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2019n-CoV Infection Prevention Playbook

Associate Workflow

Last update: 5/22/2020 1:30 PM

The 5/22 Update includes:

Added 3M Reusable Respirators (pgs. 17-33)

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Table of Contents

Important IDPH Information Related to COVID-19 for Associates ................................................................................... 3

AMITA Health COVID-19 Exposure Guide ................................................................................................................... 4

Returning from Travel.................................................................................................................................................... 8

Returning to Work ......................................................................................................................................................... 9

COVID-19 Screening Guidelines ................................................................................................................................... 12

How to save a link to your device................................................................................................................................. 13

COVID-19 Travel Algorithm .............................................................................................................................................. 14

Work Disruption Pay Continuation ............................................................................................................................... 16

3M 6000 Donning Doffing Respirator ........................................................................................................................... 17

3M 6000 Series Associate Guide .................................................................................................................................. 18

3M 6000 Series Half Facepiece Flyer ............................................................................................................................ 25

3M 6000 Series Inspection Cleaning............................................................................................................................. 28

3M 6000 Wear It Right ................................................................................................................................................ 29

3M 6000 Series Reusable Respirator-Disinfection Process ............................................................................................ 30

3M 6000 Series Masks Procedure ................................................................................................................................ 31

3M 6000 Worker Acknowledgement ........................................................................................................................... 33

Address and Phone List ................................................................................................................................................ 34

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IMPORTANT IDPH INFORMATION RELATED TO COVID-19 FOR ASSOCIATES Important IDPH Information Related to COVID-19 for Associates

AMITA Health has updated its guidance regarding COVID-19 testing for associates, including medical and non-medical staff. The new guidance is based on recommendations from the Illinois Department of Public Health (IDPH).

IDPH recommends against testing people with mild illness who can be safely managed at home -- unless they have an underlying health condition (such as chronic lung disease, COPD, asthma, diabetes or hypertension) that might impact patient management. This will minimize possible exposures and potential spread of COVID-19, influenza or other viruses to co-workers, patients and the public. For people with mild illness, rest is more important than testing.

If you are symptomatic and would like to be tested, please contact your local Associate Health Office for direction. All health care workers are at some risk for exposure to COVID-19, whether in the workplace or in the community.

Therefore, IDPH is asking ALL health care workers, regardless of whether they have had a known COVID-19 exposure, to self-monitor by taking their temperature twice daily and assessing for COVID-19-like illness.

In addition, our Associate Health Department has issued the following guidance for associates exposed to

someone with COVID-19: ● Do not furlough based solely on exposure to someone with COVID-19. Associate Health will assess if you

need to be tested and whether you can safely work with a mask and symptom monitoring. ● If you have signs and symptoms (fever >99.5, new cough, shortness of breath, sore throat) before work, do

not come to work. Notify you manager and Associate Health. If you are concerned about signs and symptoms, call your primary-care physician.

● If you have signs and symptoms (fever >99.5, new cough, shortness of breath, sore throat) during work, notify your manager and go home immediately. Call your primary-care physician if you are concerned about your signs and symptoms.

● If you go home, do not return to work until (1) ten days or more after illness onset, or three days or more after fever resolution, whichever is longer, (2) resolution or improvement of respiratory symptoms, (3) notification and approval from Associate Health and your manager. If you have questions, talk with your manager, or call Associate Health. Do the same when you are ready to return to work.

● If you have questions about pay, talk with your manager or your local human resources director, or call rHR at 888-629-6424.

Your health and safety are of paramount concern to AMITA Health, and we will closely monitor IDPH and the

Centers for Disease Control for any new COVID-19 guidance. We expect the guidance to change from time to time as this

rapidly changing situation continues to evolve and as advances in treatment emerge, and we will update you promptly

about any new developments.

We also will keep you updated about guidance we now are finalizing to assist leaders in developing the best

process in their respective areas for conservation, distribution and tracking of surgical masks across AMITA Health.

Conservation of masks and other personal protective equipment (PPE) will be essential as we prepare for a possible surge

of COVID-19 patients amid a national PPE shortage.

In addition, we plan to send you more information soon about additional COVID-19 tools and screening options.

