Last week we wrote about how to manage the first hour of a Covid outbreak. This week we have some tips to help you with the following 23 hours. While there have been a number of resources developed for helping to manage the first 24 hours, they're often a little overwhelming and hard to implement.
The Bug Control team thought that we'd expand a little on the major steps to help you anticipate the difficulties you might face while trying to manage a COVID outbreak.
Disclaimer: The order of tasks over the next 23 hours needs to be in line with your facility’s procedures.
1. Contact trace affected staff and residents and check vaccination status
You need to know who was potentially exposed to the affected resident and/or staff members, so contract tracing is crucial.
2. Arrange for staff and resident testing
The PHU will advise you so don’t jump ahead if you are unsure. They will also advise whether testing will be via RAT or PCR.
3. Have your first Outbreak Management Team (OMT) meeting
Your staff meetings and the Outbreak Management Meeting are separate although the information will be shared from both meetings. You will potentially feel overwhelmed with the tasks needed to be completed but this is an essential meeting to guide you through this outbreak, and especially the first 24 hours.
Take the relevant documents and information you have gathered and the checklist to help you organise your thoughts and ask the questions you need answers to.
4. Plan your staff roster
Once you have an idea of the potential impact of Covid in your facility, you can start planning staff rostering. Review your workforce management plan and make sure you are using your workforce as efficiently as possible. Consider options such as using furloughed staff and volunteers to relieve duties from the onsite staff or to run errands. If you can’t safely cover the roster, you will need to escalate.
5. Activate your communication plan
Your OMP should have a communication plan. You will need to notify the local PHU and Commonwealth Department of Health to meet your obligations and access government support. You may also need to report positive cases to WorkSafe. A strong communication plan and timely execution will have a direct effect on the high volume of calls and media contact – if people feel informed, they are less likely to call for reassurance.
6. Maintain and organise leadership structure for continuity of care (IPC lead)
Your OMP should specify the command-based governance structure to be implemented during an outbreak. Senior leadership should be onsite at all times, and there should be comprehensive handover information that is suitable for shift changes and relief staff.
7. Maintain prior care routines and social contact
Feelings of disconnection and uncertainty can have a direct impact on resident health. It’s crucial that as much normality is maintained as possible, where staffing levels allow. Social contact should continue where possible, and use technology facetime, zoom to make contact more accessible.
8. Cohort and zone
Saying this is easy, but doing it presents a variety of struggles. Cohorting with reduced staffing is difficult. It’s hard enough to move the resident and all their belongings when you don’t have the manpower, but you also need to reduce anguish and confusion for an already compromised resident. This is a situation you need to address at the time with the support of the Outbreak Management Team and PHU.
9. Improve PPE and environmental cleaning
The environment is an important part of infection control management. Cleaning needs to be increased in line with your OMP. Cleaning staff also need to cohort, so remember there may be further training required for staff who are covering for others or who are new to the facility. Make sure the staff and the cleaning staff are aware of their roles and responsibilities when it comes to cleaning isolation rooms, zones etc.
10. The rest of the facility
When managing the first 24 hours it is easy to forget that there is still a facility full of residents needing clinical governance and routine cares, meals, showers, wound care etc. Consider who can provide this and give clear instruction regarding the identification and reporting of symptoms from all residents.
These can be ready in advance and ready to go. A clear and simple outline of the floor plan of your facility is essential. You can also include resources to support the potential of a surge workforce, associated policies and procedures with the OMP. Having them in one place as printed copies will be an advantage.
If you have a fatigue management plan refer to this and start putting actions into place. Ask the questions how much sleep they had. Was it good sleep? Managing the roster and ensuring the staff you do have are not compromised is key.
Don’t underestimate the impact on the wellbeing of the staff. We are all fighting our own war, as they say, and this event will have an effect on staff members’ resilience.
Stay up to date
As we said in the beginning, it seems information changes hour to hour so assign a staff member download the app and stay up-to-date with the changes as they happen.
Remember all good emergency advice starts with putting the oxygen mask on yourself first. Managers need a support person assigned to them for the Covid event and their hours and their wellbeing must be an equal priority.
Managing outbreaks is stressful. Having the right tools and processes in place makes a big difference. If your facility needs better processes or more infection prevention support, call Bug Control. From staff education to facility audits to comprehensive policy manuals and guides, we have a range of resources to help you stop infections.
Don’t take our word for it. Here are some more resources so that you can be ready when COVID comes to your facility:
- Watch our short video on managing the first 24 hours of a Covid outbreak
- Sign up for our IP Lead Programme (including a free one-month trial)
- The Australian Government 'First 24 hours – managing COVID-19 in a residential aged care facility' checklist