HospitalInspections.org

Based on observations, interviews, and record review, the hospital failed to employ the methods for preventing and controlling the transmission of COVID-19 as per the CDC's recommendation when no dedicated staff assigned to care for the patients with suspected or confirmed SARS-CoV-2 infection and no social distancing implemented, creating the risk for spreading of the pandemic infection.

Findings:

According to the CDC's Coronavirus Disease 2019 (COVID-19) Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic updated 7/15/20, the recommended infection prevention and control practices when caring for a patient is suspected or confirmed SARS-CoV-2 infection include the following:

* If admitted, place a patient with suspected or confirmed SARS-CoV-2 infection in a single-person room with the door closed. The patient should have a dedicated bathroom. Airborne Infection Isolation rooms (AIIRs) should be reserved for patients who will be undergoing aerosol-generating procedures.

* As a measure to limit HCP exposure and conserve PPE, facilities should consider designating entire units within the facility, with dedicated HCP, to care for patients with suspected or confirmed SARS-CoV-2 infection. Dedicated means that HCP are assigned to care only for these patients during their shift.

Further review of the CDC's Coronavirus Disease 2019 (COVID-19) Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic showed the recommended routine infection prevention and control practice during the COVID-19 pandemic include to encourage physical distancing. Physical distancing (maintaining six feet between people) is an important strategy to prevent SARS-CoV-2 transmission.

1. On 7/7/20 at 1320 hours, a tour of the ICU was conducted with the Liaison Officer. Three patients were identified in three different private rooms (ICUs 3, 6, and 8). The doors of ICUs 3, 6, and 8 were closed with the signage posted by the door. The carts full of PPE supplies were observed at the doors of these rooms.

Review of the CCU Staff Assignments dated 7/7/20, showed the following:

* RN 1 was assigned to care for two patients who were in ICUs 3 and 6. These patients were positive for COVID-19.

* RN 3 was assigned to care for two patients who were in ICUs 8 and 2. The patient in ICU 8 was positive for COVID-19. The patient in ICU 2 was not positive for COVID-19.

* RN 2 was assigned to care for two patients who were in ICUs 1 and 5 after transferring the patient who was PUI from ICU 4 to other unit.

In a concurrent interview with the ICU Manager, the ICU Manager confirmed three patients who were in ICUs 3, 6, and 8 were positive for COVID-19; and one patient in ICU 4 was a PUI for COVID-19 and transferred out to the medical-surgical unit.

On 7/7/20 at 1630 hours, the Operations Section Chief and Liaison Officer acknowledged there was no dedicated staff in the designated COVID-19 unit due to limited staffing.

2. On 7/7/20 at 1320 hours, a tour of the hospital was conducted with the Liaison Officer. The following was identified:

* In the staff lounge of the Golden Year unit, there were four chairs surrounding the 4X4 ft. table and two more chairs at the end of the break room.

* In the hospital's cafeteria, the chairs and tables were not arranged to provide 6-ft distancing. There was no 6 ft social distancing maintained for the line to the cafeteria cashier. Without wearing mask and social distancing, the HCPs were observed sitting and eating together as a group.

The Liaison Officer acknowledged the COVID-19 infection could be spread by someone who had no symptoms and did not know that they were infected. The Liaison Officer stated that was the reason why it was important for everyone to wear masks in the public settings and practice social distancing.