In its latest guidance for long term and post-acute care providers fighting the coronavirus (COVID-19) pandemic, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) focused on how every interaction between people could increase the spread, particularly now that the virus is in most areas of the United States. 

The goal is to minimize the number of interactions with residents, AHCA/NCAL said. To achieve this goal, the association released guidance that provides some ideas on what this means, including steps to: 

--Reduce the number of various (nonessential) people entering the building; and

--Target the number of interactions with residents by reducing the number of different staff entering a resident’s room and increasing efficiency of tasks when entering a resident’s room to decrease the number of times staff enter.

“It’s a simple formula for how spread happens—the more interactions that happen with a variety of people, the greater the chance of spread. So, continue to creatively reduce the number of interactions between people, and stop the spread of this deadly virus,” AHCA/NCAL said.

In a separate note, the association said it has heard from the Centers for Medicare & Medicaid Services (CMS) that a common theme it is finding during COVID-19 infection control-focused surveys is Personal Protective Equipment (PPE) not being used correctly, including donning and doffing procedures. Surveyors are having staff demonstrate handwashing and donning and doffing of PPE, the association said.

“We encourage you to review with your teams the appropriate way to apply and remove all PPE, including gloves, gowns, masks, and eye protection. Performing observations yourself can be helpful to prepare staff for surveyor observation and to quickly correct any practices needing improvement,” AHCA/NCAL said. 

A document on donning and one on doffng can be printed and posted in each center to ensure staff are aware of how to appropriately don and doff PPE.

And, the following video explains how to do hand hygiene and donning and doffing PPE appropriately. 

Finally, AHCA/NCAL said ensuring compassionate care in the midst of the COVID-19 pandemic is a must, even as human, equipment, and financial resources are significantly strained.

“When we are balancing professional and personal struggles, this can be a challenge. Advance care planning or end-of-life conversations can be difficult in the best of circumstances, let alone in the current environment with restrictions, heightened emotions, and scarce resources,” the association said, as an example. 

​​​​​​​Read more about steps the facility can take to be prepared, as well as tips on having these conversations.

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