Hard (Non-Porous) Surfaces

If surfaces are dirty, they should be cleaned using a detergent or soap and water prior to disinfection.

For disinfection, most common EPA-registered household disinfectants should be effective. A list of products that are EPA-approved for use against the virus that causes COVID-19 is available here.

Follow the manufacturer’s instructions for all cleaning and disinfection products for concentration, application method and contact time, etc.

Additionally, diluted household bleach solutions (at least 1000ppm sodium hypochlorite) can be used if appropriate for the surface. Follow manufacturer’s instructions for application, ensuring a contact time of at least 1 minute, and allowing proper ventilation during and after application.

Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against coronaviruses when properly diluted.

Prepare a bleach solution by mixing: 5 Tbls. (1/3 cup) bleach per gallon of water or 4 Tsps. bleach per quart of water

Soft (Porous Surfaces)

For soft (porous) surfaces such as carpeted floor, rugs, and drapes, remove visible contamination if present and clean with appropriate cleaners indicated for use on these surfaces. After cleaning:
If the items can be laundered, launder items in accordance with the manufacturer’s instructions using the warmest appropriate water setting for the items and then dry items completely.
Otherwise, use products that are EPA-approved for use against the virus that causes COVID-19 and that are suitable for porous surfaces.

Electronic

For electronics such as tablets, touch screens, keyboards, remote controls, and ATM machines, remove visible contamination if present.

Follow the manufacturer’s instructions for all cleaning and disinfection products.

Consider use of wipeable covers for electronics.

If no manufacturer guidance is available, consider the use of alcohol-based wipes or sprays containing at least 70% alcohol to disinfect touch screens. Dry surfaces thoroughly to avoid pooling of liquids.

Linens, Clothing, and Other Items That Go in the Laundry

In order to minimize the possibility of dispersing virus through the air, do not shake dirty laundry.
Wash items as appropriate in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely. Dirty laundry that has been in contact with an ill person can be washed with other people’s items.
Clean and disinfect hampers or other carts for transporting laundry according to guidance above for hard or soft surfaces.

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Article provided by the American Staffing Association

State and local governments across the U.S. are issuing mandatory shutdown orders, “shelter-in-place” orders, and related interpretive guidance—all designed to immediately restrict the congregation and movement of people during the COVID-19 pandemic. These orders vary in substance and specific restrictions, but most exclude from the restrictions “life-sustaining” or “essential businesses” that may keep their brick-and-mortar offices open. Nonessential businesses must close their offices and may engage in remote work.

Many staffing firms provide temporary and contract workers to essential or life-sustaining businesses such as hospitals, pharmacies, warehouses, etc., and it is for this reason that Maryland has deemed staffing firms as essential businesses. Some state orders simply refer to the U.S. Department of Homeland Security Guidance, issued by DHS’ Cybersecurity and Infrastructure Security Agency on March 19, which identifies workers who should be considered essential to critical infrastructure across many industry sectors. In many jurisdictions’ orders, staffing firms are either omitted from lists of essential businesses (e.g., Illinois) or denoted as nonessential (e.g., Pennsylvania, which denotes “employment services” as nonessential). The question therefore becomes whether staffing firms can keep their offices open in these jurisdictions.

Some orders (e.g., New York) allow businesses that supply essential businesses with essential services to remain open, and ASA believes that a strong argument can be made that staffing firms providing workers to such business provide essential services—and thus should be allowed to keep their offices open and staff them to the extent necessary to provide those services.

Other orders do not explicitly allow for companies servicing essential businesses to remain open and, as noted, either omit staffing from their lists of essential businesses or denote employment-related services as nonessential. In such states, a conservative approach would be for staffing firms providing essential services to operate remotely to the extent possible. However, ASA recognizes that some functions, such as processing payroll, can at times require a physical presence in staffing firm offices. Firms therefore might consider using skeleton crews, for minimal times in the office, to accomplish these tasks. To the extent challenged by state authorities, such firms could credibly argue that their services are necessary for essential businesses to function, and thus the firms’ offices must be allowed to function.

Regarding temporary workers assigned to essential businesses, it would be prudent for such workers to carry with them documentation—issued either by the staffing firm or by the client—establishing that they are working for an essential business. The documentation should specify the name of the client and its essential services; it can be shared by workers with state authorities as necessary.

