At AMRI we are committed to supporting our members during the Covid19 pandemic.  

Our Covid Helpline

087 9844779

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Email: neville.sandra@gmail.com

Quick guide to prevention and preparing for Covid-19 outbreak


A way of thinking about controlling COVID-19 in any setting
Measures being taken to prevent Covid-19 entering a Community setting.

  1. Staff monitoring twice daily, temperature and question regarding any symptoms…keep record.

  2. Infection prevention and Control…On going staff education and refreshers

  3. Governance…monitor compliance with best practice

  4. Visiting guidance …compliance with HPSC advice

  5. Vigilance of residents for symptoms including atypical symptoms.

  6. Refer residents for a test if suspicious of symptoms.

  7. Ensure compliance with Admissions policy as per Health Protection Surveillance Centre HPSC guidance.

  8. PPE is provided and education on the appropriate use of same e.g. all healthcare workers wear a mask, wash hands.

  9. Serial testing of staff fortnightly is surveillance of Covid-19 among Healthcare Workers (only in settings                                            where there is 24 hour Nurse Cover).

 
All detailed guidance is available here:

PREPAREDNESS 

The latest versions of relevant documents can be accessed here:


Interim Guidance on Infection Prevention and Control for the Health Service Executive 2020 V1.2. September 2020 is a reference document for all aspects of Infection Prevention Control.
Interim Public Health, Infection Prevention & Control Guidelines on the Prevention and Management of COVID-19 Cases and Outbreaks in Residential Care Facilities V6.0 28/07/2020
Lessons learned from previous outbreaks indicate particular attention to certain matters. The following list, while comprehensive, is not exhaustive. Each provider and Person in charge is responsible for reviewing and providing support within their facility.

 


ROBUST GOVERNANCE

1. Identify deficits and effect corrective action (risk assessment)


2. Vigilance: monitoring staff wellness and evidence. Monitoring resident wellness including atypical symptoms.

 

3. Appropriate and correct use of PPE e.g. masks correctly applied where applicable


4. Maintain an up-to-date spreadsheet of all residents’ names and date of birth for quick access for batch testing; also                      needed for line listing of symptoms etc.

 

5. Maintain an up-to-date list of healthcare workers to facilitate serial and batch testing as required.


CONTINGENCY PLAN


• Carry out a simulation/ drill of urgent reorganisation required if it was necessary to isolate, to a different section immediately.


• Identify the resources needed. Safe moving and lifting considered.


• Are there enough staff to ensure safety of residents when physically moving them?


• Are there infrastructural obstacles?


• Is there access to phone, handwashing facilities etc in the isolated area?


• Use individually designated equipment in the resident’s room e.g. kettle, tea/coffee making supplies etc.. Is there an adequate stock to facilitate this?


• In an isolated area, the equipment used must be decontaminated immediately after use and before use on any other resident following standard cleaning protocols.


• This designated equipment should not be shared with other residents in non Covid-19 areas (e.g. commodes, moving aides, etc.)


• If it is not possible to designate pieces of equipment to the resident in the isolated area these must be decontaminated immediately after use and before use on any resident following standard cleaning protocols


• What is the impact on caring, laundry, cleaning and catering teams?


• Assign the roles to health care workers or those who may be assisting you, ensuring clarity on who is responsible for specific duties.

 

• Document observations and finalise plan.

 

 


STAFFING


1.   Absent Person in charge: Who will take up this role immediately? Consider depth and breadth of experience. Facilitate                            appropriate access to information within the facility.

 


2.   Significant absence of health care workers due to illness or leaving. Consider the minimum safe level of staffing. Nurses                        competent to direct and deliver care relevant to resident dependency.


3.   Identify a reliable source of additional healthcare workers e.g. Agency healthcare workers who will get sufficient work in                        the facility to discourage working across facilities at the same time. TAPS provides financial support for outbreak                                    scenarios.


4.   Identify isolation area and plan for urgent reorganisation. Additional staff to facilitate the additional work associated with                    isolation of residents.


5.   How many additional healthcare workers to maintain 2 separate teams including night duty during an outbreak episode?


6.   Ensure rest rooms and canteen for healthcare workers facilitates appropriate distancing and storage of personal items.                          Uniform policy to reflect best practice in IPC.

 

7.   Be aware of and discourage huddles e.g. in smoking areas. Assure yourself that all healthcare workers during all shifts                            including night duty and weekends are adhering to appropriate use of PPE and Infection Prevention Control advice.


RESIDENTS

 1. Be familiar with residents’ baseline and observe closely for typical and atypical signs of Covid-19. Make GP aware                            immediately if suspect symptoms and facilitate swabbing if indicated. Isolate immediately, pending results of test.

