COVID-19 RESOURCES and General Infection Control

HFAP surveyors will assess infection prevention and control practices when onsite at an ASC. This document is provided as a useful reference for ASC customers.

• ASC Infection Control Worksheet

The Clean Hands Count campaign is a collaborative effort of the CDC, CMS, State Survey Agencies, and Accrediting Organizations, aiming to improve healthcare provider adherence to hand hygiene (HH) recommendations, address myths and misperceptions about alcohol-based hand rub (ABHR), and empower patients to play a role in their care by asking or reminding healthcare providers to clean their hands.

As a basic tenet of infection control and prevention, HFAP expects all accredited healthcare entities to have an infection control and prevention program that includes HH practices based on national standards or professional organizational guidelines. HH guidelines from the CDC and the World Health Organization (WHO) recommend the preferential use of ABHR over soap and water in most clinical situations.^1,2

When hands are not visibly soiled and the facility is not experiencing an outbreak of norovirus or C. diff, ABHR is the preferred method of HH for healthcare personnel to clean their hands because it:¹

• Is more effective at killing potentially deadly germs on hands than soap.
• Requires less time.
• Is more accessible than hand washing sinks.
• Produces reduced bacterial counts on hands.
• Improves skin condition with less irritation and dryness than soap and water.

During surveys, surveyors observe healthcare staff HH practices and use of ABHR.  Please be aware that they may :

• Observe HH practices.
• Review HH procedures (CDC and WHO recommend procedures promoting the   preferential use of ABHR).
• Observe whether ABHR is readily available for staff to use to support effective HH.
• Document non-compliance related to infection control and prevention, including HH.

HH compliance makes a difference in reducing healthcare associated infections. This combined effort of CMS, AOs and SSAs reinforces the need for effective HH and the importance of access to and use of ABHR as the preferred method of HH for healthcare personnel.

Footnotes and additional links

1. Centers for Disease Control and Prevention (CDC). Hand Hygiene in Healthcare Settings
2. World Health Organization. WHO guidelines on hand hygiene in health care.

•  Clean Hands Count: https://www.cdc.gov/handhygiene/campaign/index.html
• Quality, Safety and Oversight (QSO) memorandum 20-03-NH

 

The main CDC page for coronavirus information can be found here. Additional and more focused links are identified below. Please refer to News on the hfap.org homepage for additional items which can be filtered by program type or topic tag.

HFAP customer FAQs can be found here.

General Guidance

Patient guidance on seeking non-COVID-19 medical care and what to expect from healthcare providers as they enact measure to encourage patient safety. (from CMS)

U.S. government resources related to response and recovery (from HHS office of the Asst. Secretary for Preparedness and Response (ASPR))

Disinfectants to control COVID-19 (from EPA)

Guidance on workplace preparedness (from OSHA)

Healthcare Guidance

General information

Resumption of temporarily suspended or reduced services (from CMS)

Blanket waivers from CMS (including updates through May 8, 2020)

Coronavirus stability on surfaces (from NIH – study to establish how long the virus remains on cardboard, copper, plastic, and stainless steel surfaces)

COVID-19 resource page (from ASHE–American Society for Health Care Engineering– some content is members-only, but much is available to all)

CMS EMERGENCY DECLARATION FACT SHEET released 03.13.2020

Hand hygiene FAQs (from CDC – addresses best method, alternative to ABHR, shortage of ABHR)

Interim IPC recommendations for patients with suspected or confirmed COVID-19 (from CDC)

Return to work criteria (from CDC, test-based and non-test-based) for allowing an employee who has tested positive for COVID-19 to return to work)

PPE

N95 mask decontamination and sterilization systems covered under EUA (from AAMI, a recorded webinar with representatives from 3M, STERIS, BATTELLE, ASP, and Sterilucent)

FAQ – Guidance on shortages of surgical masks and gowns (from FDA, endorsed by CMS April 10, 2020)

PPE (esp. medical glove) conservation strategies letter (from FDA – strategies are categorized for a range of needs and supply levels and are intended to assist health care organizations as they determine procedures during the COVID-19 pandemic)

PPE FAQs (from CDC – covers issues of transporting patients within the facility, asymptomatic exposed patients, EVS)

Strategies to optimize PPE (from CDC)

Strategies for optimizing the supply of N95 respirators (from CDC)

NIOSH-approved disposable respirators (from CDC)

Guidance for use of certain industrial respirators by health care personnel (from CMS)

For hospitals

Interim Final Rule: Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (CMS QSO memo 20-37-CLIANH, August 25, 2020 and related posting in the Federal REgister on September 2, 2020)

Guidance for licensed independent freestanding EDs to participate in Medicare during the COVID-19 public health emergency. (CMS QSO memo 20-27, April 21, 2020; information that a hospital considering affiliating with such an ED should know.)

Risk assessment and public health management of healthcare personnel with potential exposure in a Healthcare Setting to Patients with COVID-19 (from CDC – March 7, 2020)

Clinical guidance for management of patients with confirmed COVID-19 (from CDC – updated March 30, 2020: Site provides information on clinical presentation, clinical course, diagnostic testing, laboratory and radiographic findings, clinical management and treatment, investigational therapeutics, and discontinuation of transmission-based precautions or home isolation.)