The foregoing issues generally have not been addressed by states or localities through formal guidance or otherwise. Therefore, staffing firms should discuss their particular circumstances and jurisdictions’ orders with their legal counsel and determine how best to function efficiently while protecting their workers and servicing their clients.

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Even the most aggressive COVID-19 strategies may not be enough to keep the hospital system from being overwhelmed during this pandemic.

Imperial College London projections from last week, while just one set of estimates among many and based largely on modeling for influenza outbreaks instead of the current facts on the ground, painted a grim picture. It found even the most aggressive mitigation strategies — general social distancing, quarantines, closing schools — would not be enough to prevent US hospitals from eventually being overwhelmed unless the country is willing to commit to these drastic measures until a vaccine becomes available.

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Key Take Aways

• Nurses are more important than ever. 
• Nurses are primarily responsible for the implementation of        isolation practices.
• Innovative approaches are needed when managing infections requiring isolation.
• Adjust workload measurements to accommodate infection prevention and control procedures.
• The classic debates (1) on transmission route and (2) on special isolation techniques may not matter in the face of insufficient clinical resources.
• Nursing and clinical healthcare support staff are needed in sufficient numbers now more than ever. 

 The COVID-19 pandemic accelerates changes already underway in the healthcare workplace. In our present situation, the complexities of caring for patients with infectious co-morbidities have increased exponentially, and the potential impact on the job functions of clinical staff and healthcare workers has never been greater. 

That said, our US-based healthcare workers already know how to handle infectious disease. Prior to our current pandemic, the daily work of healthcare professionals has been impacted by the worldwide increase in Methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and Clostridium difficile.

The recent COVID-19 pandemic is stretching our healthcare system’s ability to cope. According to a recent scientific study by Kaba et al. (2017), there are at least three main impact areas:

1. The daily work of healthcare staff has been impacted by an increased and increasing number of infections requiring isolation.
2. Nursing care and healthcare in general has expanded to include the management of multiple infectious diseases, often overloading healthcare staff and creating backlogs.
3. A 2017 case study in the American Journal of Infection Control suggests innovative approaches are needed when managing infections requiring isolation – including adjusting workload measurements to accommodate the increased time necessary for infection prevention and control procedures. 

Unfortunately, hospital and healthcare systems are often resistant to process or procedural change. In fact, the proverbial timeline between a discovery and the implementation of said discovery in clinical practice is 17 years.  In our current pandemic, this “science to service lag” could easily create significant healthcare challenges.

Backlogs and overloading of clinical staff is the inevitable result – raising concerns around the quality and continuity of care.

As Jackson and Lynch (1985) note, nurses are the persons primarily responsible for the implementation of isolation practices. In their study, two relevant themes for today emerged.  First, we have not settled the transmission question establishing the importance of the airborne route vs. the importance of contact with moist body substances.  And, second, we have not settled the question of whether special isolation techniques are needed for persons with diagnosed infections vs. the potential that all persons harbor potentially infectious agents.

All this said, the cumulative impact of additional infection prevention and control appears to result in trade-offs and cutting corners. Backlogs and overloading of clinical staff is the inevitable result – raising concerns around the quality and continuity of care. 

So, regardless of your approach or the stance you take on the above debates, what is clear is that having sufficient personnel in place is critical.  Your nursing and clinical healthcare support staff are needed in sufficient numbers now more than ever.  

Articles Cited:

A descriptive case study of the changing nature of nurses’ work: The impact of managing infectious diseases requiring isolation.

Kaba A., Baumann A., Kolotylo C., Akhtar-Danesh N.

(2017) American Journal of Infection Control, 45 (2), pp. 200-202.

Isolation practices: A historical perspective

Jackson M., Lynch P.

(1985) AJIC: American Journal of Infection Control, 13 (1), pp. 21-31

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“As a dialysis nurse, I am committed to providing excellent care and maintaining a schedule to ensure all patients receive their treatments in a timely manner.  Being on dialysis, is equivalent to a part time job, and my patients depend on maintaining a routine.  Dialysis easily takes 12+ hours out of their lives weekly.  When staffing is short, patients have to wait to begin their treatments and miss out on other planned activities.

