BEST AGED CARE COVID PLAN

Want to know what should be included in the best aged care COVID plan? Want to know the best plan to manage COVID outbreak in the aged care? This is the best complete aged care COVID plan guide you will find on the internet.

Over 60 adult care facilities have been infiltrated by COVID-19 in Victoria alone, and a lot of people are angry, confused, and anxious. The worst case of COVID-19 on aged care facilities has already been recorded in Sweden, Italy, the United Kingdom, as well as the United States of America, where a lot of elderly people have died. Should we wait till it gets to this state? No!

Adult care facilities must try their efforts to prevent as much as possible and manage confirmed cases and outbreaks of COVID-19 in their facilities. This is one of the responsibilities of their aged care facilities and infection control.

Explanation on how to best control and manage COVID-19 outbreaks in adult care facilities has been given by the National Guidelines. Guidance and recommendations have also been given to adult care facilities on actions required on the COVID-19 pandemic situation within their facility by the National adult care guidance on coronavirus COVID-19 outbreak tiers and adult care provider responses of the Australian Health Protection Principal Committee.

All states as well as territories have given public health instructions for adult care facilities to follow. Visit the health department of your local state or territory for more.

To get ready for a COVID-19 outbreak, providers are recommended by the Australian Government to:

  • Put an outbreak management plan in place.There is an outbreak preparedness checklist in the national guidelines.
  • Make sure there is an employee management plan that includes a backup plan in case there is an outbreak. This must include finding workers through recruitment agencies and inside the large organization.

Now, let’s go in-depth in discussing these two key tools.

Pro-activeness, Prevention& Early Detection

  • Preparation

Adult care facilities must make sure that they are ready for COVID-19 outbreaks including their first COVID-19 case occurrence. The importance of an effective infection prevention and control (IPC) response is an effective functioning program that perfectly works together with an active working health program.

  • Train Workers

The responsibility of each aged care facility is to make sure that the workers are properly trained and competent in all areas of outbreak management before an outbreak. Workers should know the signs and symptoms of the disease. This will enable them to figure out and take quick action against a potential outbreak.

Also, all workers (including hospitality, casual, volunteer, and domestic workers) must understand the aged care facility infection control guidelines and be active in implementing these measures against an outbreak.

The following topics should be included in workers education and training:

  • COVID-19 symptoms and signs.
  • Proper use of PPE such as gowns, masks, gloves, and eye protection, as well as how to wear and remove PPE properly.
  • Hand hygiene, sneeze as well as cough etiquette.
  • The risk level of exposure to COVID-19 plus awareness of the benefit of travel history and geographical areas of risk.
  • Environmental cleaning.
  • Safe handling of food and proper cleaning of utensils used for food gathering and handling of the respiratory swab should be proper and in compliance with the worker’s prior training and skillset.
  • Things to do if experiencing COVID-19 symptoms (get tested, avoid working or visiting aged care home).
  • How to handle and dispose of clinical waste.
  • How to process reusable equipment.
  • Safe handling and washing of linen

You can access online training modules for aged care facility workers at COVID-19 training. All workers should undergo frequent refresher training on prevention and control measures for infection.

  • Ensure Supplies

Aged care homes should make sure that they have enough stock of all necessary consumable materials during an outbreak and ensure they have an effective technique in place to collect extra stock from suppliers when necessary.

Supplies include:

  • Hand hygiene products, such as liquid soap, alcohol-based hand sanitizer, paper hand towels, etc.
  • Personal protective equipment, such as eyewear, gloves, masks, and gowns.
  • Cleaning supplies, such as detergent and disinfectant products. Check TGA list of active disinfectants against COVID-19, or a hospital-grade disinfectant listed by TGA with effectiveness against viruses (as indicated on label/product info) or products like chlorine, such as the sodium hypochlorite. Cleaning advice will be discussed later in this article.
  • Diagnostic materials (swabs).

For effective stock level monitoring, aged care homes should:

  • Perform take stock regularly
  • Make use of an outbreak kit/box

Prepare an Outbreak Management Team

Think of whom in the facility will handle different functions contained in the outbreak management team. Assigning these roles before an outbreak enables workers to go over the details of the duties they will perform in advance.

  • Workforce

Check policies for sick leave to enable workers to stay home if they have COVID-19 symptoms. Prepare a workers’ contingency plan in case there is an outbreak where sick workers need to excuse themselves from work for a longer period. Think of the actual nature of the pandemic and current outbreaks when organizing leave. Employees may also need to be excluded from the workplace if they have traveled recently.