For now, we urge all of you to monitor your health closely as you continue to help others in the days and weeks

ahead. Thank you for everything you are doing to care for our patients and to protect our community during this

difficult time.

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AMITA Health COVID-19 Exposure Guide March 26, 2020

The purpose of this document is to assess the infection prevention risk of associates who may be exposed to patients with COVID-19, and to provide

guidance regarding any subsequent work restrictions.

A medium-risk exposure is defined as a close contact with a confirmed COVID-19 patient with incomplete Personal Protective Equipment (PPE) not in

an aerosol – generating procedure.

A high-risk exposure is defined as close contact with a confirmed COVID-19 patient during an aerosol- generating procedure and the full

recommended PPE were not in worn.

Epidemiologic risk factors

Exposure

category

Recommended Monitoring for

COVID-19 (until 14 days after

last potential exposure)

Work Restrictions for Asymptomatic

HCP

Patient care with aerosol-generating procedures

HCP PPE: Any variation that does not include

the full recommended PPE (respirator, eye

protection, gown, gloves)

High Active monitoring Exclude from work for 14 days after last

exposure or return to work with a mask*

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Patient care with no aerosol-generating procedures

HCP PPE: None High Active Monitoring Exclude from work for 14 days after last

exposure or return to work with a mask*.

HCP PPE: No N95 or mask worn (but HCP was

wearing eye protection, gown, and gloves)

Medium Active Monitoring Work with 14 day active monitoring and

mask

HCP PPE: No eye protection worn (but HCP was

wearing mask, gown, and gloves)

Medium Active Monitoring Work with 14 day active monitoring and

mask

*Based on the staffing at the different facilities, if there is a shortage related to furloughing, high-risk exposure HCPs who are asymptomatic and on

furlough, may return to work with a properly worn mask at all times in addition to daily active monitoring at time of work. The decision will be made by

the local incident command center in conjunction with Associate Health after weighing the risks to patients and caregivers.

**** Any questions, please contact Associate Health or your local Incident Command

Definitions Used in this Guidance

Health Care Personnel (HCP) - All employed and non-employed individuals providing services for the health ministry. Self-monitoring means people should monitor themselves for fever by taking their temperatures twice a day and remain alert for cough or difficulty breathing. If they feel feverish or develop measured fever, cough, or difficulty breathing during the self-monitoring period, they should self-isolate, limit contact with others, and seek advice by telephone from a healthcare provider to determine whether medical evaluation is needed.

Active monitoring means communication occurs at least once each day. The mode of communication may include telephone calls or any electronic or internet-based means of communication. Aerosol-generating procedure: Procedures that generate aerosols that include positive pressure ventilation (BiPAP and CPAP), endotracheal intubation, airway suctioning, high frequency oscillatory ventilation, tracheostomy, chest physiotherapy, nebulizer treatment, sputum induction, and bronchoscopy. Close contact is defined as: a) being within approximately 6 feet (2 meters) of a COVID-19 case for a prolonged period of time (>2-3 minutes); close contact can occur while caring for, living with, visiting, or sharing a healthcare waiting area or room with a COVID-19 case or b) having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on)

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Returning from Travel

Q: I am returning from level 3 travel location as designated by the CDC, and/or I had a

stopover in a level 3 location. Do I need to be furloughed?

A: Yes, health care workers who have traveled directly to a level 3 location as

designated by the Centers for Disease Control or had a stopover in a level 3 location will

need to be FURLOUGH IMMEDIATELY FOR 14 DAYS even if they are asymptomatic.

Q: Who can I contact with questions about my pay?

A: Questions about your pay, please contact HR/Benefits. 888-629-6424, option 2

Q: What steps do I need to take when returning to work after Domestic Travel within

the 48 states?

A: You will need to self-monitor twice daily for 14 days once BEFORE you leave from

home to work and then in the evening. You are to check both temperature and signs of

COVID-19 (sore throat, body aches, fever >99.5, new cough, shortness of breath).

If asymptomatic, you may work.

If you become symptomatic before work, remain at home and contact you manager and call

your local Associate Health office.

If you become symptomatic during work, notify their manager and immediately go home.

