In late March, Laguna Honda Hospital and Rehabilitation Center reached out to the Global Center for Health Security (GCHS) and National Emerging Special Pathogens Training and Education Center (NETEC), a program sponsored by the CDC and the Assistant Secretary for Preparedness and Response, for assistance in mitigating the risk of COVID-19 spreading amongst staff and residents. A team of GCHS and NETEC experts from across the country assembled virtually to help the hospital identify and address any existing risks to their residents and staff, and suggest best practices to mitigate spread of COVID-19.
The team discussed the administrative controls (i.e., policies and procedures) and engineering controls (e.g., physical modifications and ventilation) as well as personal protective equipment (PPE) challenges faced by the hospital. Discussion included operational workflow, negative pressure rooms, the area healthcare workers donned and doffed PPE, and how and where food delivery took place—watching closely to determine where gaps in infection control may exist and where additional measures could be implemented. The team also requested and examined the schematic of the facility’s HVAC system to determine if changes needed to be made from an engineering standpoint in order to minimize the virus’ spread.
All of the information gathered was closely examined by the team; opportunities were identified and remedies were suggested, all of which was compiled into a playbook for reference. A few of the suggestions made to benefit the facility’s residents and staff include establishing a restricted area for confirmed patients and for patients under investigation to prevent cross contamination, providing protocols and staff training on proper donning and doffing of PPE, and bundling services to preserve PPE. Bundling services limits the number of staff entering/exiting the isolation area such as having a nurse already in a patient’s room providing care, delivering meals, and cleaning high-touch surfaces; this avoids unnecessary exposure risks to food delivery staff and minimizes frequency of environmental services in the isolation area. The playbook containing these and additional recommendations, with links to resources for each recommendation, has been provided to Laguna Honda Hospital and Rehabilitation Center; and it will also be made widely available for other facilities needing additional support in mitigating the risks associated with the COVID-19 pandemic.
The team discussed the administrative controls (i.e., policies and procedures) and engineering controls (e.g., physical modifications and ventilation) as well as personal protective equipment (PPE) challenges faced by the hospital. Discussion included operational workflow, negative pressure rooms, the area healthcare workers donned and doffed PPE, and how and where food delivery took place—watching closely to determine where gaps in infection control may exist and where additional measures could be implemented. The team also requested and examined the schematic of the facility’s HVAC system to determine if changes needed to be made from an engineering standpoint in order to minimize the virus’ spread.
All of the information gathered was closely examined by the team; opportunities were identified and remedies were suggested, all of which was compiled into a playbook for reference. A few of the suggestions made to benefit the facility’s residents and staff include establishing a restricted area for confirmed patients and for patients under investigation to prevent cross contamination, providing protocols and staff training on proper donning and doffing of PPE, and bundling services to preserve PPE. Bundling services limits the number of staff entering/exiting the isolation area such as having a nurse already in a patient’s room providing care, delivering meals, and cleaning high-touch surfaces; this avoids unnecessary exposure risks to food delivery staff and minimizes frequency of environmental services in the isolation area. The playbook containing these and additional recommendations, with links to resources for each recommendation, has been provided to Laguna Honda Hospital and Rehabilitation Center; and it will also be made widely available for other facilities needing additional support in mitigating the risks associated with the COVID-19 pandemic.