  • Prepare for a Surge Workforce

The workforce management plan should be enough to cover between 20 to 30% worker absentee rates. Create and maintain a list for casual workers or external nursing agencies to make sure you can quickly activate a surge of the workforce if there should be an outbreak.

Surge workforce employees should be educated and orientated properly up to the function of the facility before they start working. Arrange the workforce management plan to reduce staff movement over different areas.

Workers caring for patients with COVID-19 should not be sent or permitted to care for patients who are not exhibiting the symptoms of the illness. Be sure to consider the risks when using an external agency or casual workers.

Staff should be restricted from working at other aged care facilities during an outbreak. Much effort should be concentrated on maintaining consistent workers in each adult care facility.

  • Cohorting

Make plans to arrange residents together in a wing or rooms. When you have more than one confirmed case of a resident with COVID-19, they need to be cared for in the same area away from other residents who are not affected. This implies that there should be consideration towards rearrangement of rooms as well as re-purposing of other places before an outbreak.

Moving well residents to other safe areas for quarantine may be a way to obtain enough space needed to manage an outbreak. This would be necessarily done with advice from the public health unit.

  • Communications

Create a list of contact details which include the local public health unit, the primary health network, the email address of the Australian government, and attending general practitioners. Make an extensive communication plan. There may be an increased level of anxiety as well as uncertainty about how residents, workers, and families will be impacted as well as the way such risks will be managed during an outbreak.

The aged care homes should create a communication plan to support the provision of consistent, clear, and timely information to all parties.

The following elements should be included in the plan:

  • Dedicate workers to manage communications.
  • Select communication channels like webinars, email, website, phone numbers, and social media.
  • Informative signs should be prepared in advance.
  • Email templates, as well as talking points, concentrated on the former announcement of the outbreak as well as what residents, workers, and families should expect during the outbreak.
  • Plan an approach for disseminating information to patients, families, and workers during the outbreak period, such as:
    • Messaging workers on how infection risks are managed, including support for workers who are flagged as infected or as close contacts.
    • How families will receive an update on the status as well as the well-being of their residents.
    • Options for connecting residents with their loved ones during long term isolation, like video calls, window visits, and phone calls.
    • Protocols for media inquiries management.

You can get help on communications with residents and families from the Older Persons Advocacy Network.

Prevention

Currently, there is no vaccination to prevent COVID-19. The most important measure for preventing the virus in adult care homes is to avoid exposure. These include:

  • Avoid Introduction of the Virus

The overall techniques recommended as prevention against the spread of COVID-19 in adult care homes are the same methods used for other respiratory viruses, such as influenza. Adult care facilities should work to prevent the introduction of COVID-19 into the home.

Workers, family members of residents, as well as other visitors (such as visiting workers) can spread Sars-Cov-2 to residents. The actions below should be taken to prevent the introduction of COVID-19:

  • Educate workers, residents, and families to take caution:Clear information should be provided to residents, their families, as well as RCF workers in playing their role in preventing the introduction of COVID-19. Everyone should understand the early symptoms and signs of COVID-19. They need to understand the importance of physical distancing, respiratory hygiene, hand hygiene, as well as cough etiquette.

Visitors and employees must monitor themselves for COVID-19 symptoms, specifically for acute respiratory symptoms and fever. They must understand the importance of not visiting if they exhibit any symptoms of the disease, are in quarantine as a contact of a confirmed case, or havetraveled recently from a high-risk area.

  • Provide hygiene resources:Adult care homes must make sure that enough hand washing supplies, tissues, alcohol-based hand rub, and lined disposable bins are provided and be used by visitors. These must be, to the lowest, at the entrance of the adult care home, in the visitor area as well as in the room of each resident.
  • Consumable stocks:Providers must make sure that they have enough stocks of all necessary PPE and consumables. These include PPE (surgical masks, gloves, eye protection, long-sleeved gowns, and P2/N95 respirators), approved alcohol-based hand sanitizer, cleaning supplies, and testing swabs. They also should have procedures available to monitor stock levels and perform stocktaking regularly. Providers should check stockpiles against the projected increased worker’s requirements in case there is an outbreak, plus increased demand for and the use of PPE.
  • Checklist for adult care providers:The adult care facility response will be based on the current stage the state is at the pandemic together with local factors. All during the first containment stage should come up with or check their outbreak response plans, supporting policies and procedures for their organization. The targeted action phase as well as the peak action stage will involve extensive measures.

A set of checklists particular to an adult care facilities should be used. They include checklists by phase.

The following are included in the set of checklists:

  • Actions for adult care facilities in the first action stage.
  • Actions for adult care facilities in the targeted action phase when there is a community outbreak.
  • Actions for adult care facilities in the peak action phase.
  • Checklist for managing COVID-19 patients in adult care homes.