 

2. Continue to ensure observation for and action other medical / respiratory conditions common place among residents.

 

3. Be aware of potential for rapid deterioration and keep family informed.

 

4. Facilitate communications with medical personnel who may be unfamiliar with facility e.g. out of hours.

 

5. Adhere to HPSC advice on admissions, transfers etc. (Interim Public Health, Infection Prevention & Control Guidelines on:          Admissions, Transfers to and Discharges from Long Term Residential Care Facilities during the COVID-19 Pandemic V1.1              21.09.2020 )

 

 


PPE

 


1. Maintain a reserve of PPE reflective of resident capacity to sustain requirements of an outbreak for 1 week or while                        awaiting an emergency delivery. This reserve should be additional to stock used on a daily basis.


2. Be aware of stock levels of each PPE item. Have a quick reference inventory.


3. Engage with PPE ordering process in a timely manner. (Details in separate sheet re contact details)


4. Set up a PPE station at isolation area to facilitate recommended method of donning and doffing PPE.

 

5. Provide for extra waste, appropriate storage and disposal of waste.


CLEANING

 


1.     Ensure adequate cleaning resources e.g. cleaning trolleys, clearly identified and located within the isolation area.


2.     Evident cleaning schedules for all areas. Cleaning schedules outlining all areas, date and time cleaned should be visible.                        (Sample checklists provided)


3.     Ensure cleaning products have the recommended detergent and disinfectant composition.


4.     Consider the cleaning team’s capacity and flexibility to implement deep cleaning and more frequent cleaning procedures                      during outbreak.


5.     Ideally this should extend to separate teams for the section where the isolated resident is.


6.     Ensure availability of additional resources of competent personnel as required.


7.     Where possible, use single-use equipment for the resident and dispose of it as healthcare risk waste into a designated                            healthcare risk waste bin inside the room.


8.    Where single use equipment is not possible, the equipment must be decontaminated immediately after use and before use                   on any other resident following standard cleaning protocols. This designated equipment should not be shared with other                       residents in non Covid-19 areas (e.g., lifting devices, commodes, moving aides etc.)


9.     If it is not possible to designate pieces of equipment to the resident or cohort area these must be decontaminated                                   immediately after use and before use on any resident following standard cleaning protocols.

 

10.  Are there adequate resources to carry out this cleaning? Clearly assign the duties of equipment cleaning.


CATERING

 


1.    Ensure availability of additional resources of competent personnel as required. E.g. chef/ cook with appropriate                                      knowledge of specialist diets. Access to individual residents requirements


2.   Are there separate dining areas for those who are isolated, with capacity to distance appropriately? If not is there a system                    hereby the meals can be delivered to a chair outside the room, if the isolated individual can access the meal? Is there a                           nominated person to deliver the meals, who will knock at the door but not have any contact with the person in isolation?                       The same person should collect the tray using gloves and ensure that the utensils are cleaned separately as per protocol.


3.   If the isolated individual is unable to access the tray outside the door, then PPE is to be used when entering the room


4.   Where possible does the isolated area have access to dishwashing facilities?

 

5.    If possible avoid transport of used dishes from Covid-19 area through non-Covid-19 area.


LAUNDRY

 


1. Ensure availability of additional resources of competent personnel as required. E.g. familiarity with laundry machinery and           wash programmes. Access to individual residents requirements regarding personal laundry.


2. Separate laundry trolleys for the isolated area, clearly identified.


3. If possible avoid transport of laundry from Covid-19 area through non-Covid -19 area.


4. Laundry assistant carries out appropriate cleaning of contact areas and overall laundry area.

 

5. Ensure adequate reserve of linen, towels, etc to provide for increased usage or delayed delivery if using external suppliers.

Public Health Information

As always, for the most up to date information and advice on Coronavirus, please go to: https://www2.hse.ie/coronavirus/ and https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/.

 

You can find the COVID-19 A-Z information here from the HSE’s Health Protection Surveillance Centre (HPSC).
https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/covid-19a-z/

ASSOCIATION OF Leaders of Missionaries and Religious of IRELAND CLG, AMRI is a registered Charity. CRA 20023263.

Registered in Dublin, Ireland. Charity Number: 9301. Company Registration: 529508.

Directors: Brendan Coffey, Edmund Garvey, Evelyn Greene, John Hennebry, Rita Kelly, Mary Hanrahan, Kathleen McGarvey, Paula Molloy, Aidan McGrath, Thomas O’Connor, Sally Roddy, Timothy Lehane.