E mer genc y Pr epar edness Pr epar ation And COVID-19 Ka - - PowerPoint PPT Presentation

E mer genc y Pr epar edness Pr epar ation And COVID-19

2020

Ka te Hill, RN

FIRST A BIG THANK YOU

COVID-19

Soc ial Distanc ing

COVID-19

• If you feel sick, stay home
• If your children are sick, keep them

home

• If someone in your household has

tested positive, keep the entire household at home.

• If you are an older person, stay home

and away from other people

• IF you are a person with a serious

underlying health condition that can put you at increased risk, stay home and away form other people. cdc.gov/COVID-19

COVID-19

cdc.gov/COVID-19

Pr

• tec tive Gear

cdc.gov/COVID-19

Re moving PPE

Doffing (taking off the gear): More than one doffing method may be acceptable. Training and practice using your healthcare facility’s procedure is critical. Below is one example of doffing.

• 1. Remove gloves. Ensure glove removal does not cause additional contamination of
• hands. Gloves can be removed using more than one technique (e.g., glove-in-

glove or bird beak).

• 2. Remove gown. Untie all ties (or unsnap all buttons). Some gown ties can be broken

rather than untied. Do so in gentle manner, avoiding a forceful movement. Reach up to the shoulders and carefully pull gown down and away from the body. Rolling the gown down is an acceptable approach. Dispose in trash receptacle.*

• 3. HCP may now exit patient room.
• 4. Perform hand hygiene.

cdc.gov/COVID-19

Re moving PPE

• 5. Remove face shield or goggles. Carefully remove face shield or goggles by grabbing the

strap and pulling upwards and away from head. Do not touch the front of face shield or goggles.

• 6. Remove and discard respirator (or facemask if used instead of respirator).* Do not touch

the front of the respirator or facemask. » Respirator: Remove the bottom strap by touching only the strap and bring it carefully over the head. Grasp the top strap and bring it carefully over the head, and then pull the respirator away from the face without touching the front of the respirator. » Facemask: Carefully untie (or unhook from the ears) and pull away from face without touching the front.

• 7. Perform hand hygiene after removing the respirator/facemask and before putting it on

again if your workplace is practicing reuse cdc.gov/COVID-19

COVID-19

1. Avoid close contact with people who are sick. 2. Cover your cough or sneeze with a tissue, then throw the tissue in the trash. 3. Avoid touching your eyes, nose and mouth 4. Clean and disinfect frequently touched objects and surfaces. 5. Stay home when you are sick, except to get medical care. 6. Wash your hands for 20 seconds with soap and water. cdc.gov/COVID-19

OR E GON OF F ICE OF E ME R GE NCY MANAGE ME NT

OR E GON OF F ICE OF E ME R GE NCY MANAGE ME NT

OREGON PEAK MAY 5, 2020

OR E GON OF F ICE OF E ME R GE NCY MANAGE ME NT

• Ore g o n COVI

D-19 da ily upda te

• so c ia l dista nc ing
• g o o d hyg ie ne
• re spo nsib le sho pping
• pre pa ring yo ur ho me
• pro te c ting yo ur me nta l he a lth
• c o ping with stre ss a nd c risis line s
• 2 we e ks re a dy

DO YOUR PART :

Door Sign

STOP

FOR

SAFETY

PATIENT THE TEAM, INC. ZONE™

PROTECTION

COMPLIANCE

If you are experiencing any of these symptoms: Cough Fever Shortness of breath Please go back to your car and call us. Clinic Phone Number We will come OUTSIDE to you.

Go to the c a r, g ive the m a ma sk a nd tria g e the pa tie nt in the c a r.

