18 March 2020

COVID–19 Questions and Answers

Rhonda Sherriff, NZACA Clinical Advisor

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How do we support staff who are fearful and anxious?

  • Hold regular and frequent meetings to ensure staff are kept fully informed of all the latest developments from New Zealand and overseas along with recommendations from the NZ Ministry of Health(MOH)on the management of COVID-19.
  • It is essential that you continue with an open-door policy for staff to be able to access management for discussions and support about staff’s concerns regarding the virus and its implications.
  • Electronic newsletters and messages can be provided quickly to staff and this will also keep them updated and knowledgeable on how to manage any outbreak.
  • Continued updates and reminders on good infection control practices and hand washing techniques are imperative to ensure staff feel confident in their abilities to manage an infection outbreak.
  • Be supportive of staff who are sick and off work for any period of time, and ensure you provide ongoing support to them on their return to work.
  • Provide access to external independent support or EAP (Employee Assistance Programme) for staff requiring additional support.
  • Continual support and reassurance will be required for all staff during the pandemic.

Do we need to have more than the usual back up supply of medicines?

  • It is essential that you hold good stocks of the following on your sites for pandemic symptom management: paracetamol as a first line defence in managing fevers (pyrexia/high temperatures), along with other types of analgesia for pain management, antibiotics for secondary infections and other base stock medications useful in managing people with infections. Your pandemic plan should have reference to the medication stocks that should be held on your site.
  • It is worthwhile having a discussion with your facility’s dispensing pharmacy on the service that can be expected from them during a pandemic outbreak, including access to more medications should you require them on your site, and the expected speed of delivery. This will then be considered part of your pandemic planning protocol.

What do we do if we can’t access PPE from the local DHB?

  • You should firstly hold significant stocks on your individual sites for a pandemic outbreak and be continuing to order stock supplies of PPE equipment from your suppliers in the advent of an imminent viral outbreak.
  • The MOH have informed us that DHBs should have adequate supplies stockpiled. Regional DHB Infection Control personnel are contacting sites to ensure they are prepared for the viral outbreak should it occur.
  • You should also contact your regional planning and funding manager now to ascertain the availability and accessibility of their stocks to our sector along with the process to be undertaken should it be required. This may vary amongst each regional DHB. Many DHB’s are already sending out information and holding ARC meetings around the country to provide this essential information to the sector, so ensure you attend these to be kept fully informed. Should we be restricting visitor access to our facilities?
  • We recommend that you diligently screen visitors before they enter your facilities, ensuring that they have not been overseas in the last 14 days, are not feeling unwell or have COVID19 symptoms, and have not been in contact with anyone who has recently returned from overseas, or has COVID-19 symptoms.
  • You should have signage in place around all entries to your facility with the instructions to visitors clearly displayed.
  • Should New Zealand move to widespread community transmission, you will need to implement stronger restrictions on visitors, but this has not happened yet. The MOH will provide recommendations should this occur and we will keep you informed and updated. How do we get APCs for nurses who have retired?
  • The Registered Nurses themselves will need to apply to the NZ Nursing Council and provide the required information for their APCs to be renewed, prior to them making themselves available to help in a pandemic outbreak.
  • The MOH and the NZACA have already been in discussions with the Nursing Council on how to expediate the process of APC renewal for retired Registered Nurses.

How do we staff our facilities if our workers are getting sick?

  • You will need to develop a contingency plan (if not already written into your business continuity plan) that describes how the site is to provide residents care with a diminished workforce. This will include a structure of revised care delivery able to be provided with fewer staff.
  • This is an opportunity to be creative in managing the care for residents with reduced access to staff and resources. Ultimately, we will need to be able to manage our sites and resident care with the onsite resources available. When developing a plan, I recommend you consider:
  • How you manage the residents’ care in a time of pandemic outbreak. This will include a review of all service delivery (meals, cleaning, laundry, maintenance, care delivery, medication administration/management, infection control practices, activities, etc) and what you can safely reduce (or increase) without putting residents’ lives at risk.
  • How the facility runs with the least numbers of staff available (night shift) and whether this is feasible and can be modified to work over a longer period. Determine what are the resident care priorities.
  • How communicating with residents/families will occur and how this will be achieved.
  • Can your staff multi-task and if so, how? I.e. can your activity coordinator work as a cleaner or carer?
  • When rostering, is there scope to change hours of duties (longer or shorter), have teams of people sleep over, and provide meals to staff as well as residents to maintain the workforce?
  • Are there any volunteers who can assist with some tasks following full infection control training? Should I be recording where my staff have travelled to, or are travelling to?
  • Yes, you should keep a record of where staff have travelled to or are travelling to and be encouraging staff to reconsider their travel plans to destinations that would put themselves at risk.
  • You should be compiling a list of staff who have returned from overseas travel and are selfisolating for 14 days, should the MOH or government departments require this information.
  • As with all pandemic and infection outbreaks you will be required to submit a list of affected staff (and residents) to the Public Health Department.

Will my insurance cover me for having to pay staff to self-isolate for 14 days when they only get 5 days sick leave?

  • Most insurance companies do not provide cover for pandemic outbreaks in their insurance policies and have a clause that precludes them from having to pay out cover in this type of situation, however this is individual to each facilities/company’s policy.
  • I recommend that you read your insurance documents clearly, especially the fine print regarding pandemic outbreaks and clarify with your individual insurer whether they cover this type of event, or not.
  • Refer to the Government’s Employer COVID-19 wage subsidy and leave payment scheme announced on 17 March 2020.

Rhonda Sherriff
NZACA Clinical Advisor