Call your local Associate Health Office

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Returning to Work Q: When can I return to work after being sick? A: Associates may return to work after illness:

• At least 3 days (72 hours) have passed since recovery defined as resolution of fever

without the use fever reducing medication AND there must be resolution or improvement of respiratory symptoms (cough, shortness of breath); AND

• 10 days since symptoms first appeared.

Q: When can I return to work after a confirmed positive, but I didn’t have any symptoms of COVID? A: Associates will remain off from work for 10 days from the date of their first positive COVID 19 test if you have not become ill since the date of your test.

• In both instances, Associate Health will help manage your return to work sooner when safely possible.

Return to work Practice and Work Restrictions . Q: Who should I notify? • Notify you’re your manager and local Associate Health when you are ready to return to work.

Q. What do I need to do?

• Wear a facemask at all times while in the healthcare facility. A facemask in preferred over a

home-made face cloth during this time while you are recovering.

Q: Do I need to do any self – monitoring after my illness? A: You will continue to self-monitor for signs and symptoms and seek re-evaluation if your symptoms recur or worsen. BEFORE you leave from home to work and then in the evening. You are to check for both temperature and signs of COVID (sore throat, body aches, fever >99.5, new cough, shortness of breath, loss of taste or smell). You will need to avoid caring for immunocompromised or vulnerable patients until you complete your 14 monitoring and may have to wear a mask.

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Testing Q: Do I need to be tested if I have mild symptoms? A: The Illinois Department of Public Health feels most illness caused by coronavirus is mild and does NOT recommend testing patients with mild illness who can be safely managed at home, unless they have a diagnosis that will impact patient management such as significant health histories. If you have no symptoms, testing in not recommended. Q: What if I have a high-risk condition such as Diabetes, Asthma, COPD, hypertension, obesity or I am pregnant and having symptoms of COVID19?

A. Please contact your local associate Health who will provide direction on being tested.

Q: What if I have symptoms of COVID 19 and have concerns about people in my home?

A. Please contact your local associate Health who will provide direction on being tested.

Q: Are there any special precautions for Pregnant Health Care workers? A: Information is very limited on how COVID-19 will affect pregnant health care workers. It is recommended to consider limiting exposure of pregnant health care workers to confirmed or suspected COVID-19 patients. Especially during higher risk procedures (e.g. aerosol – generating Procedures) if feasible based on staffing. Health Care workers who have concern can apply for an accommodation through rAMITA.

Monitoring Q: What type of monitoring should I be doing? A: Every day before you leave home for work you must assess for symptoms of COVID and take your temperature. If you don’t have any symptoms or fever, you may report in to work.

• Associates can either use a paper tracker form available through Associate Health or your manager. Or you may use an electronic COVID 19 Screening application developed for monitoring of health care workers on any smart phone.

COVID 19 Screening Application

Ascension has developed an application to help associates and the organization monitor the health of health care workers. (Instructions on the following pages.) AMITA Health has adopted this process and if you have a smart phone you should use the application daily before you leave home for work.

The link or QR code will bring you to a web page that may be used on any android or

iPhone. There is now a version in the Spanish language. http://ascn.io/AscensionScreen Each time the application is used, it transmits back to Associate Health.

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• The tool awards a different color code each day to associates deemed healthy and

ready for work.

• Show the color code on your smartphone to the screener

• Take temperature and be granted access to the ministry.

• When you are ill or have symptoms COVID you will receive a message you are not

approved to work. You will;

• Notify your manager

• Stay at home

• Receive a link to report temperature and other symptoms twice

daily. This information is uploaded to a dashboard monitored by

Associate Health nurses who will contact you during your

recuperation.

• The application can be saved on your smart phone screen for ease of daily use.

See the following pages for more information.

• If you do not have a smart phone, you may track you symptoms on a paper form available

through Associate Health or your manager.

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COVID-19 Screening Guidelines

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How to save a link to your device

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COVID-19 Travel Algorithm

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COVID-19 Response

March 22, 2020 | 4:30 PM

Guidance for AMITA Associate Pay Continuation in Response to COVID-19

Distribution of this communication to AMITA Executive Leadership: Ministry Market Executives, Clinical

Leadership Team, Operations Leadership Team, AMG Dyad Leaders, Chief Clinical Officers, Chief

Nursing Officers, Chief Medical Officers, Regional Compliance Officers, Chief Strategy Officers, and

Human Resources Leadership.

