During these difficult times, it is critically important to decrease the risk of resident and staff exposure to COVID-19. The nature of what we do day-to-day lends itself to risk so it might be time to step back and re-evaluate how we do things as this is how “we have always done it” may not be an option anymore. There is no time like the present to take action and decrease the risk of spreading infection!
If your center has operated in “silos” it is time to come together as an interdisciplinary team and brainstorm! Consider compiling a list of all duties that are performed when staff goes into a resident room. Yes, interdisciplinary, nursing, housekeeping, laundry, environmental, social service, activities, everyone! What is it that each of us does, and can we consolidate these services to limit the number of times we enter a resident room? Remember, some residents may have specific needs that need to be addressed individually however, generally speaking, we can make a difference by proactively identifying ways to meet these needs more efficiently.
Train nursing staff be thinking more globally when entering a resident room to assess vital signs and administering medications. Step away from the “task at hand” and maybe enter the room with a fresh container of ice water and TWO straws instead of one? We can also take this opportunity to check on other resident needs such as toileting, grooming, tidying the room, gathering needed items for the resident, i.e., remote control, tissues, wastebasket, phone, writing paper, and pen, as well as independent activity items. Oh, and don’t forget to do the same for the roommate even if it isn’t time for their medications!
Remember, we are in a crisis situation and need to have an “all hands on deck” approach. We may need to perform tasks that might be outside of the “norm”. For example, it might not be the housekeeping staff who are disinfecting doorknobs, faucets, floors, picking up and emptying wastebaskets, etc., it might be you, so be sure all staff are educated on COVID housekeeping protocols.
Specific examples below:
- Using hydration carts? Consider engaging residents in meaningful solo activities by stocking the carts and offering recreational activity items:
- Crossword puzzles
- Books on tape
- Ask the resident what they would like and assist in gathering the items
- Universal Caregivers? Train direct care staff on the concept so that during the provision of care they can assist with:
- light housekeeping
- inventory essential supplies, i.e., Kleenex, etc.
- check closets for clothing needs/laundry
- Restock soap dispenser and paper towels
- Provide hand sanitizer at the bedside
- Ask the resident if they need anything specific
“Normal” housekeeping should still be performed at least weekly and include a deep cleaning of bathrooms, high touch surfaces, etc. Consider scheduling deep cleaning to be performed on resident shower days so the resident is out of the room, decreasing exposure.
- Afternoon/Evening care? This might be a good time to assist residents with technology to assist them in staying connected with family and friends and/or “surf” and quiet time activities:
- Face Time
- Online classes
- Activities/games on-line, i.e., solitaire, etc.
- If available, assist with other “online” activities provided by the state/city/towns. Deliver requested supplies as identified during morning care.
- Serving meals to rooms? Assess vital signs, change in condition (Stop and Watch tool), include extra ice water, hand wipes, etc. If ancillary staff are assisting with meal delivery encourage them to engage the resident in conversation, topics of interest, current events, asking if they have been in contact with family, etc.
- Struggling with activities/isolation: Consider “doorway” games, Bingo, Jeopardy, do “mail call” and get everyone involved. Prepare handwritten postcards for each resident in the event everyone doesn’t receive mail from outside and won’t feel left out.
- Holistic approach? Train our staff to tune into the “whole resident” and each time they respond to a call light, meet the residents’ needs and remember NEVER leave the room without asking “is there anything else you need or would like”? This will give your residents a feeling of comfort and security.
Remember, interdisciplinary team approach, as care needs increase, non-direct staff should be assisting CNAs and nurses with performing non-clinical tasks, answering call lights, making beds, etc. to allow CNAs/nurses to have time to meet “hands-on” care needs.