Ask sc re e ning que stio ns:

Ha ve yo u tra ve le d o utside the US, whe n a nd whe re o r e ve n in the US to NY o r L A. Ha ve yo u b e e n in c o nta c t with so me o ne who ha s the virus Che c k fo r fe ve r, so re thro a t, a nd sho rtne ss o f b re a th. De c ide : I f suspic io us fo r COVI D-19, thre e c ho ic e s Se nd the m ho me if minima l sympto ms to se lf q ua ra ntine Se nd the m fo r te sting Se nd the m to a ho spita l if a c ute sympto ms ne e ding furthe r c a re . I nfo rm infe c tio n pre ve ntio n a nd c o ntro l se rvic e s, lo c a l a nd sta te pub lic he a lth a utho ritie s, a nd o the r he a lthc a re fa c ility sta ff a s a ppro pria te a b o ut the pre se nc e o f a pe rso n unde r inve stig a tio n fo r COVI D-19. L imit the numb e r o f pa tie nts in the wa iting ro o m.

A T T HE C L INIC

YOUR F ACE

T ry no t to to uc h yo ur fa c e . T he muc us me mb ra ne s o n yo ur fa c e a re e a sy e ntry-wa ys fo r the c o ro na virus. So unds simple b ut mo st pe o ple to uc h the ir fa c e 92 time s a da y a nd we to uc h it mo re whe n we a re stre sse d. Ye s so me o ne did a study o n tha t. Ma yb e tha t will he lp yo u re me mb e r!

Suspec ted Positive Patients

Use o ne ro o m o nly a nd ha ve a sig n o n tha t do o r. I f pa tie nt is a b le , the y sho uld c o me in a lo ne Ale rt Pub lic he a lth a utho ritie s K e e p a lo g o n e ve ryo ne who e nte rs tha t ro o m, sta ff inc lude d K e e p the numb e r o f pe o ple in tha t ro o m to a minimum, o nly e sse ntia l sta ff PPE fo r Sta ff. I f yo u use no n-dispo sa b le line n, ho w a re yo u ha ndling it? T ry no t to use it a t this time .

T ra in yo ur Sta ff, ta ke da ily sta ff te mpe ra ture s sinc e so ma ny a re a sympto ma tic E nsure tha t c linic a l sta ff kno w the rig ht wa ys to put o n, use , a nd ta ke

• ff PPE

sa fe ly. Re c o g nize the sympto ms o f COVI D-19— fe ve r, c o ug h, sho rtne ss o f b re a th. I mple me nt pro c e dure s to q uic kly tria g e a nd se pa ra te E mpha size ha nd hyg ie ne a nd c o ug h e tiq ue tte fo r e ve ryo ne . Ask sta ff to sta y ho me if the y a re sic k. Se nd sta ff ho me if the y de ve lo p sympto ms while a t wo rk.

Get Your Clinic R eady

Disc ontinuing Home Isolation

People with COVID-19 who have stayed home (home isolated) can stop home isolation under the following conditions: If you will not have a test to determine if you are still contagious, you can leave home after these three things have happened: You have had no fever for at least 72 hours (that is three full days of no fever without the use medicine that reduces fevers) AND

• ther symptoms have improved (for example, when your cough or shortness of breath

have improved) AND at least 7 days have passed since your symptoms first appeared If you will be tested to determine if you are still contagious, you can leave home after these three things have happened: You no longer have a fever (without the use medicine that reduces fevers) AND

• ther symptoms have improved (for example, when your cough or shortness of breath

have improved) AND you received two negative tests in a row, 24 hours apart. Your doctor will follow CDC guidelines.

Goa ls

• Be a b le to sta te the re q uire me nts
• f CF

R §491.12 (E me rg e nc y Pre pa re dne ss (E P) fo r the RHC)

• Be a b le to ide ntify re so urc e s to

c o mple te a c usto mize d E P Pla n

• Be able to state the ratio nale fo r

c re ating an Afte r-Ac tio n Re po rt

Emergency Preparedness 42 CFR 491.12

E mer genc y Pr epar edness Plan

• Pla nning fo r thing s we ho pe will ne ve r ha ppe n.
• On-site e ve nts a nd e me rg e nc ie s whic h ma y put sta ff a nd pa tie nts a t

risk.

• Off-site e ve nts a nd e me rg e nc ie s whic h ma y impa c t the de live ry o f

se rvic e to RHC pa tie nts.