As cases of COVID-19 increase across the country, AMITA continues to diligently monitor the situation to

ensure we are protecting our associates, patients, medical staff and the communities we serve. The

following guidelines are intended to provide direction and assist leaders in helping to mitigate the impact

to those associates and their families directly or indirectly affected by this crisis. These guidelines are

subject to change as our response to the pandemic evolves, and apply only to the specific situations

outlined below:

1. Furlough Pay Continuation Due to Exposures

Assessment

Associate Health should be notified of any potential social- or work-related COVID-19 exposures.

Upon notification, Associate Health will complete an assessment to determine appropriate

management of potential exposure. The assessment will determine whether the associate can

return to work with self-monitoring or must remain off work with self-monitoring. An associate

who is asymptomatic and was on furlough may return to work wearing a mask at all times in

addition to conducting daily active monitoring while at work. The return to work decision will be

made by the local incident command center in conjunction with Associate Health.

Note: This Guidance for AMITA Associate Pay Continuation in Response to COVID-19 is subject to change based

on CDC guidance and AMITA’s discretion.

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If it is determined that the associate is not able to return to work, the following compensation

procedures will apply:

Work-related Exposure

● An associate directed to not return to work following a work-related exposure will self-

monitor for a period of up to 14 days and the following guidelines will apply:

○ If the duties of the associate’s position allow, the associate will work remotely until

cleared to return to work.

○ If the duties of the associate’s position are not able to be performed remotely, the

associate will be eligible for pay continuation. These hours should be entered using

the PANDEMIC FURLOUGH Kronos pay code for both exempt and non-exempt

associates.

● If an associate becomes positive for COVID-19 due to a work exposure, the case will

transition to Associate Health and a Worker’s Compensation (WC) claim will be

opened and pay continuation will be pursuant to our WC program.

Community-related Exposure

● An associate directed to not return to work following a social/community-related

exposure will self-monitor for a period of up to 14 days and the following guidelines

will apply:

○ If the duties of the associate’s position allows, the associate will work remotely

until cleared to return to work.

○ If the duties of the associate’s position are not able to be performed remotely,

STD Claim and/or PTO would be used per plan rules.

■ Associates will be eligible for a PTO advance, up to a maximum of 80 hours

(prorated by FTE), which allows them to go into a negative PTO balance

situation. The paycode for this PTO advance is PTO ADVANCE. The

paycode will be available starting on the 3/22/2020 pay period and should

only be used after exhaustion of already accrued PTO.

● If an associate becomes positive for COVID-19 due to social/community-related

exposure, continue with a potential STD claim (regardless if the 14-day self

monitoring is complete).

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Work Disruption Pay Continuation

These guidelines apply to associates whose hours are reduced, or regular

duties/assignments discontinued, as a result of the impact that COVID-19 is having on

AMITA workforce staffing, particularly in response to decisions to reduce elective and non-

urgent cases. Please note, these guidelines are subject to change, at the Employer’s

discretion, as the response to this pandemic evolves.

Specific decisions about closures and/or reduced hours will be made by individual Ministry

Market and System leaders and should be aligned with local, state and federal guidelines

and recommendations. We will continue to monitor the situation and determine if changes to

these decisions are warranted.

It is very important to understand and communicate to associates that accepting

reassignment to provide staffing coverage to other areas during this time of national crisis, if

asked, is a condition to receive pay continuation. If reassignment is not available, the

associate will be eligible for pay continuation as described below.

Pay continuation will be provided for all full-time and part-time associates based upon the

associate’s scheduled hours, including PRN associates who have worked on average at

least .4 FTE during the previous six months.

Pay continuation shall begin effective March 16. The ongoing need for pay continuation shall

be reviewed by the manager on a weekly basis and aligned with the operational decisions of

each Ministry Market and System leadership. Pay continuation includes any multiple

components of pay, but does not include special or premium pay, such as shift, holiday, or

weekend differentials. Multiple components of pay are added to base pay in some ministry

markets to pay for float, PRN, special schedules, career ladders, certifications, etc. Eligibility

for associate benefits will continue during any pay continuation period.

