COVID POTPOURI
During collection of staff specimens, the testing area should be cleaned how often?
Every hour and at the end of the testing. (Tables/hard surfaces/chairs where staff sit)
Name 2 scenarios when a POC Rapid test would be a good choice to quickly identify a positive case.
Symptomatic resident or associate, known or suspected exposure to positive case (roommate), to allow vendor/contractor/etc. in who has not been tested.
When a resident is transferred to the red zone after a positive test result, what UDA must be scheduled and what documentation can be discontinued?
Acute respiratory UDA should be scheduled. Every 8 hour COVID monitoring on the MAR should be d/c'ed.
A resident who develops respiratory or COVID like symptoms should be place on what type of TBP?
Contact/Droplet
Name the three testing triggers per F886.
(3 sceanarios that trigger testing)
Symptomatic (resident or staff)
Outbreak (any new case)
Rountine (serial) testing
A POC rapid test requires specimen collection with a nasal swab, a nasopharyngeal swab, or a culture swab?
Nasal swab
If a resident is symptomatic and test positive by POC/Rapid test, you should immediately do a PCR test to confirm the positive result.
False--CMS Algorithm state NO confirmatory test is needed.
True or False: An associate may work half of their shift in the red zone and then finish their shift in the yellow zone.
False Associates may not leave the red zone and enter the rest of the building for any reason. Preferably, the red zone has dedicated staff (same staff that do not work other zones during the outbreak)
Residents on contact/droplet precautions should : a. remain in their rooms b. have their door closed to their room c. wear a cloth mask when staff is providing care d. all of the above
D--all
Serial/routine testing by county positivity rate: who gets tested
Associates/facility staff only-not residents
A resident who goes out for a medical appointment should be put in TBP based on risk that is assessed and documented how/where?
Appointment-Essential Medical Services Departure/Return progress notes. (Iowa must isolate all resident who return form medical appt.)
POC/Rapid tests must be reported to the state portal and ______ within ______ hours of the test.
NSHN, 24
Name 3 criteria for determining resident recovery and transfer from the red zone
10+ days since onset of symptom or positive test Improving symptoms No fever for 24 hours without medication.
When there is an outbreak with one or mor resident positive cases, what type of mask should associates wear?
N95
Serial/routine testing by county positivity rates: when is twice weekly testing of staff required?
10% or greater positivity in the county
Protocol for nebulizer treatments during the COVID pandemic include extra safety measures to prevent possible spread of COVID during aerosol generating procedure. Name 3.
Remove roommate from room, pull cubicle curtain, crack window, fan blowing toward the window if available, wear N95 mask.
NHSN reporting requires completion of ___________ which is emailed to_________ and _________________ as soon as possible after the test is completed __________days per week.
NSHN POC reporting worksheet---Denise and Theresa --7 days per week.
When operating a red zone with COVID + residents, the tool to use to guide the community /nurses through the process is:
QAPI Outbreak Clinical Action Plan
When there is an outbreak with one or more positive resident cases, which residents should be placed on TBP? a. only positive cases b only roomates to positive cases c all residents d. only residents who develop symptoms e. a, b, and d
C
If an associates' PCR test comes back "inconclusive" what is the protocol?
Run another PCR test ASAP and staff should be off work/self quarantine until a confirmed positive or negative results is obtained.
Proactive response to a positive resident case includes asking the practitioner to consider diagnostic and treatment orders. Name 3 things to ask about.
CVC, CMP, Baseline coagulation markers, CXR, Vitamins C and D, Zinc, Dexamethasone or prednisone therapy, Broad spectrum antibiotic, antithrombotic therapy, oxygen.
The swab, processing tube and pipette (if used) must be disposed of in _____________
Biohazard Waste Container
All COVID positive residents should be referred to both ____________________ and _____________ consultants for review/recommendations.
Pharmacy consultant and dietary consultant (dietician)
Current protocol is a new mask/n95 respirator ____________for every associate or more often as needed.
daily --N95 on yellow zone, red zone, and whole house during outbreak with positive resident cases. When no outbreak exists, green zones may wear procedure mask. NO KN95's.
Other than associates, name three other individuals that are considered "facility staff" and must be tested to provide care/services to the residents.
Consultants, Medical practitioners (NP/Dr), Hospice staff, therapists.