Thursday, September 24, 2020
DR EPIC Newsletter
For Arizona SNFs Regarding Emergency Preparedness Infection Control
Overview of the Disaster Ready Emergency Preparedness & Infection Control (EPIC) Program
Hopefully, you received a letter announcing the new EPIC program. Just in case you missed it, here is a video introduction to it. Basically, it will consist of four major components, targeting skilled nursing throughout the state:
  1. Analysis of infection control trends identified in ADHS surveys and a deep dive into facility assessments and how they properly reflect infection control practices.
  2. Targeted evaluation of the value of NHICS and other tools as implemented during the COVID- 19 pandemic.
  3. Education and technical assistance with industrial hygiene and facility sanitation. We will also be developing a portfolio of online resources in all of these subject areas.
  4. Establishment of an EPIC Helpline (See below).
DR EPIC Helpline Established
EPIC@azhca.org or 602-241-4644
Do you have questions about infection control clinical or regulatory guidance? Or facility sanitation or industrial hygiene? Well, we've established an EPIC Online Help Center to answer those questions. If you have any questions about infection control you can email the EPIC online Help Center at EPIC@azhca.org. You can also call the DR EPIC phone Helpline at 602-241-4644 and we will assist you.
September is National Preparedness Month
National Preparedness Month is recognized each September to promote family and community disaster planning now and throughout the year. As we continue to respond to COVID-19, there is no better time to be involved and prepared. Check out our Disaster Ready website at www.disasterreadyaz.org for resources to guide you in your preparedness efforts.
Meet Derrick Denis, DR EPIC Industrial Hygiene Expert
One of the key objectives of the EPIC program is to provide facilities with support in infection control from an industrial hygiene perspective. We know that facility sanitation practices are essential in protecting residents from the transmission of COVID-19 and other infections. Derrick Denis CIAQP, CAC, CIEC, Vice President of Indoor Environmental Quality for Clark Seif Clark, Inc. has been engaged to assist our members in addressing these very concerns. Meet Derrick in this video profile. Derrick will assist in answering your EPIC HELPLINE questions, so bring them on!
We Need your Feedback on the Disaster Ready Program
Since 2011, AHCA has been funded by ADHS to assist skilled nursing facilities in Arizona to prepare, respond and recover from emergencies and disasters.  To help evaluate this program, we are asking providers and appropriate staff to complete this short questionnaire to identify program strengths, gaps and opportunities for improvement. Please distribute this questionnaire to key people within your facility or organization who have participated in Disaster Ready training so they can answer some simple questions and provide us with valuable feedback. Please complete this by September 25, 2020 and contact Krysten Dobson, Disaster Ready Program Manager at kdobson@azhca.org with any questions. Thank you for your support of the Disaster Ready program!
Legionella and Legionnaire’s Fact Sheet
Germs are everywhere, even in the water we drink. Water systems in skilled nursing facilities can be complex and underused. Managing the health of your water systems is critical to protecting the health of your occupants and staff. Legionellosis, like many other diseases, disproportionately affects the immunocompromised (e.g. the sick and aged). Make sure you establish a team to address Legionella in your facility planning on a recurring basis. For more on Legionella prevention and response, see our EPIC Fact Sheet on Legionnaire's Disease, visit one of the other resources available through the EPIC program, or reach out to one of our EPIC consultants directly. To learn more, check out the fact sheet.
Information courtesy of Derrick Denis, EPIC consultant
Transmission-Based Precautions
  • Do you have the appropriate transmission-based precaution signage outside the resident room that is on isolation precautions? Does the signage indicate precaution type, i.e., droplet, contact, airborne?
  • Who is in charge of ensuring the isolation bin is always fully stocked?
Recommendations:
  • Ensure that the Isolation bins are always fully stocked.
  • Consider utilizing signage that indicates the type of isolation and the PPE requirements.
  • Consider placing instructions for donning and doffing on resident room door. https://www.cdc.gov/hai/pdfs/ppe/ppe-sequence.pdf
Information courtesy of Buffy Lloyd-Krejci, EPIC consultant
Here is a recent question answered by the DR EPIC Helpline.

Q. Can you help clarify the 28 day isolation requirement from Maricopa County? When would the first day of the isolation begin?
 
A. The Maricopa County guidance states that if a facility has a resident that develops COVID-19 in the building (not admitted with and not acquired within the first 14 days after admission) the facility is required to use COVID-19 isolation precautions for all residents, until 28 days have passed with no new cases. Please see below:
 
“Isolation of residents without respiratory symptoms or laboratory-confirmed COVID-19 can be lifted after 28 days (2 maximum COVID-19 incubation periods) have passed with no new cases identified in the facility who might have been exposed in the facility (i.e., resident was in the facility at any point during the 14 days before they became symptomatic/were tested). This does not include those who were known to be positive upon admission.” Here is a link to this guidance.
Questions? Contact EPIC@azhca.org |This program is funded by ADHS HPP
The Disaster Ready Emergency Preparedness Infection Control (DR EPIC) program provides education and technical assistance for skilled nursing providers throughout the state. Individual providers will need to exercise their independent discretion in how to apply this information and technical assistance to the unique operation of each facility. For that reason, a facility’s of its professional judgment and due diligence in utilizing the program for infection control and risk management practices is solely within the facility’s control for which it is entirely responsible. 
Copyright 2020.