Guidance for Infection Control and Prevention of COVID-19 – Revised (CMS QSO memo 20-13)

CDC_hospital-preparedness-checklist

Emergency Management Compliance (HFAP recommendations)

EMTALA requirements and implications related to COVID-19 (from CMS)

Patient triage, Placement and Discharge (from CMS QSO memo)

• Discharge from hospital to home  (from CDC)
• Discharge from hospital to long-term care or assisted living (from CDC)

Discontinuing transmission-based precautions for COVID-19 patients (from CDC, test-based and non-test-based decision strategies)

For laboratories

Electronic Laboratory Reporting (ELR) points of contact (from CSTE, updated September 29, 2020: Lists the appropriate ELR contacts for each jurisdiction so that laboratories and other reporting facilities can connect with health department staff regarding ELR onboarding requests and issues.)

Do not distribute list for COVID-19 serology tests (from CDC, updated May 22, 2020)

Interim laboratory biosafety guidelines for handling and processing specimens associated with COVID-19 (from CDC, updated May 11, 2020)

Serology testing for COVID-19 (from CDC)

COVID-19 Reponse Weekly Calls (from CDC)

CDC Laboratory Outreach Communication System (LOCS)

COVID-19 information for laboratories from the CDC 

CMS SARS-CoV-2 Laboratory Testing Comparison (from CLIA, memo 20-06-CLIA)
–Testing Infographic

qSARS-CoV-2 IgG/IgM Rapid Test approval letter April 1, 2020 (FDA EUA)

–Fact Sheet for Healthcare Providers (from FDA)

–Fact Sheet for Patients (from FDA)

–Package insert (FDA download)

Abbott product letter (Use of the i-STAT CG4+(Blue) and i-STAT G3+(Blue) cartridges during the COVID-19 public health emergency)

Biosafety FAQ (from CDC)

CLIA FAQ for laboratories performing COVID-19 patient testing (from CMS)

Emergency use authorizations (from FDA: This link includes a list of all EUAs. Refer to this News item for a summary related to recently identified tests.)

Updated FDA FAQs (includes waived categorization language and non-EUA tests)

For compounding pharmacies

Compounding alcohol-based hand sanitizer during COVID-19 pandemic  (from USP: This document is for informational purposes only and is intended to address shortages of alcohol-based hand sanitizers associated with the COVID-19 pandemic.)

USP response to shortages of garb and PPE for sterile compounding during COVID-19 pandemic  (from USP: This document is for informational purposes only and is intended to address the garb and personal protective equipment (PPE) shortages caused by the COVID-19 pandemic.)

For dialysis centers

ICP concerning COVID-19 in dialysis facilities (from CMS)

HFAP has paused all survey activity through April. On April 15, we will make a decision about surveys in May. (THiS INFORMATION WILL BE UPDATED MONTHLY WHILE UNDER THE NATIONAL EMERGENCY DECLARATION.)

If it is not possible for us to complete a survey before your accreditation or certification is due to expire, provisions have been made to extend your expiration date so that neither your accreditation/certification nor your organization’s Medicare deemed status will lapse. Please reach out to your account manager directly, or to [email protected], with additional questions about your status.

Refer also to this news item.

You should submit your application on time whenever possible. If you need extra time due to the impact of COVID-19 on your organization or your community, please contact your account manager. When survey activity resumes, there will be a backlog of organizations to visit and having your application on-hand will facilitate our ability to plan and prioritize.

The clinical privileges of providers scheduled to expire during a period of national emergency (as declared by the President of the United States) may be extended for a period of 60 days. Upon activation of the organization’s Emergency Operations Plan, the governing body has the option to issue a written memorandum/resolution to extend clinical privileges of a practitioner for a specified time period unless prohibited by State regulations.
If the emergency continues beyond the time frame established for the extension, the governing body, in collaboration with the CEO, CMO, and President of the Medical Staff should reevaluate the need to continue.

Disaster privileges are one type of temporary privileges that may be granted upon activation of an organization’s Emergency Operation Plan. The hospital defines the clinical volunteers requiring disaster privileges. The hospital may use such volunteers within the scope of their license or certification.
The hospital must have a plan to verify each clinical volunteer’s identity, license, credentials, certifications, malpractice insurance, and privileges granted by other organizations, within 72 hours of activating the Incident Command Center, when possible.
This plan should provide for primary source identification from the volunteer’s hospital. A documented phone call is acceptable.
The volunteer’s identity and evidence of state professional license must be verified prior to providing patient care. Federal, local or state-based systems are used to verify the identity and credentials of health professionals, when possible.
Upon verification, temporary disaster privileges may be approved, as per the medical staff bylaws.
The medical staff must have a process to evaluate the performance of each clinical volunteer granted disaster privileges. Based on this evaluation, the hospital determines, within 72 hours of the practitioner’s arrival, if granted disaster privileges should continue.
Note: “Volunteer” refers to licensed medical professionals such as physicians, nurse practitioners, physician assistants, CRNAs, registered nurses, respiratory therapists, radiology technicians, surgical technicians, and others that come to an organization in response to a community emergency. For more information, see Acute Care Hospital standard 09.01.09 Volunteers.

Physicians and non-physician practitioners (NPP) currently credentialed and privileged by the organization do not require additional credentialing or privileging to provide the same service using telehealth technology.
Physicians and non-physician practitioners (NPP) that are not currently privileged by the organization will require credentialing and privileging prior to providing patient care using telehealth technology. The medical staff determines which services, if any, may be offered using telehealth technology. Disaster privileges may be granted for telehealth, in accordance the medical staff bylaws and state law.