OHCA The Oregon Caregiver Fall Winter 2021

The Oregon Caregiver FALL/WINTER 2021 www.ohca.com 14 QUALITY Infection Prevention and Control: What is Here to Stay? By Linda Kirschbaum, Oregon Health Care Association I nfection prevention and control policy, safety practices, and education are essential cornerstones of quality long term care facility operations and are vital to keeping residents, staff, and families safe. Federal and state infection prevention and control standards and guidelines have been in place for decades, long before the first COVID-19 cases occurred in the U.S. Infection prevention and control standards and guidelines are continuously updated to include new treatments and evidence-based practices to prevent and control infectious diseases such as colds, influenza, norovirus, healthcare-associated infections, and, of course, now COVID-19. Over the past nineteen months of the pandemic, the long term care sector experienced a deluge of COVID-19- related infection prevention policy changes. Facility leaders and clinicians modified and operationalized new COVID-19 infection prevention stand- ards for resident care and services. Early in the pandemic, it was not unheard of to receive policy updates daily. Staying attune to and on top of regulatory changes has necessitated additional staff positions in many facilities. Infection prevention efforts are led by an infection preventionist in nursing facilities per federal Centers for Medicare and Medicaid (CMS) rules of participation. In 2022, assisted living and residential care facilities must designate an infection prevention specialist to direct infection prevention programing and education. As the pandemic moved from 2020 into 2021, we now understand so much more about COVID-19 and how to effectively respond to and prevent it. Many say the world has changed forever because of COVID-19; this will likely prove to be an undisputed statement, particularly in our sector. As we consider what changes we can expect for the long term, we must begin by asking the following questions: • What are the lessons and the silver linings from this historic public health crisis? • What are the ongoing infection prevention lessons being gleaned from the pandemic that will strengthen infection prevention and control and ultimately resident and workforce safety? Let’s consider the following. Vaccines Vaccines have been an incredibly powerful tool in the fight against COVID-19. Getting vaccinated against SARS-CoV-2 substantially reduces the risk of developing moderate or severe illness and being hospitalized or dying from COVID-19. While each of the vaccines—Pfizer, Moderna, and Johnson and Johnson—protects against COVID- 19, a small percentage of people who have been fully vaccinated can still get COVID-19, which are called break- through cases. Now, following the COVID-19 vaccine mandate for health- care workers, we know that all staff have been vaccinated against COVID-19 or have received a medical or religious exception. Resident vaccine rates hover at around 90 precent fully vaccinated. The significant drop in cases and deaths demonstrate how successful the vaccine is as an infection prevention treatment. COVID-19 vaccination protocols and practices will continue to evolve and will likely mirror influenza vaccination public health policy and programming in the future. In late fall, another evolution of COVID-19 vaccination policy took place. Pfizer vaccine booster shots were made available to Oregonians aged 65 and older, and those who live or work in a long term care facility and were opened up to all adults in late November.. A COVID-19 booster shot is an additional dose of a vaccine given after the protection pro- vided by the original shot(s) has begun to decrease over time. Typically, you would get a booster after the immunity from the initial dose(s) naturally starts to wane. The booster is designed to help people maintain their level of immunity for longer. This will strengthen the immunity of residents and staff to provide additional protection to lessen the severity of COVID-19 if they were to contract it. The long term care community and partners continue to focus efforts on getting all eligible residents and staff boosted. There are more logistics involved with boosters depending on the date of fully vaccination and the type of vaccine. Visitor Screening and Visitation Screening every individual (staff, families, visitors, vendors) entering a facility continues to be a first line of infection prevention strategy and will likely remain an ongoing prevention practice into the future. Many facilities have purchased self-check-in temperature and screening kiosks. This technology is efficient and frees up staff time to assist with resident care and services. Rapid testing can also be used, but is not required, in the screening process as well. Facility staff will have the ongoing job of monitoring visitor and resident adherence mask use, personal protective equipment (PPE) (as applicable), social distancing, and proper hand hygiene guidelines. Testing COVID-19 testing is another important tool in the long term care profession’s infection prevention toolkit. Rapid antigen tests and PCR tests will continue to assist providers with screening and identifying staff and residents who have