• Co nting e nc y pla nning fo r inte rruptio n o f he a lthc a re se rvic e s.

L e ssons L e a rne d 2005

A le sso n le a rne d fro m Hurric a ne K a trina : I n 2005, o nly 25% o f o ffic e - b a se d pro vide rs we re using e le c tro nic me dic a l re c o rds. E ntire life time s o f he a lthc a re do c ume nta tio n we re lo st fo re ve r fo r ma ny c ritic a lly a nd c hro nic a lly ill pa tie nts. E MR is no w the sta nda rd.

Hurric a ne Ka trina

• Do ro thy Jo ne s, RHI

T , he a lth info rma tio n supe rviso r a t Me dic a l Ce nte r

• f L
• uisia na in Ne w Orle a ns, tho ug ht re mo ving the b o tto m ro ws o f

re c o rds in he r ho spita l’ s b a se me nt sto ra g e fa c ility wo uld b e e no ug h to g ua rd a g a inst Hurric a ne K a trina ’ s punc h Aug ust 29, 2005.

• I

n a ma tte r o f ho urs, 400,000 me dic a l re c o rds we re re duc e d to pulp.

Hurric a ne Sa ndy 2012

Hurric a ne Sa ndy

• While wa te r wa s impo ssib le to ho ld b a c k, the a va ila b ility o f he a lth

info rma tio n b e fo re , during , a nd a fte r the sto rm re ma ine d re ma rka b ly sta b le .

• Amo ng the use rs o f E

HRs in the g re a te r Ne w Yo rk City a re a the re wa s

• nly o ne re po rt o f re c o rds b e ing lo st, in a sma ll c linic tha t wa s a c tua lly

in the pro c e ss o f c o nve rting the ir pa pe r re c o rds into a n E HR syste m. Ho we ve r, the re we re wide spre a d re po rts o f pa pe r re c o rds b e ing lo st.

• I

n Ne w Je rse y, with fe we r ho spita ls in the dire c t impa c t zo ne , the Sta te Re g io na l E xte nsio n Ce nte r Pro g ra m pla nne d in a dva nc e b y c o nta c ting pro vide rs prio r to the sto rm’ s la ndfa ll with instruc tio ns o n ho w to b a c k up da ta sto re d in the the ir E

• HRs. T

his pla nning a ssure d tha t pa tie nt info rma tio n wo uld b e sa fe a nd a c c e ssib le during a nd a fte r the sto rm.

L e ssons L e a rne d 2013

A le sso n le a rne d fro m Mo o re Me dic a l Ce nte r, OK : Appro xima te ly 50 pa tie nts/ sta ff a nd 300 c o mmunity me mb e rs survive the E F

• 5 to rna do .

Displa c e me nt fo r sta ff/ pa tie nts. 4 ye a rs to re b uild.

L e ssons L e a rne d 2015

A L e sso n L e a rne d fro m I nla nd Re g io na l Ce nte r, CA: Afte r 14 pe o ple kille d a nd 22 injure d, we no w te a c h he a lthc a re sta ff “Run/ Hide / F ig ht” whe n imme dia te thre a t no te d.

L e ssons L e a rne d 2017

Hurricane Harvey

Hurric a ne Ha rve y

Nursing Ho me with 15 patie nts strande d in waist hig h wate r. Co mmunic atio n we le arne d fro m Harve y.

L e ssons L e a rn 2017

A le sso n le a rne d fro m the UK ’ s Na tio na l He a lth Se rvic e s. Sla shing the b udg e t se t fo r I T upda te s/ se c urity is no t a c c e pta b le . Ma lwa re is a re a l risk fo r lo ss o f re c o rds a nd inte rruptio n o f he a lthc a re se rvic e .

