대한의료관련감염관리학회 Korean Society for Healthcare-associated infection Control and Prevention.

pISSN 0705-3797. eISSN 2586-1298.

Table. 4.

Table. 4.

Coronavirus disease 2019 (COVID-19) outpatient dialysis facility preparedness assessment tool*

1. Infection prevention and control policies and training for healthcare personnel (HCP): Completed In progress Not started
Facility leadership including, but not limited to, the Chief Medical Officer, quality officers, medical directors, facility administrator, nurse manager, infection prevention personnel, chief operating officer, nephrologists, nurse practitioners has reviewed the lefts for Disease Control and Prevention's COVID-19 guidance for dialysis facilities
Facility provides education and job-specific training to HCP regarding COVID-19 including:
Signs and symptoms of COVID-19
Importance of hand hygiene, respiratory hygiene, cough etiquette and wearing a facemask
Use of personal protective equipment (PPE) including competency evaluation
Triage procedures and patient placement
Institutions’ policies for HCP sick leave
Self-monitoring for fever or respiratory symptoms
Report system of patients who are COVID-19 suspected or confirmed
Facility provides education to patients about the following:
Symptoms of COVID-19 and how COVID-19 is transmitted
Importance of immediately informing HCP if they feel feverish or ill
Infection control guidance (e.g., hand hygiene, covering their cough, maintaining and wearing a facemask)
Actions the facility is taking to keep the dialysis procedures safe (e.g., visitor restrictions, changes in PPE)
2. Process for rapidly identifying and isolating patients with confirmed or suspected COVID-19:
Facility has provided prior education to patients not to visit dialysis facilities if they have fever or respiratory symptoms, or has prepared with process to check patients by calling ahead and asking them to report fever or symptoms of respiratory infection
Installation of selective care left
Signs are posted in triage areas (e.g., at entrance, and in waiting areas) advising patients with fever or symptoms of respiratory infection to immediately notify triage personnel so appropriate precautions can be put in place
Facemasks are equipped to all patients upon entry to the facility and kept on until they leave the facility
Alcohol based hand sanitizer for hand hygiene is available at each entrance, in waiting areas and near treatment stations
Facility has space of waiting area for ill patients (to sit separated from other patients by at least 2 meters)
Facility has a process to ensure patients with confirmed or suspected COVID-19 are placed in the appropriate isolation area
Facility has a process in place for immediate notification of facility leadership when a suspect case is identified
Facility has a process to notify local or state health department of a suspect case
3. Patient placement:
Confirm the number and location of available isolation rooms in the facility
Facility has an isolation room for patients with undiagnosed respiratory infection
If an appropriate isolation room is unavailable, facility has a designated dialysis station(s) at a corner or end-of-row, away from the main flow of traffic, separated by at least 2 meters from nearest patient (in all directions), to dialyze a masked symptomatic patient
Facility has a plan for cohorting patients and HCP if they are dialyzing multiple patients with suspected or confirmed COVID-19 [e.g. in the same section of the unit and/or on the same shift - consider the last shift of the day]
Facility has plans to minimize the number of HCP who enter the isolation dialysis room (or isolation station) (e.g., having dedicated HCP to care for patients with suspected or confirmed COVID-19)
4. Transmission-Based Precautions: Completed In progress Not started
Facility has a procedure for supplying and assessing of personal protective equipment (PPE) and other infection prevention and control supplies (e.g. hand hygiene supplies)
Facility has a contingency plan to optimize PPE use during shortages
Facility is providing all staff with face covering or face masks that are to be worn at all times while in the facility
HCP receive appropriate training on selection and proper use of (including putting on and removing) PPE with a required demonstration of competency
Facility has a process for auditing HCP adherence to recommended PPE use
5. Movement of patients with confirmed or suspected COVID-19 within the dialysis facility:
Process of patient movement to the isolation room (isolation station) or other institutions when COVID-19 suspected or confirmed patients were reported within the dialysis facility
Patient will be asked to wear a facemask
6. Hand hygiene (HH):
HH supplies including alcohol-based hand sanitizer are readily accessible in patient care areas, including areas where HCP put on and remove PPE
Facility has a process for auditing HCP adherence to recommended hand hygiene practices
7. Environmental management:
Facility has a appropriate guideline to ensure proper cleaning and disinfection of environmental surfaces and equipment in the patient isolation room or station
All HCP in the dialysis facility understand the environmental management guideline and the instructions for use and contact time for selected products
Disinfectants used in dialysis facilities must be approved by health authorities
Facility uses disinfectants that are effective on bloodborne pathogens (HBV, HIV)
8. Monitoring and managing HCP:
Facility has sick leave policies for ill healthcare personnel (HCP) or those who reported they have symptoms to stay home
Facility has a process to conduct active-and/or self-monitoring of HCP
Facility has a process to conduct symptom and temperature checks of HCP prior to the start of the shift
9. Visitor access and movement within the dialysis facility:
Facility has a plan to restrict or monitor visitors from entering the facility
Visitors entering the facility will be required to wear a facemask at all times
Visitors are screened for symptoms of acute respiratory infection before entering the facility
10. Facility maintains situational awareness of COVID-19 at the national level:
Facility regularly monitors the situation on COVID-19 which are reported at the national level
Facility checks which institutions to contact within the local area that are available for treatment and hospitalization of COVID-19 patients
Facility maintains the system to cooperate with local health authorities

* Based on Coronavirus disease 2019 (COVID-19) outpatient dialysis facility preparedness assessment tool from Centers for Disease Control and Prevention in 2020.

Korean J healthc assoc Infect Control Prev 2020;25:11~20 https://doi.org/10.14192/kjicp.2020.25.1.11
© Korean J healthc assoc Infect Control Prev