This week, CMS released a 158-page Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes to include 15 sections of best practices from various states. We've pulled out some of the best of best in Cleanliness and Infection Control for your quick scan this week. 

Read on and download/print our At-A-Glance infographic to share among your peers.

N95 Respirator Disinfection

One noticeable trend across various states is funding of the Battelle Critical Care Decontamination System (CCDS)™ for N95 respirator disinfection to address PPE shortages. Noted in the CMS toolkit are Connecticut, Indiana, Massachusetts, Mississippi, Montana, New Mexico, and Ohio. 

Partnerships with Infection Control and Quality Organizations

Another general best-practice trend among states is partnering with formal infection control and quality organizations for weekly calls. Also, know that many states have specially-trained and equipped National Guard teams on-call to disinfect nursing homes. 

Infection Control Surveys - Alaska, Colorado, Florida, Montana, and Nevada

These states are conducting infection control surveys in nursing homes using risk-based criteria to determine facility selection and scheduling. Colorado and Montana are doing these as often as weekly.

Nursing Home Strike Teams - Ohio, New Jersey, and Maryland 

Many states are creating strike teams specific to testing, PPE, and infection control. Ohio, New Jersey, and Maryland have strike teams focused specifically on nursing homes.

In Maryland, the Office of Governor Larry Hogan created statewide strike teams to provide on-site medical triage, supplies, and equipment to overburdened nursing homes. Teams include National Guard, state and local health department representatives, EMS clinicians, and hospital doctors, and nurses. 

The Office of Congressman Josh Gettheimer in New Jersey is sponsoring Outside Support (SOS) Act of 2020 legislation to provide immediate support to nursing homes, long term care facilities experiencing outbreaks of COVID-19 in New Jersey – and across the country.

Advanced Entrance Screening - California and New Mexico 

Two Palm Nursing Center, Inc. in California created a pre-entry, outside screening and infection prevention station for all health care workers and visitors: 

  • All are screened one at a time for COVID-19 signs and symptoms
  • Following, they proceed to an outside "washing station" where they sanitize their hands and don PPE, including gowns, N95s, and face shields.
  • Lastly, they step on a bleaching mat to ensure they do not track contaminants from the outside into the facility.

Similarly, the New Mexico Department of Health is considering mandating three additional requirements for long term care facilities to include:

  • Anti-viral shoe spray for all individuals entering facilities
  • Clothing changes for all staff upon facility entry and exit
  • Reporting deaths in their data collection portal

Secret Shoppers for Hand Hygiene - District of Columbia (DC)

The DCHCA implemented Secret Shoppers for Hand Hygiene program. Understandably, with fatigue comes forgetfulness. But, we can all help each other by monitoring and reminding.

COVID Safety Officers (CSOs) - Florida

Orlando Health System implemented COVID Safety Officers (CSOs), who cover every shift to observe employees donning and doffing PPE, performing appropriate hand hygiene, and assuring that all other infection control and prevention policies/procedures are followed.

Fresh Air - Georgia

The Georgia Department of Health reminds us of common-sense practices like opening windows to let fresh air in and giving residents some outdoor time.