May 2, 2022
To protect both residents and health care personnel it is crucial for Nursing Homes to have a strong Infection Control and Prevention program. Taking necessary precautions to help mitigate the risk of COVID-19 transmission continue to be extremely important.
Upholding a robust Infection Control and Prevention practices in the facility will facilitate in protecting both residents and staff from serious infections, hospitalizations, and death since not all LTC residents and staff are up to date on their COVID19 vaccinations, making it likely for them to still become infected by visitors and interactions in the community. Furthermore, individuals can spread COVID-19, which include new variants, despite being vaccinated and up to date with COVID-19 vaccinations (IDPH, 2022).
The Core Principles of COVID-19 Infection Prevention
- Vaccination (e.g., getting boosters/being up to date)
- Source control (masks, face coverings, and other respiratory protection)
- Resident and staff testing
- Hand hygiene (use of alcohol-based hand rub and/or frequent handwashing)
- Physical distancing (e.g., 6 feet away from others)
- Appropriate use of personal protective equipment (PPE) – (gowns, gloves, well-fitted facemasks, N95, eye protection – face shields or goggles)
- Instructional signage throughout the facility and communication
- Infection prevention and control education and competency
- Cleaning and disinfecting high frequency touched surfaces and equipment (e.g EPA list N of cleaning products)
- Appropriate ventilation and engineering controls to improve air quality (e.g., outdoor air. MERVs filter)
- Effective cohorting
Anyone entering the facility, regardless of their vaccination status, must screen via electronic monitoring system. Individuals who meet any of the following criteria needs to be managed accordingly:
1) a positive viral test for SARS-CoV-2
2) symptoms of COVID-19, or
3) persons who meet criteria for quarantine, isolation, or exclusion from work.
Symptomatic Healthcare personnel regardless of their vaccination status should report if they meet the criteria mentioned above and be restricted from work until they have been thoroughly evaluated.
Any visitors meeting any of the above criteria are restricted from entering the facility until they have met criteria to end isolation or quarantine. They must follow the quarantine and isolation guidance for LTC residents and NOT the shortened CDC time periods for the public.
Newly Identified Positive Case in an HCP or Resident
Due to the of the risk of unrecognized infections among HCP or residents, any single new case of COVID-19 in HCP or resident is evaluated as a potential outbreak.
There will be an Increase monitoring and screening of all residents and HCP for signs and symptoms of COVID-19 from daily to each shift to swiftly identify those with new symptom onset until there are no more positive cases for 14 days.
Contact tracing is completed per IDPH recommendation ensure all high-risk exposures or potential close contacts are identified and tested.
The facility has two options for outbreak investigations to determine which approach to use.
- Unit-based approach involves contact tracing to help identify any high-risk exposures in HCP or close contacts in residents. This requires testing to be done on ALL residents and HCP working on the unit where the new case was identified. An additional testing and contact tracing may be required if the investigation spread out beyond the affected unit.
- Broad-based approach involves contact tracing to identify any high-risk exposures in HCP or close contacts in residents AND testing is undertaken on all residents and HCP in the facility.
- Visitors who are unwilling or unable to adhere to the core principles of COVID-19 infection prevention and control should not be permitted to visit or should be asked to leave.
- If a resident’s roommate is not up to date with COVID-19 vaccinations or immunocompromised (regardless of vaccination status), visits should not be conducted in the resident’s room, if possible.
- Executive Order 22-06 has lifted the universal face covering requirement for the public effective February 28, 2022. However, all individuals regardless of vaccination status shall continue to be required to wear a face covering in health care facilities such as long-term care facilities.
- Visitors, regardless of vaccination status, should wear source control and physically distance themselves from other residents or HCP.
Indoor Visitation During an Outbreak
- While it is safer for visitors not to enter the facility during an outbreak, visitors must still be allowed in the facility.
- Visitors should be made aware of the potential risk of visiting during an outbreak and adhere to the core principles of infection prevention.
- If residents or their representative would like to have a visit during an outbreak, they should wear well-fitting masks during visits regardless of vaccination status.
- Visits should occur in resident rooms rather than public areas on the affected unit(s).
Illinois Department of Public Health. (2022, March 22). Updated Interim Guidance for Nursing Homes and Other Licensed Long-Term Care Facilities. https://dph.illinois.gov/content/dam/soi/en/web/idph/covid19/guidance/ltc/LTC-Guidance_03.22.2022.pdf
From Sunny Hill Administrator Maggie McDowell
Dear Residents, Family Members and Community Friends,
A year in reflection, and where to begin. 2020 a year that as with every New year started out with so much promise and optimism. Little did anyone know what lay ahead, how events that will forever be studied and imbedded in history, began to unfold in front of our eyes and we were all part of the unfortunate cast.
In March the World Health Organization (WHO) declared a worldwide pandemic and a Public Health Emergency (PHE) and since then life as we knew it changed forever. Kirkland Nursing Home in Washington, DC, heralded the plight of all nursing homes into the spotlight and concurrently it felt like someone flipped a switch and everything was different, Coronavirus, no indoor visitation, wearing masks, screening, social distancing, telemedicine, PUI – Person Under Investigation, isolation precautions and if this myriad of life altering events wasn’t enough a whole new vocabulary emerged too.