All adult care homes should be up to date with the current guidance on the department’s website.


Responses for Certain Scenarios

Here are some specific cases that adult care facilities could encounter during the pandemic and which the facility should be well prepared to tackle.

Checklists for actions to be taken for each case are highlighted here:

  1. A suspected infection case in a resident
  2. A confirmed infection case in a resident
  3. A confirmed infection case in a worker
  4. A confirmed infection case in a visitor
  5. An outbreak of the disease in residents or workers
  6. Response to a Suspected Infection Case in an Aged Care Resident Checklist
  • Implement droplet and contact infection control procedure regarding outbreak management plan immediately. Isolate the resident in a single closed room if possible. Prevent unnecessary interactions from the workers to the resident. If isolation of the resident is not possible, prevent interaction with other residents and have the resident wear a face mask, if possible, all residents. Consider cohorting in case isolation is impossible.
  • Inform Victorian Adult Care Response Center immediately there is a suspected case in resident (or workers) through email at COVID19Notifications@health.gov.auand add this “REPORTING SUSPECTED COVID19 CASE” as the subject heading. Or via phone, call 0413 399 020 (from 9 am to 7 pm 7 days a week).
  • Perform continual care provision for residents Think of how to support each resident that has complex behaviors like dementia and mental health diagnosis, with effective methods.
  • Add to the rate of clinical observations as well as monitoring of adult care regarding Care Plan for suspected or confirmed COVID-19 case in adult care resident.
  • Figure out if the resident has a comprehensive care plan and make sure workers and family are familiar with the preferences and values of the resident.
  • Any person coming into the room should put on droplet and contact precautions PPE (gloves, face shield, gown, P2N95 respirator, and eye protection).
  • Make sure the doctor or worker interacting with the resident is on PPE, and that there are enough PPE, hand sanitizer/hand washing, and waste disposal providers available in the room.
  • Talk to the healthcare provider (if not present already) to schedule for clinical evaluation and testing. Sick residents must be checked by their GP no matter whether there is an outbreak or not. Let them know that this is a suspected COVID-19 case.
  • As this is a sensitive organization, testing and moving of the test to the laboratory should be given the highest priority based on directives by the Department of Health and Human Services.
  • Schedule for moving of the resident to the hospital only if advised by the clinic, after consulting the healthcare provider as well as the department. If the transfer is needed, let the hospital know and transport workers that the resident has a COVID-19 suspected case.
  • Gather important information about the case, including contacts/exposures
  • Look into enhanced infection control measures as well as surveillance for more cases. Go through outbreak plans and get ready for more cases.
  1. Response to a Confirmed Infection Case in an Aged Care Resident Checklist
  • Implement droplet and contact infection control procedure regarding outbreak management plan immediately. Isolate the resident in a single closed room if possible. Prevent unnecessary interactions from the workers to the resident. If isolation of the resident is not possible, prevent interaction with other residents and have the resident wear a face mask, if possible, all residents. Consider cohorting in case isolation is impossible.
  • Make sure the doctor or worker interacting with the resident is on PPE, and that there are enough PPE, hand sanitizer/hand washing, and waste disposal providers available in the room.
  • Call 1300 651 160 to inform the Department of Health and Human Services of the resident’s confirmed case.
  • Inform the commonwealth department of health via agedcareCOVIDcases@health.gov.auof any COVID-19 cases of residents.
  • After notification by the department, there will be the performance of risk/situation assessment on the facility in line with the department, to figure out the further actions to be taken.
  • Find out what further actions to be taken by working with the Health Service or Cluster and/or healthcare first responder including or excluding Prevention and control outreach Nurse Team.
  • Help the department with a collection of important information as well as contact tracing (all workers at aged care homes, including health workers and visitors).
  • Declare and start an outbreak management plan with a selected outbreak management team.
  • All workers and residents swabbed for COVID-19.
  • Position outbreak notification posters at strategic places on facility and resident’s rooms.
  • Don’t stop to provide routing care for infected resident regarding Care Plan for suspected/confirmed COID-19 case in adult care resident, and all other residents.
  • Think of how to support each resident that has complex behaviors like dementia and mental health diagnosis, with effective methods.
  • Add to the rate of clinical observations as well as monitoring of adult care regarding Care Plan for suspected or confirmed COVID-19 case in adult care resident.
  • Figure out if the resident has a comprehensive care plan and make sure workers and family are familiar with the preferences and values of the resident.
  • Put in place improved surveillance to find out more cases early (through daily screening and observation of symptoms).
  • Choose a technique for daily status, which includes clinical status and bring the department up to date. Notify the department instantly if the case reduces or if there is a need for transfer.
  • The resident should be kept in isolation until advised otherwise by the department as well as treating the overall practitioner.
  • Shuffle workers to dedicated working teams inside the facility. Advise workers not to work anywhere else.
  • Reduce non-essential visit to the facility based on directives and guidelines from Chief Health Officer.
  • Conduct a risk assessment to figure out any environmental/infection control setbacks. Find out and put in place improved infection control measures.
  • Arrange regular daily communication to notify workers, residents, and families or visitors.

