HospitalInspections.org

Based in observation, interview and document review, the facility failed to provide active surveillance for COVID-19 infection when the facility failed to daily take and record temperatures of staff and visitors as part of their screening for COVID-19. This had the potential to impact staff and patients.

Findings include:

During observations on 9/16/20, at 8:00 a.m., it was observed that staff questioned visitors about their COVID-19 status, but did not actively screen visitors for fever and take and record their temperatures.

During an interview with Infection Preventionist (IP)-H, on 9/16/20, at 3:00 p.m., she confirmed that staff and visitors are were not actively screened for fever, by taking and recording temperatures. She started the hospital performed a risk benefit analysis of taking and recording temperatures and determined that since so many people who were positive were afebrile, there was a lot of expense for not a lot of benefit. Instead staff used an attestation for freedom from symptoms. In other words, each day, staff attest to the fact that they are symptom free when they clock into work and when they log onto their computers.

On 9/16/20, at 11:04 a.m. nursing assistant (NA)-M stated employees were not actively screened by another person daily for COVID-19 signs and symptoms.

On 9/16/20, at 11:16 a.m. housekeeper (H)-N stated she used to be actively screened for signs and symptoms of COVID-19 daily in her department, but had not been screened for approximately the last month and a half. H-N did not know why staff were no longer required to be screened daily.

On 9/16/20, at 12:08 p.m. emergency department technician (EDT)-Q stated staff used to be actively screened daily, but EDT-Q had not been screened for the last two months. EDT-Q explained the facility told staff to self-monitor for signs and symptoms of COVID-19, so EDT-Q would take his own temperature at work with a probe thermometer. EDT-Q thought the daily staff screenings might have been stopped because the infrared thermometers (non-contact laser thermometer that measures temperature from a distance) used for screening provided lower than accurate temperature readings, and made it difficult to tell if anyone actually had a fever.

The document provided titled NEW COVID-19 ATTESTATION, dated 8/6/20, and provided by hospital staff, was reviewed and revealed the following:

To keep our employees and patients safe, all Allina Health Employees are asked to confirm that they are asymptomatic at the beginning of their shift or work period. By badging in/logging in, you are attesting that: You are aware of the Allina Health Ability to Work Guidelines...which states you are not allowed to work at an Allina Health Facility if you have been advised to Self-Quarantine due to exposure to someone with COVID-19 or You currently have ONE or more of the following NEW/UNEXPLAINED symptoms that started within the last 72 hours:

Fever or chills
Cough
Shortness of Breath/Difficulty Breathing
Diarrhea- greater than 3 loose stools on 24 hours
Vomiting
Sore throat
Loss of smell or taste, or change in taste
Body/Muscle aches/Fatigue
Headache
Congestion/runny nose
Nausea

The policy COVID-19 Infection Prevention and Control Response Plan, dated 9/14/20, was reviewed and revealed the following:

Policy and Procedure:

14. Staff Education and Training
a. Staff should follow PPE donning and doffing tipsheets. Just in time training will be conducted when needed.
b. Staff should view donning/doffing videos
c. COVID-19 LMS with attestation is available
d. Communicate updates via safety huddle process and per site communication plan

Providing Care in a safe setting:

4. Symptom and temperature screening
a. Staff, providers, contractors, and visitors will be screened for COVID-19 symptoms and subjective or self-monitored temperature >100.0 F prior to starting their shift/visiting a patient
b. Staff and providers reporting a subjective or self-monitored temperature >100.0 F or reporting symptoms of COVID-19 will be instructed to contact the EOH COVID-19 hotline for assessment and will not be allowed to work.
c. Visitors reporting a subjective or self-monitored temperature >100.0 F or reporting symptoms of COVID-19 will not be allowed to visit patients and will be asked to leave the facility.