Coronavirus Update – April 15, 2020

Your Coronavirus update for April 15

More than 2 million cases of coronavirus (COVID-19) have been diagnosed as of Monday evening, including nearly 119,000 deaths. Healthcare officials in the United States have reported more than 682,000 positive COVID-19 patients and more than 23,000 deaths. 

Online Assessment Tool Intends To Assist Hospitals With COVID Emergency Nurse Staffing

The Academy of Medical-Surgical Nurses (AMSN) has launched an online assessment program intended to help healthcare facilities to appropriately place newly hired staff members and contingent healthcare providers in suitable roles that match their overall skillset.

The self-assessment tool, a free service offered by AMSN officials, is designed to match roles with where needs are most significant by evaluating the competence of this new workforce and assigning professionals to the appropriate patient assignments or tasks that are based on individual level of practice. 

“Within the healthcare industry, this is an unprecedented time for hospital administrators and human resources,” said Terri Hinkley, EdD, MBA, BScN, RN, CAE, AMSN’s chief executive officer. “To help fill in their frontlines, they are looking to retired RNs, nurses from other specialties, and even students to support. This tool will help those making these staffing additions much easier, as administrators will find out where their contingent staffers’ strengths lie and what knowledge they have in med-surg, so they can assign them accordingly.” 

The tool functions by asking individual contingent nurses to complete a 20-minute online self-assessment survey, which they are asked to print or email and submit to the appropriate manager. The competencies used in the self-evaluation survey are based on an extensive literature review, evaluation of current medical-surgical nursing role descriptions, and the practice of medical-surgical nurses from a variety of geographic, institution and practice settings, according to AMSN officials. The organization reportedly worked with a taskforce of med-surg nurses from around the country and additional consultants on measurable competencies for nurses at all experience levels to develop the tool.

The tool is available at www.amsnstaffingtoolkit.org. Users are asked to complete and submit a form, and then receive a link with instructions on how to proceed. According to Hinkley, institutions are instructed to make decisions that align with their own internal policies and procedures. Those organizations that utilize the tool are also asked to provide feedback.

Guidance Released For Respirator Reuse & Extended Use

Officials at the ECRI Institute, Plymouth Meeting, PA, have announced newly updated clinical evidence assessment related to the potential risks and benefits of reusing N95 respirators or utilizing the instruments for extended use during the COVID-19 pandemic. The announcement comes as a means to guide practical decision-making for healthcare providers.
With published clinical studies not available to assess the safety of reuse and extended use during critical shortages, officials examined more than 20 laboratory studies that may provide a rational basis for actions during a crisis. Limited evidence from the studies supports prioritizing extended use over reuse because N95s may readily spread infection by touch if donned and doffed and are prone to mechanical failure upon reuse, ECRI officials said. The studies, which reportedly tested more than 30 respirator N95 models, found that covering respirators with surgical masks had no clinically significant effect on breathing effort and gas exchange. Decontamination of N95 respirators by steam, disinfectants such as bleach, or ultraviolet germicidal irradiation may be safe and effective in some settings. However, each method must be tested on each model because model materials vary, according to ECRI officials. Evidence supports prioritizing N95 extended use over reuse because of the following reasons:1

  • The reported pathogen transfer risk from N95s is high by contact, but low by aerosol.
  • Use of surgical masks or similar disposable covers over N95s during extended use are unlikely to result in significant adverse effects.
  • Mechanical failure with only a few reuses was common among N95s cleared for medical use by the U.S. Food & Drug Administration.
  • Commonly effective disinfection methods can achieve adequate disinfection, with some filter performance loss.

ECRI’s clinical evidence assessment “Safety of Extended Use and Reuse of N95 Respirators” is available online.1

A study that could determine those individuals who have been infected with COVID-19 and potentially immune to the virus is expected to be launched by Beaumont Health in Michigan, a state with the third-highest number of confirmed coronavirus cases in the country, according to recent reports. The Washington Post is reporting that the study is believed to be the nation’s largest test for novel coronavirus antibodies and that the information could steer public health officials’ decisions about reopening United States society.2

Blood samples from nearly its 40,000 hospital employees and thousands of additional physicians and affiliates will reportedly be tested in the voluntary collection. The study could shed light on how extensively the virus has circulated in the U.S. and who may have immunity. Tests will assess for disease-fighting proteins and could identify asymptomatic people, those who had mild symptoms that may have been mistaken for another illness, and those who were known to be sick with the virus and recovered. 

According to the Post report, critical medical and public health decisions could be impacted. Additional insight into how the virus spreads and why some people develop severe illness could also be gleaned. Beaumont officials have reportedly validated the antibody test on a group of 1,000 participants, and the full results of the study are expected to be published by the researchers. Volunteers are currently being recruited and researchers reportedly anticipate the work to be completed by the end of May, according to the Post report. Participants who are found to have high levels of antibodies may be able to donate blood plasma to assist current patients with the U.S. Food & Drug Administration reportedly approving “convalescent plasma transfusion,” a technique that has also been used to treat measles, polio, mumps, and influenza, as a therapy for patients.

References
1. Safety of extended use and reuse of N95 respirators. ECRI. 2020. Accessed online: https://assets.ecri.org/PDF/COVID-19-Resource-Center/COVID-19-Clinical-Care/COVID-ECRI-N95-Respirators-updated.pdf

  1. Harris S. Michigan hospital system will test workers’ blood in effort to help reopen country. Washington Post. 2020. Accessed online: www.washingtonpost.com/health/michigan-hospital-system-will-test-workers-blood-in-effort-to-help-reopen-country/2020/04/13/20830

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