  1. Response to a Confirmed Infection Case in Worker Checklist
  • Any worker (healthcare or not) who exhibits symptoms related to COVID-19 should quickly be removed from the facility and should be kept away while test are been performed.
  • The worker can return to work immediately they are well based on their condition and monitoring from their doctor and if COVID-19 is not discovered.
  • Call 1300 651 160 to inform the Victorian Department of Health and Human Services Public Health Unit of resident’s or workers’ confirmed case
  • Inform the commonwealth department of health via agedcareCOVIDcases@health.gov.auof any COVID-19 cases of residents
  • A worker must not go back to work and must be in isolation until the department or their delegate cleared them in case the worker is confirmed of COVID-19.
  • Shuffle workers to dedicated working teams inside the facility. Advise workers not to work anywhere else.
  • Find out what further actions to be taken by working with the Health Service or Cluster and/or healthcare first responder including or excluding Prevention and control outreach Nurse Team.
  • All workers and residents swabbed for COVID-19.
  • Help the department with gathering important information through contract tracing.
  • Conduct an environmental risk assessment to figure out any breaches to infection control policies, identify and put in place improved infection control measures as well as cleaning/disinfection procedures.
  • Put in place enhanced surveillance for future cases inside the facility and amongst workers.
  • Mobilize outbreak management team and create outbreak plans and necessities for implementation.
  • Solve staffing issues.
  • Notify workers, residents, and families/visitors.
  • Position outbreak notification posters at strategic places on facility and resident’s rooms.

4. Response to a Confirmed Infection Case in a Visitor Checklist

  • Help the department in gathering vital information – figuring out if there are any close and direct contacts of the case and the period of exposure.
  • Find out whether isolation of each resident or worker, quarantine, or cohorting of a part of the facility is necessary, with directives from the department.
  • Look into the restricting movement of visitors in and out of the facility.
  • Notify workers, residents, and families/visitors.
  • Practice improved infection control policies as well as cleaning/disinfection procedures.
  • Restrict non-essential visits to the facility based on directions and guidelines from Chief Health officer.
  1. Response to an Infection Outbreak in the Aged Care Home Checklist
  • An outbreak, in this case, means one confirmed case in a worker or resident.
  • Find out what further actions to be taken by working with the Health Service or Cluster and/or healthcare first responder including or excluding Prevention and control outreach Nurse Team.
  • Think of how to support each resident that has complex behaviors like dementia and mental health diagnosis, with effective methods.
  • Put in place improved surveillance to find out more cases early (through daily screening and observation of symptoms), with the use of COVID-19 screening tool for adult care services.
  • Increase rate of the clinic, monitoring and observations of affected residents regarding the Care Plan for suspected or confirmed COVID-19 in adult care residents.
  • Implement an Outbreak Management Team (OMT) and enforce the outbreak response plan. The facility is responsible for managing the outbreak. This will include further restricting the movement of workers over providers or to other workplaces as necessary.
  • Arrange isolation of cohorting residents in units or rooms as required
  • Let dedicated workers monitor isolated or cohort residents to mitigate the risk of transmission to other residents
  • The log of the whole outbreak should be kept by the outbreak lead, have daily meetings, and work with the department. Choose a method for everyday status updates with the department and give a daily clinical status update to the department.

Let the department be aware immediately a case reduces or requires a transfer. The facility should try an infection control consultant or contact the residential in-reach service located at their nearest health service if they need extra support during an outbreak.

  • Do not transfer residents to hospital unnecessarily, take new admissions, or re-admissions unless they deem necessary.
  • Restrict visitors
  • Notify residents, workers, and families/visitors
  • Putin placestele-health appointments where necessary and possible to avoid movements.
  • Residents should only be removed from isolation unless the department and overall practitioner agrees to it.

Conclusion

The outbreak of COVID-19 is what every organization has to look out for and prepare for. The checklists for aged care COVID plan given above will enable all adult care facilities to get prepared for an outbreak of the coronavirus (COVID-19) and it also contains the necessary response to give in case there is any suspected or confirmed case, whether in residents, workers, or visitors to the facility.