COVID-19: Protecting Healthcare Workers and Dealing with LTC Visitors
Jeannine LeCompte, Compliance Research Specialist
The COVID-19 crisis has prompted the Centers for Disease Control (CDC) to issue strict guidelines for protecting healthcare personnel (HCP) and for dealing with visitors to long-term-care facilities, all aimed at lowering the spread and infection rate of the disease.
According to the CDC, all facilities should constantly evaluate and manage HCP who show any signs of respiratory illness. This means implementing sick leave policies that are non-punitive, flexible, and consistent with public health policies that allow ill HCP to stay home.
As part of routine practice, HCP (including consultant personnel) must be asked to regularly monitor themselves for fever and symptoms of respiratory infection, and they must be reminded to stay home when they are ill.
If HCP develop fever or symptoms of respiratory infection while at work, they should immediately put on a facemask, inform their supervisor, and leave the workplace. Consultation with management and occupational health officials must follow to determine further evaluation and return to work status.
All HCP should be screened at the beginning of their shift for fever and respiratory symptoms. This means actively taking their temperature and documenting any absence of shortness of breath, new or change in cough, and sore throat. If they are ill, have them put on a facemask and leave the workplace.
HCP who work in multiple locations may pose higher risk and should be asked about exposure to facilities with recognized COVID-19 cases. For this purpose, nonessential healthcare personnel (including consultant personnel) and volunteers should be restricted from entering all buildings.
When transmission in the community is identified, nursing homes and assisted living facilities may face staffing shortages. Facilities should develop (or review existing) plans to mitigate staffing shortages.
Dealing with visitors poses the same set of issues. Facilities should immediately restrict all visitation except in the case of certain compassionate care situations, such as end of life.
Send letters or emails to families advising them that no visitors will be allowed in the facility except for certain compassionate care situations. Use of alternative methods for visitation (e.g., video conferencing) should be facilitated by the facility.
Post signs at the entrances to the facility advising that no visitors may enter the facility.
Decisions about visitation during an end of life situation should be made on a case by case basis, which should include careful screening of the visitor for fever or respiratory symptoms. Those with symptoms should not be permitted to enter the facility.
Those visitors that are permitted must wear a facemask while in the building and restrict their visit to the resident’s room or other location designated by the facility. They should also be reminded to frequently perform hand hygiene.
Source: COVID-19 Preparedness Checklist for Nursing Homes and other Long-Term Care Settings, https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html
