The following story about the need to be vigilant and knowledgeable about protecting patients and the community was recently reported by a Centers for Medicare and Medicaid Services (CMS) designated Quality Improvement Organization (QIO; Livanta, 2021). The patient had been discharged from the hospital, and when the admitting home health nurse arrived at the home, the nurse was not wearing a face mask to prevent transmission of COVID-19. The nurse refused the patient's request to wear a mask and further stated that protective measures, including the vaccine, were unnecessary. The patient filed a complaint with the QIO and a representative contacted the home health agency and learned the clinical manager had not been aware that the employee disregarded agency protocols and Centers for Disease Control and Prevention (CDC) guidelines. When made aware, the clinical manager called the patient to get more details and followed up with the nurse, who admitted to not wearing personal protective equipment (PPE) and to violating the agency's protocols for infection control. The agency provided additional training to all clinicians, as well as replacing the nurse in the home.
Information about why we take action is as important as what we are to do. The rationale explains the reasoning for the action. Free on-line resources are available to understand both the what and the why of IPC. The following resources provide current information to inform home care practice and policy related to COVID-19.
CMS: https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergenc
CDC: https://www.cdc.gov/coronavirus/2019-nCoV/?deliveryName=USCDC_2067-DM21539
Project Firstline
Project Firstline is a collaboration led by the CDC and diverse partners to provide free IPC education. This approach of directly targeting frontline workers is different than most training targeted to IPC professionals, who then would teach the frontline workers. The training disseminates best practices in virtual forums appropriate for all practice settings and all geographic locations. The interactive training videos are easy to understand and last approximately 10 minutes. People can access small bites of information to learn wherever they are. A short video can be individually viewed or easily fit into a clinical case conference or meeting. The training can enhance new-hire orientation and ongoing clinical education programs. The Project Firstline web page address is: https://www.cdc.gov/infectioncontrol/projectfirstline/index.html.
Project ECHO (Extension for Community Healthcare Outcomes) is one part of Project Firstline. This collaboration between the CDC and the American Nurses Association formed interdisciplinary groups with case-study-based presentations and discussion during spring of 2021. Topics include IPC basics such as infectious disease transmission, use of PPE, crisis standards of care, and more. Clinicians taking part in the ECHO team model of learning apply best practices in their own settings and then discuss the success of the project with the team. Free continuing nursing education credits are available to participants. Read about Project ECHO and how to register at https://nursefocus.org/project-echo.
APIC
The Association for Professionals in Infection Control and Epidemiology (APIC) has a COVID-19 task force that reviews and disseminates changing guidance related to COVID-19. APIC offers free webinars that include short presentations by an IPC expert followed by questions and answers. You do not need to be an APIC member to access the webinars at https://apic.org/covid19.
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