from splashes and sprays. o Respirators, which filter inspired air, offer respiratory protection.
• When the supply chain is restored, facilities with a respiratory protection program should return to use of respirators for patients with known or suspected COVID-19. Facilities that do not currently have a respiratory protection program, but care for patients infected with pathogens for which a respirator is recommended, should implement a respiratory protection program.
• Eye protection, medical gown, and gloves continue to be recommended. o If there are shortages of medical gowns, they should be prioritized for aerosolgenerating procedures, care activities where splashes and sprays are anticipated, and high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of HCP.
Employees will follow procedures for proper use of their respirators under conditions specified by this program and in accord with the training they receive on the use of each particular model or type of respirator. The appropriate types of respirators to be used and the exposure conditions are listed in the respirator selection chart in Appendix A of this RPP. Respirators relying on a tight facepiece-to-face seal must not be worn when conditions prevent a good seal. Such conditions may be a beard, long moustache, sideburns, or even razor stubble as well as scars, other facial deformities, piercings, and temple pieces on glasses. In addition, the absence of one or both dentures can seriously affect the fit of a facepiece. Employees and supervisors are expected to be diligent in observing practices pertaining to ensuring the safe use of respirators. To ensure proper protection, the wearer will perform a user seal check, in accord with manufacturer’s instructions and the training provided at the time of fit testing, each time he or she puts on a tight-fitting respirator. Employees who wear corrective glasses or other personal protective equipment must wear these during their fit testing to ensure that it does not interfere with the facepiece seal. When respirators with cartridges are used, the RPA shall determine a cartridge change schedule, which will be included in Appendix A. Odor or taste may not be used as the primary basis for determining the useful life of a cartridge for gases or vapors. In addition to the manufacturer’s recommendations, the NIOSH Respirator Selection Logic and Federal OSHA Respirator e-Tool can aid in the development of a change schedule for cartridges. [If your facility only has filtering facepiece respirators then you may leave this out.] When filtering facepiece respirators are used, respirators should be discarded after each use or sooner if breathing becomes difficult or if the respirator is damaged, soiled, or contaminated. D-8 Employees must leave the respirator use area: To adjust their respirator if the respirator is not fitting correctly or impeding their ability to work. To wash their face if the respirator is causing discomfort or rash. To change the respirator, filters, cartridges, or canister elements. To inspect the respirator if it stops functioning as intended, such as detection of vapor or gas breakthrough, changes in breathing resistance or leakage of the facepiece (e.g., fogging of eyeglasses).
Beth Schubert BSN RN PCCN
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