L e ssons L e a rn 2017

Ca mp F ire Pa ra dise , CA

• Whe n to e vac uate
• Ge tting ambulanc e s

L e ssons L e a rn 2017

Camp Fire Paradise, CA

• Getting ambulances is a big problem

R HC E mer gency Pr epar edness (E P)

R isk Assessment and Planning Polic ies and Pr

• c edur

es Communic ation Plan T r aining and T esting

E mer gency P r epar edness P r

• gr

am

R isk Assessment and Planning

R isk Assessment and Planning

E P PL AN Must:

• Be b a se d o n a nd inc lude a do c ume nte d, fa c ility-b a se d a nd

c o mmunity-b a se d risk a sse ssme nt, utilizing a n a ll-ha za rds a ppro a c h.

• I

nc lude stra te g ie s fo r a ddre ssing e me rg e nc y e ve nts ide ntifie d b y the risk a sse ssme nt.

• Addre ss pa tie nt po pula tio n, inc luding the type o f se rvic e s the RHC ha s

the a b ility to pro vide in a n e me rg e nc y a nd c o ntinuity o f o pe ra tio ns, inc luding de le g a tio ns o f a utho rity a nd suc c e ssio n pla ns.

• I

nc lude a pro c e ss fo r c o o pe ra tio n a nd c o lla b o ra tio n with lo c a l, trib a l, re g io na l, Sta te , a nd F e de ra l e me rg e nc y pre pa re dne ss o ffic ia ls' e ffo rts to ma inta in a n inte g ra te d re spo nse during a disa ste r o r e me rg e nc y situa tio n.

R isk Assessment and Planning

…inc luding do c ume nta tio n o f the RHC’ s e ffo rts to c o nta c t suc h

• ffic ia ls a nd, whe n a pplic a b le , o f its pa rtic ipa tio n in c o lla b o ra tive a nd

c o o pe ra tive pla nning e ffo rts. Ne w a s o f 11.29.19 Do c ume nta tio n o f e ffo rts to c o nta c t the se o ffic ia ls is no lo ng e r re q uire d b ut yo u must ha ve a pro c e ss.

R isk Assessment and Planning

R isk Assessment and Planning

R isk Assessment and Planning

What e ve nts are mo st like ly to impac t the se rvic e s yo ur o rganizatio n de live rs to patie nts?

• Sho rt-te rm I

nc le me nt We a the r E ve nts

• Po we r o r Wa te r I

nte rruptio ns

• Pro vide r/ Sta ff I

llne ss

• T

e c hno lo g ic a l/ Co mmunic a tio n F a ilure s

• F

ire

• Wildfire s
• F

lo o ds

R isk Assessment and Planning

R isk Assessment and Planning

Man Made Natural Disasters Public Health Emergencies Active Shooter Tornadoes Pandemic Flu Cyber Attack Hurricanes Zika Virus Outbreak Bioterrorism Severe Storm Biological Hazards Total Power Outage Earthquakes COVID-19 Chemical events Flood Mass Casualties * Loss of provider

R isk Assessment and Planning

I nte rpre tive Guide line s:

• E

P pro g ra m must de sc rib e the RHC's c o mpre he nsive a ppro a c h to me e ting the he a lth, sa fe ty, a nd se c urity ne e ds o f the ir sta ff a nd pa tie nt po pula tio n during a n e me rg e nc y o r disa ste r situa tio n.

• T

he pla n will a ddre ss ho w the RHC wo uld c o o rdina te with o the r he a lthc a re fa c ilitie s, a s we ll a s the who le c o mmunity during a n e me rg e nc y o r disa ste r (na tura l, ma n-ma de ).

• T

he e me rg e nc y pre pa re dne ss pro g ra m must c o mply with a ll a pplic a b le F e de ra l, Sta te a nd lo c a l e me rg e nc y pre pa re dne ss re q uire me nts.

Polic ie s a nd Proc e dure s

Polic ie s a nd Proc e dure s

T he po lic ie s a nd pro c e dure s must b e re vie we d a nd upda te d b ie nnia lly.