We were all in a state of disbelief and longed for things to return to “normal” the normal and familiar life we knew pre Covid-19, but the realization quickly revealed itself. Covid-19 or SARS Cov-2, a respiratory type illness is not a transient phenomenon but something that has continued to prevail and claim the lives of 361K Americans and 1.8 M lives globally.
Despite many challenges we have all learned so much in a short span of time. We started to speak a whole new language including Phases of Reopening, Phases of Mitigation, Testing and Response Strategy and a whole host of new processes and procedures came barreling down the pipeline.
In the mean-time Sunny Hill staff continued to care for and support our residents and their families and we have all pulled together to navigate this storm. New focus areas have emerged requiring attention. IDPH has developed and outlined guidance regarding a new program to facilitate “Essential Caregiver” involvement in resident and person centered care. These “Essential Caregivers” are not considered visitors but individuals essential to residents well-being. In light of Covid-19 duration and residents being unable to experience life as they knew it with obvious adverse effects IDPH took a deeper dive into effects and implications and devised some guidelines for facilities. Sunny Hill is in the process of adopting, developing and implementing these guidelines and initiatives. Additional information will be shared at a future date.
Sunny Hill kicks off the New Year on a very positive note with our first Covid-19 Vaccination Clinic for residents and staff occurring on January 5th, in the Main Dining Room starting at 9:00am – 6:00pm. Sunny Hill has partnered with Walgreens to administer vaccinations with subsequent follow up clinics occurring on January 26th and February 16th, 2021. Based on some raw data it appears that approximately 70% or so of residents have consented to receive the Pfizer vaccine.
Sadly, we also remain mindful of the many friends and family members that we have lost this last year, and our deepest sympathies are extended to their loved ones. We were also able to welcome many new friends into our lives, and want to express our gratitude to those that entrust us to care for them. We will continue to celebrate each other and the gifts we bring to our extended family relationships.
Thank you to our family members, visitors, volunteers and community friends for their support and friendship as it has truly meant so much during these difficult times for all. We appreciate the love and support extended and displayed in so many different ways.
May health and wellness be with you and your families throughout 2021. Please stay physically distant but socially connected.
Maggie McDowell, Administrator
Coping with Stress due to Covid-19
The last few months have brought dramatic changes to all our lives, from how we do our shopping to how we connect with our family members and friends. Each of us is likely to experience different degrees of stress as a result of the impact of COVID -19 on our lives. Here are some ideas based on several articles as well as my own experience working with Sunny Hill residents to help you identify and cope with the symptoms of stress you or your family members may be facing.
Identify the signs and symptoms of stress
The symptoms of stress can be physical as well as emotional and can include:
- Sadness (including feeling grief over what has been taken from you due to COVID -19)
- Worry/racing thoughts/trouble concentrating/loss of energy
- Changes in sleep and eating patterns
- Relationship problems
- Physical symptoms including headache, teeth clenching and muscle aches
- Increased use of alcohol and tobacco
Acknowledging that what you are feeling is stress and talking about your experiences and emotions helps to validate that these emotions are real and allows you to take the steps to manage them. Note that if any of these symptoms are persistent or interfering with your daily functioning (eg. ability to work, study) please contact your health professional.
Identify what you can control and let go of what you can’t
While we can’t control the choices of other people we can control the choices we make to maintain our safety, such as practicing good hygiene, wearing masks and social distancing. Educate yourself on the latest about the virus through reputable sources. If thoughts about the future and what might happen become overwhelming steps to ground yourself in the present can be helpful. These may include deep breathing, distracting yourself by engaging in an activity like coloring, and reminding yourself that you have overcome difficult times in the past. The three coping strategies listed below are all helpful to manage stress and ones that I also review with residents here at Sunny Hill.
Engage in Self Care
Taking time every day for yourself allows you to recharge your emotional and physical batteries to best be able to manage stress successfully. Strategies may include:
- Physical activity – Walking, exercise, yoga, playing with a pet
- Meditation, prayer or engaging in another kind of spiritual devotion, journaling what you are grateful for
- Crafts, puzzles, reading, games (alone or with family)
- Learning a new hobby or skill
- Maintaining a daily routine
Moderate your Media Consumption
Watching news reports for hours every day can be emotionally draining, so try to limit your media time over the course of the day and note if your stress symptoms increase while watching and step away from the television, radio or computer!
Maintain Social Connections while Social Distancing
While we may not be able to get together in person staying in touch with family and friends remains important to our emotional well being. Strategies may include:
- Phone calls or video chats
- Window visits
- Writing letters or cards
- Sending along or bringing some pictures or reminiscing can be great ways to spend a visit or additions to a card and can spark conversations within the facility as well!
- SAMHSA Taking Care of Your Behavioral Health – PEP20-01-01-007_0.pdf
Karen Nekolny Smith, Psy.D.
Licensed Clinical Psychologist