If an associate refuses an alternate work assignment for which they are able to perform the

essential duties with or without accommodation, the associate will not be eligible for pay

continuation. The associate may use PTO based upon the associate’s standard scheduled

hours but will not be eligible for PTO ADVANCE.

Pay continuation hours will be entered by the manager. These hours should be entered using

the PANDEMIC PAY CONTINUATION Kronos pay code.

If an associate is reassigned, they will clock in and clock out as normal. Their time needs to

be transferred to the reassigned business unit and department.

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3M 6000 Donning Doffing Respirator

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3M 6000 Series Associate Guide

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3M 6000 Series Half Facepiece Flyer

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3M 6000 Series Inspection Cleaning

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3M 6000 Wear It Right

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3M 6000 Series Reusable Respirator-Disinfection Process

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AMITA Health

Associate and Occupational Health 3M 6000 Series Masks Procedure

DISTRIBUTION

• Priority to frequent N95 users and/or high-risk situations or those with poorly fitting disposable N95

masks. High risk/ high volume users include but not limited to the ED, ICU, COVID Units, Respiratory

and Laboratory. Includes physicians in these areas.

• As masks become available, they can be provided to those areas with limited, but direct patient care

to COVID + patients.

• Masks are not approved for Surgical Areas.

• Automated spreadsheet for tracking mask distribution

o Enter the fit test into Pure OHS –Under Fit testing

• Have worker sign the acknowledgement form.

Medical Evaluation

• Current medical evaluation may be used for the 3M 6000.

Fit Testing

• Fit testing must occur to validate a comfortable fit and seal.

• If the mask is not fitting well, you can move to another size mask.

• The failed mask needs to be cleaned and reprocessed before it can be used again.

User Education and Training

• Provide the worker a training video or handout on proper use of the mask.

• 3M 6000 Series Half Facepiece Respirator Training Presentation

• 3M™ 6000 Series Half Facepiece Respirator with 7093 Filter (Assembly, donning and

doffing)

• Interim Disinfection 3M™ 6000 Series Half Facepiece Respirator (Features two filter

types)

Key Item for worker education.

• Maximum use of filters – 3 months or if they get wet or issues with airflow

• Daily Cleaning process

o Wipe down at shift end, air dry according to the wipe used, leave them in their locker, they should

not take them home, they should not leave the hospital unless they are floating to another

AMITA Ministry.

o Each site is using their own cleaning products which are available

o Follow manufacturer recommendations

o No alcohol

o Bleach wipes are fine; follow dwell time

o If sensitivity exists, wipe down with plain water after cleaning and appropriate dry time.

o Label filters with name and date of needed filter change (relabel if ink comes off during

cleaning)

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o Replacement parts and strap information in table below.

o Advise the worker they need to educate the patient they are working with of the mask to decrease

patient anxiety; perhaps post pictures

o Mask must be returned to facility upon termination

o skin protection products

o Mepilex Lite might be applied to nose bridge to help prevent skin breakdown

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3M 6000 Worker Acknowledgement

Associate Health

OSHA Mandatory FIT testing form (In Compliance with revised OSHA Respiratory Protection Standard 1910.134)

Associate Information:

Name__________________________________________________

DOB___________________ or Associate ID#_____________________

3M 6000 series mask size:

6100, Size Small

6200, Size Medium

6300, Size Large

I did watch and read all the educational materials provided to me by my manager, and I

understand that I take the responsibility of taking care, properly storing, cleaning and

maintained on my 3M 6000 series mask.

I understand that I am responsible for the mask while it is in my possession, and I will make

sure that the mask always remains at my ministry. I will not mark or stick labels on the mask,

and store as instructed.

Upon my resignation or leaving I will return the mask to my manager. (Manager to return to

AH)

I understand that my department is financially responsible if the mask is lost or stolen.

Associate signature: ___________________________ Date: _____________

(AOH to attach to fit test form upon receipt)

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Address and Phone List

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