At a minimum, the po lic ie s a nd pro c e dure s must a ddre ss the fo llo wing : (1) Sa fe e va c ua tio n fro m the RHC, whic h inc lude s a ppro pria te pla c e me nt o f e xit sig ns; sta ff re spo nsib ilitie s a nd ne e ds o f the pa tie nts. (2) A me a ns to she lte r in pla c e fo r pa tie nts, sta ff, a nd vo lunte e rs who re ma in in the fa c ility. (3) A syste m o f me dic a l do c ume nta tio n tha t pre se rve s pa tie nt info rma tio n, pro te c ts c o nfide ntia lity o f pa tie nt info rma tio n, a nd se c ure s a nd ma inta ins the a va ila b ility o f re c o rds. (4) T he use o f vo lunte e rs in a n e me rg e nc y o r o the r e me rg e nc y sta ffing stra te g ie s, inc luding the pro c e ss a nd ro le fo r inte g ra tio n o f Sta te a nd F e de ra lly de sig na te d he a lth c a re pro fe ssio na ls to a ddre ss surg e ne e ds during a n e me rg e nc y.

Polic ie s a nd Proc e dure s

• RHC will c o mply with a ll F

e de ra l, Sta te , a nd lo c a l la ws re g a rding c o mmunity-wide a nd RHC e me rg e nc y pre pa re dne ss

• E

P Pla n will b e re vie we d a t le a st b ie nnia lly a nd upda te d with a ny c ha ng e s a rising fro m finding s with Afte r-Ac tio n Re po rt (AAR)

• Addre ss Pa tie nt Po pula tio n

E xa mple : pa tie nts with limite d mo b ility in a c linic o n 2rd flo o r

• Se rvic e s Offe re d during E

me rg e nc y E ve nts RHCs pro vide o ut-pa tie nt se rvic e . T his will b e a ddre sse d fo r pro viding the se se rvic e s o r c lo sing

Communic a tion Pla n

Communic a tion Pla n

• Co mply with F

e de ra l a nd Sta te la ws – se e Sta te E OP re q uire me nts

• Upda te the E

P Pla n a t le a st Bie nia lly

• I

nc lude re q uire d Co nta c t I nfo rma tio n

• I

nc lude Alte rna tive Me a ns o f Co mmunic a ting – T e xt, E ma il, Pho ne , So c ia l Me dia pla tfo rms

• Pro vide I

nfo rma tio n a b o ut Pa tie nts – RHC Pa tie nt T ra c king F

• rm fo r

T ra nsfe rs a nd the Ame ric a n Re d Cro ss Pa tie nt Re unific a tio n Pro g ra m

• De te rmine Clinic Ne e ds a nd/ o r the Clinic ’ s Ab ility to Pro vide

Assista nc e to the Co mmunity

Communic a tion Pla n

Communic a tion Pla n

• Staff
• Pro vide rs
• E

ntitie s Pro viding Se rvic e s Unde r Arrang e me nt

• Othe r RHCs/ F

QHCs

• Vo lunte e rs
• F

e de ral/ State / T ribal/ Re g io nal/ L

• c al E

P Staff

DON’ T F ORGE T T O I NCL UDE T HE OT HE R RHCs I N YOUR ARE A – YOU MUST I NCL UDE CONT ACT I NF ORMAT I ON E VE N I F T HE Y ARE NOT I N YOUR HE AL T HCARE SYST E M.

Communic a tion Pla n

Co mpile “a dva nc e d e me rg e nc y pho ne tre e s” whic h no t o nly re q ue sts sta ff me mb e r ho me pho ne numb e rs, b ut a lso :

• Mo b ile numb e rs fo r te xt me ssa g ing
• E

ma il a ddre sse s fo r ma ss c o mmunic a tio n

• E

me rg e nc y fa mily c o nta c t info rma tio n

• Alte rna te a ddre sse s in c a se o f te mpo ra ry re lo c a tio n

Re think the Pho ne T re e

Communic a tion Pla n

• A me a ns o f pro viding info rma tio n a b o ut the g e ne ra l c o nditio n a nd

lo c a tio n o f pa tie nts unde r the fa c ility's c a re .