From a provider standpoint, I start my day at 4:30 a.m. Patients begin treatment as early as 5am, and the last appointment is at 6 p.m.  Like the rest of us, healthcare providers occasionally get sick, and they need to be confident that their patients along with their teammates are being taken care of when they are unable to come to work.

Having a float pool to call when a teammate takes a leave of absence, maternity leave, and/or there is an unforeseen sickness would alleviate the stress that healthcare workers feel when these things arise.  This would help current staff, who already works long hours on their feet, not to feel helpless when a teammate is unable to work.  It would build the morale of teammates knowing that our management recognizes the work we are doing, and that there is no expectation to work when sick, work longer hours, or forgo breaks to keep up with the workload in a 12-14 hour shift.”

—  Rachael Nuscher, BSN-RN

“Dialysis Clinics have regular clients that require time-sensitive, life-saving procedures. When these procedures are not conducted according to the prescribed schedule, patients frequently require hospitalization. We are putting credentialed teams together to float in and fill crucial medically-necessary positions. Having qualified healthcare workers available and ready to go supports our hospital systems, as well as Atlanta area chronic care facilities during the present COVID-19 pandemic.”

— Maggie Deason, MS, MBA, SLP, Director Medical Staffing at OPA Staffing

“This is our opportunity to support the community during this difficult time. OPA Staffing services are an important component of helping the medical communities on many different levels. The floater pools suggested by Rachael and Maggie help keep critical procedures on schedule and support patient outcomes and comfort. Furthermore, our supporting role will help  ensure that clinic overflow does not unnecessarily burden hospitals during the current pandemic.”

— OPA Staffing CEO, Stephen E. Deason

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Amidst the uncertainty of the Corona Virus reaching pandemic status in the U.S. this week, OPA Staffing moved its offices into the strategically located Pavilion Center in Roswell, Georgia and opened its door for business. While the new location had been in the planning process for months, OPA Staffing is definitively poised to support the onslaught of medical care predicted to be needed in the oncoming weeks and months as the country gears up to battle Covid 19.

Along with the OPA Staffing offices, the building offers 24-Hour access, additional conferencing areas, and an Atrium. “The building is ideal for OPA Staffing, because it offers all the amenities to help us grow in an easy to access location,” said CEO Stephen E. Deason.

Located on the GA 400 corridor, one of the fastest growing sub-regions in the Metro Atlanta area, the office space is easily accessible from both Atlanta as well as the northern suburbs. Public transit is available on the Red Line from the North Springs Station, via the 185 Bus.

“The Red Line connection and the Medical Center Marta Station was one of the factors we took into consideration when we selected this location,” said Deason. “It is located near one of Atlanta’s major medical hubs on the northern perimeter of the city. There are dozens of hospitals including, Northside, Children’s Healthcare of Atlanta, Emory, St. Joseph, as well as many, medical offices and clinics.”

OPA Staffing provides a full range of clinical and administrative staff to facilities, including but not limited to RNs, LPNs, Vocational Nurses, Certified Nurse Assistants, Nurse Practitioners, Physician Assistants, Travel Medical Assistants, Therapists and their Assistants. They also place and hire
Rehabilitative, Respiratory, Radiology, and Laboratory Professionals; Pharmacists; Dental Hygienists and Assistants; Healthcare Administrative Personnel, and many other Allied Healthcare Administrative Personnel.
“We recruit highly-qualified, expertly-trained medical professionals with the required skills, attitude, education, experience and work ethic to meet the exacting standards of each healthcare facility,” said OPA RASA VP Systems, Lisa Wilson.

“We are committed to work collaboratively to deliver the highest level of service that meets the mission and culture of our valued clients.”

– VP Systems Lisa Wilson

The staff is trained to understand the needs of every facility or practice, including expectations, requirements, environment and organizational culture. Their team of consultants matches staffing needs with exactly the right candidate, whether it be per diem, contract staff, permanent placement, travel, or temp to perm assignments.

As a full-service recruitment/staffing agency, they understand that hiring high caliber, experienced candidates to work with patients is of the utmost importance. All candidates are properly trained, screened and credentialed, utilizing The Joint Commission Accreditation Standards and Department of Health Regulations. “We meet your staffing needs and optimize your workforce, while ensuring all staffing placements are mutually stress free for employers and candidates,” said Deason.

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