National CMS/CDC Nursing Home COVID-19 Training: Week 9 Recap

Is Your Nursing Home Ready to Handle the Demands of the COVID-19 Pandemic? Assessing Readiness: Advice from the CDC

Together with Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) and state and local health departments, the Centers for Disease Control and Prevention (CDC) tele-Infection Control Assessment and Response (tele-ICAR) team is supporting nursing home on the ground during the COVID-19 pandemic. The tele-ICAR team has shown the CDC how its recommendations are being carried out at the local level, which has helped to hone agency guidelines since the pandemic began.

Dr. Nimalie Stone, MD, MS, a medical epidemiologist for the CDC Long-Term Care division of Healthcare Quality Promotion, is a member of the CDC tele-ICAR team. With her unique perspective assisting local nursing homes, she supplemented her July 23, 2020 presentation of the Infection Prevention and Control Assessment Tool for Nursing Homes Preparing for COVID-19 with plenty of examples of local nursing home ingenuity you can adapt to your own facility.

The CDC tele-ICAR team has administered 752 onsite or remote ICAR assessments in 22 different jurisdictions so far. Also available in Spanish, this infection control tool is designed to help nursing homes to:

  • Keep COVID-19 out of the facility
  • Identify infections as early as possible
  • Prevent spread of COVID-19 in the facility
  • Assess and optimize personal protective equipment (PPE) supplies
  • Identify and manage severe illness in residents with COVID-19

Stone acknowledged that many nursing homes have been implementing ICAR activities since March 2020, but the tool helps highlight specific areas of COVID-19 preparedness that may change over time. Frequent tele-ICAR assessments — either self-administered or given by a QIN-QIO or health department — will help nursing home leaders identify areas where more support is needed. The six sections of the ICAR include:

Section 1: Visitor Restrictions and Non-Essential Personnel Restrictions 

This section also addresses outreach and education to families. Section 1 is important to revisit as some centers consider re-opening or easing visitor restrictions.

Section 2: Education, Monitoring and Screening of Health Care Personnel

Check out the presentation recording for examples of clever ways that nursing homes are providing visual reminders to staff to monitor temperatures, perform hand hygiene, don and doff personal protective equipment (PPE) and more.

Section 3: Education, Monitoring, and Screening, and Cohorting of Residents

The CDC offers separate COVID-19 testing guidelines for residents and staff. Another CDC document outlines guidelines for cohorting and managing new COVID-19 cases.

Section 4: Availability of Personal Protective Equipment (PPE) and Other Supplies

With infections surging in some areas of the U.S., Section 4 helps nursing homes evaluate the accessibility of PPE, tissues and hospital-grade disinfectant.

Section 5: Infection Prevention and Control Practices

Section 5 covers hand hygiene, PPE and disinfectant use.

Section 6: Communication

The health department should be informed if a resident is hospitalized or dies following a severe respiratory infection, if COVID-19 is suspected or confirmed in any resident or staff member, or if three or more residents or staff members develop new cases of respiratory illness within three days. This section assesses readiness to communicate with the health department, residents, families and staff regarding individual COVID-19 cases or an outbreak.

To Learn More

Download the CDC slides and resources from the National CMS/CDC Nursing Home COVID-19 Training Series page, visit www.QIOProgram.org to connect with the QIN-QIO serving your state or territory and sign up for updates about the National CMS/CDC Nursing Home COVID-19 Training Series.