• A me a ns o f pro viding info rma tio n a b o ut the RHC's ne e ds, a nd its

a b ility to pro vide a ssista nc e , to the a utho rity ha ving jurisdic tio n o r the I nc ide nt Co mma nd Ce nte r, o r de sig ne e .

Communic a tion Pla n

T ra ining a nd te sting .

What we tr ain for , we succeed in… “Muscle Memor y”

Wha t we Se e

• Ha ving the E

P Pla n, b ut no t tra ining the sta ff

• Omitting re q uire d c o nta c t info rma tio n
• L

a c king a n a ll Ha za rds Vulne ra b ility Asse ssme nt

• Pro vide r-Ba se d Clinic s sta ting the y a re pa rt o f a n inte g ra te d

he a lthc a re syste m, b ut no t me e ting hig he r le ve l o f do c ume nta tio n

RHC E P

• Outpa tie nt pro vide rs a re no t re q uire d to ha ve P&Ps fo r the pro visio n o f

sub siste nc e ne e ds.

• RHCS must still ha ve a P&P de ta iling ho w re frig e ra te d me dic a tio ns will

b e ha ndle d during / a fte r disa ste rs tha t disrupt e le c tric a l po we r.

• RHC pro c e dure ma y b e to e va c ua te sta ff/ pa tie nts whe n sa fe to do

so , c lo se / se c ure the c linic , a nd no tify sta ff/ pa tie nts tha t the c linic is c lo se d until furthe r no tic e .

E P Re sourc e s

CMS.GOV a nd CDC.GOV

• Pro vide rs a nd Supplie rs sho uld re fe r to the re so urc e s o n the CMS

we b site fo r a ssista nc e in de ve lo ping e me rg e nc y pre pa re dne ss pla ns. CMS We b site L ink: https:/ / www.c ms.g o v/ Me dic a re / Pro vide r-E nro llme nt-a nd- Ce rtific a tio n/ Surve yCe rtE me rg Pre p/ inde x.html

CMS.GOV

CMS.GOV

CMS.GOV

F re q ue ntly Aske d Que stio ns (F AQs) ha ve b e e n de ve lo pe d a nd a re po ste d o n the CMS E me rg e nc y Pre pa re dne ss We b site https:/ / www.c ms.g o v/ Me dic a re / Pro vide r- E nro llme nt-a nd- Ce rtific a tio n/ Surve yCe rtE me rg Pre p/ E me rg e nc y-Pre p-Rule .html SCGE me rg e nc yPre p@ c ms.hhs.g o v

E P Che c klist

F E MA.GOV

CE RT : Community E me rg e nc y Re sponse T e a m

https://www.citizencorps.fema.gov/cc/listCert.do

CE RT : Community E me rg e nc y Re sponse T e a m

https://www.citizencorps.fema.gov/cc/listCert.do

T he Co mmunity E me rg e nc y Re spo nse T e a m (CE RT ) pro g ra m e duc a te s vo lunte e rs a b o ut disa ste r pre pa re dne ss fo r the ha za rds tha t ma y impa c t the ir a re a a nd tra ins the m in b a sic disa ste r re spo nse skills, suc h a s fire sa fe ty, lig ht se a rc h a nd re sc ue , te a m

• rg a niza tio n, a nd disa ste r me dic a l o pe ra tio ns.

CE RT

• ffe rs a c o nsiste nt, na tio nwide a ppro a c h to vo lunte e r

tra ining a nd o rg a niza tio n tha t pro fe ssio na l re spo nde rs c a n re ly o n during disa ste r situa tio ns, whic h a llo ws the m to fo c us o n mo re c o mple x ta sks. T hro ug h CE RT , the c a pa b ilitie s to pre pa re fo r, re spo nd to a nd re c o ve r fro m disa ste rs is b uilt a nd e nha nc e d.

CAL HOSPIT AL PRE PARE .ORG

ASPRT RACIE .HHS.GOV

CIDRAP.UMN.E DU

Additional R HC R esour c es

https://www.ruralhealthinfo.org/

Questions

Kate Hill, RN khill@thecomplianceteam.org 215-654-9110