1. Adhere to established practices and guidelines.

Here are the basics:

Follow the Centers for Disease Control and Prevention’s COVID-19 guidelines. And ensure the bathing environment is as germ-free as possible by using only Environmental Protection Agency-registered disinfectants recommended for SARS CoV-2, the virus that causes COVID-19, advises Connie Steed, RN, MSN, CIC, FAPIC, president of the Association for Professionals in Infection Control and Epidemiology (APIC).

And don’t assume manufacturers are experts, either, stresses  Patricia Howell, RN, BSN, WCC, CFCS, clinical support manager for McKesson Medical-Surgical Extended Care. In other words, do your own homework. 

But using recommended chemicals is only half the battle.

“Properly cleaning hygiene equipment is not easy, but it’s a lot easier than treating an infection or virus,” says Len Sears, director of sales, Lopital Showering Solutions at ProCare Medical. He suggests thorough cleanings between each shower or bath, ending each day with a comprehensive cleaning focusing on the hard-to-reach-and-clean areas.

Mary Madison, RN, RAC-CT, CDP, clinical consultant-LTC/Senior Living for Briggs Healthcare, urges common sense. “I recommend diligent and frequent cleaning of areas like door handles in and out of bathing rooms — after each resident bath,” she says. “Don’t forget towel racks and bath chairs.”

2. Ensure supplies are kept in stock.
The completion of bathing is no time to discover there’s no replacement for the mask that just fell into bath water.

As Howell points out, the CDC guidance for pandemic preparation recommends facilities maintain six to eight weeks of certain supplies, although “few nursing homes have followed that recommendation.” One frequently overlooked supply item, unfortunately, is body bags, several sources have noted.

A majority of personal protective equipment is manufactured in the Hubei Province of China, and after almost two months of a manufacturing hiatus, it created supply chain challenges for the industry, acknowledges Stacy Rubenstein, public relations manager for Medline Industries, which continues to explore “innovative ways to bring greater quantities of urgently needed facemasks” to nursing homes.

3. Beware of cutting corners or taking shortcuts.

While it may be tempting to opt to provide a quick shower, where aerosolizing is minimal, a COVID-19-positive resident could spread the infection on surfaces after touching their T-Zone or coughing, says Howell. Bathing basins are another problematic infection source.

“Most people want to do the right thing. But on shower days when residents are lined up for their shower, staff may cut corners during cleaning and disinfecting,” she adds. “It is important to keep up the staff’s training and retraining when your healthcare workers make missteps.”

4. Anticipate rule changes.

They’re already underway, according to Sears, noting that the QAPI components in the requirements of participation for infection prevention “sets the bar. Moving forward, facilities will have to continually improve.”

“Nursing homes are under the microscope more than ever,” adds Howell, citing the new COVID-19 Focused Survey for Nursing Homes. Howell also believes F880 Infection Control continues to be one of the most-cited F-tags for nursing homes. 

For now, “there is an expectation that the guidance already in place for cleaning and disinfection between each resident is being followed,” observes APIC’s Steed. “This standard likely will not change, but there could be more emphasis on it in the future.”

5

 Professionals agree: There’s no such thing as too much training.

“The care that we provide every single day in every single long-term care or assisted community means the world to our residents and their families,” says Madison. “We may be afraid right now, but we need to dig deep and remember our training and our commitment to the work we do. Our residents depend on us.”

Madison urges caregivers to “work smart and remember that we are the families for these residents now. Remember these days and their challenges. When this emergency passes — there will likely be something new down the road and we’ll be ready for that challenge.

“Something else will arrive down the road to test our mettle,” she adds. “What we learn from this will guide changes to infection prevention and control — hopefully, with the focus on more prevention. The survival of our society depends on it.”