NEW: Ventilator basics for the non-ICU nurse - a super basic quick reference!
Introduction to Respiratory Support (basics)
Recommended PPE for healthcare workers
The Royal College of Physicians. Video guide: An expert update for health professionals from
What Nurses Need to Know to be Prepared. By Dr. Tener Goodwin Veenema, Expert in Disaster Nursing and Public Health Emergency Preparedness, Associate Professor, Johns Hopkins University. Recommended by The American Association of Colleges of Nursing. 26th February 2020.
Making Informed Decisions in Responding to COVID-19. As the academic nursing community prepares to address the Coronavirus outbreak, AACN has consulted with experts is disaster planning on how nursing schools can maintain quality programs while keeping students, faculty, and staff safe. Please join us for the first webinar in our new series on COVID-19 featuring one of the nation’s leading experts on overcoming public health threats. The discussion will center on AACN’s newly released guidelines for schools to consider related to emergency preparedness and response. Please note login is required.
General guidance for health professionals by the UK Government
In 11 languages, inc. English, Arabic, Chinese, Hindi, Japanese, Khmer, Korean, Russian, Somali, Spanish, Thai and Vietnamese. By Washington State Department of Health.
Guidance for people with confirmed or possible coronavirus infection by the UK Government. This document superseded the specific guide for nurses on 12th of March.
What nurses and health professionals can do to safeguard against the virus. By American Federation of Teachers.
By the USA’s OSHA.
Guidance and Resources on Infection Control. By the USA’s CDC.
Clean Hands Count for Safe Healthcare. By the USA’s CDC.
What you need to know about handwashing. By the USA’s CDC.
Role of Inanimate Surfaces
Guidance for disinfection and sterilization in healthcare facilities. Summary is here.By the USA’s CDC. Last updated 2018.
Potential role of inanimate surfaces for the spread of coronaviruses and their inactivation with disinfectant agents. G. Kampf (2020), The Journal of Hospital Infection.
Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents. G. Kampf, D. Todt, S. Pfaender, E. Steinmann (2020). Journal of Hospital Infection.
🇬🇧🔗Find your local health protection team in England
Protecting your local team in England by the UK Government.
Protecting your local team in Scotland by the UK Government.
Protecting your local team in Northern Ireland by the UK Government.
Protecting your local team in Wales by the UK Government.
WHO’s Q&A on infection prevention and control for health care workers caring for patients with suspected or confirmed 2019-nCoV. Are boots, impermeable aprons, or coverall suits required as routine personal protective equipment (PPE) for healthcare workers (HCW) caring for patients with suspected or confirmed 2019-nCoV infection? Can disposable medical face masks be sterilized and reused? Do patients with suspected or confirmed 2019-nCoV need to be hospitalized if they have mild illness? Here you will find answers to these and other questions related to infection prevention and control for health care workers caring for patients with suspected or confirmed 2019-nCoV.
Exploring the reasons for healthcare workers infected with novel coronavirus disease 2019 (COVID-19) in China. Jiancong Wang, Mouqing Zhou, Fangfei Liu D (2020), The Journal of Hospital Infection.
COVID-19 in medical personnel: observation from Thailand. Viroj Wiwanitkit (2020), The Journal of Hospital Infection.
Integrated infection control strategy to minimize nosocomial infection of corona virus disease 2019 among ENT healthcare workers. Dan Lu, Haiyang Wang, Rong Yu, HuiYang, Yu Zhao (2020), The Journal of Hospital Infection.
What should I do if I think I have been exposed to or infected with COVID-19? Alert your healthcare provider immediately if you think you may be infected with COVID-19, including if you have been exposed to someone with the virus and have signs/symptoms of infection. If you are experiencing symptoms, you should tell your healthcare provider about any recent travel to areas where COVID-19 is spreading. If you believe you have been exposed on the job, alert your supervisor or occupational health clinic immediately. By the USA’s OSHA.
Document, data template and data dictionary. WHO’s Health workers exposure risk assessment and management in the context of COVID-19 virus. This tool is to be used by health care facilities that have either cared for or admitted COVID-19 patients; it is to be completed for all health workers who have been exposed to a confirmed COVID-19 patient in a healthcare facility. It will help determine the risk of COVID-19 virus infection of all HCWs who have been exposed to a COVID-19 patient and then provides recommendations for appropriate management of these HCWs, according to their infection risk.
Employer Obligations to Protect Employees from Coronavirus. By the USA’s Employers Council.
Highlights OSHA standards and directives (instructions for compliance officers) and other related information that may apply to worker exposure to novel coronavirus, COVID-19.
WHO guidance: Rational use of personal protective equipment for coronavirus disease 2019.
Personal Protective Equipment recommendations. By the USA’s CDC.
Open source COVID-19 medical equipment requirement.
Hospital PPE. Infection control: donning and doffing. University of Nebraska Medical Centre.
How to put on personal protective equipment (PPE)
FFP3 Donning & Doffing (PPE)
Quick guide for removal of personal protective equipment (PPE)
FAQ about using respirators.By the USA’s CDC.
WHO’s advice on the Use of Masks. This document provides rapid advice on the use of medical masks in communities, at home and at health care facilities in areas that have reported outbreaks caused by the 2019 novel coronavirus (nCoV). It is intended for public health and infection prevention and control (IPC) professionals, health care managers, health care workers and community health workers.
Experts explain necessary respiratory protection for COVID-19. By the Centre for Infectious Disease Research and Policy (CIDRAP).
Association between 2019-nCoV transmission and N95 respirator use. Xinghuan Wang, Zhenyu Pan, Zhenshun Cheng (2020), The Journal of Hospital Infection.
CMS’s key protective mask guidance for healthcare workers.
From : Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill
Adults with Coronavirus Disease 2019 (COVID-19)
A comprehensive guide on how to reuse and disinfect respirator.
In order to Preserve the PPE supply, the following is guidance for the Safe Reuse Strategies for N95 Masks:
PPE: practice, overthink your movement and anticipate to the max.
Before: eat, drink, pee
UK Coronavirus action plan. As of 2rd of March 2020.
How are Hospitals Preparing for COVID-19? A podcast from the John Hopkins Hospital.
Coronavirus hospital preparedness tool by CDC.
The UK’s NHS visitor guidance. It applies to all inpatient, diagnostic and outpatient areas.
Healthcare Personnel Preparedness Checklist for COVID-19. Front-line healthcare personnel in the United States should be prepared to evaluate patients for coronavirus disease 2019 (COVID-19). The following checklist highlights key steps for healthcare personnel in preparation for transport and arrival of patients with confirmed or possible COVID-19. By Centre for Disease Control and Prevention (CDC).
This checklist is adapted from a variety of HHS Pandemic Influenza Pandemic Planning resources. It is not intended to set forth mandatory requirements by the Federal government. Each jurisdiction should determine for itself whether it is adequately prepared for disease outbreaks in accordance with its own laws and authorities. We strongly encourage continued review of HHS’ Centers for Disease Control (CDC) COVID-19 guidance which is available on their website for the most current information. By HHS.
The USA’s CDC. COVID-19 Preparedness Checklist for Nursing Homes and other Long-Term Care Settings. There is a recent addition to the above listed below:
COVID-19 is being increasingly reported in communities across the United States. It is likely that SARS-CoV-2 will be identified in more communities, including areas where cases have not yet been reported. As such, nursing homes should assume it could already be in their community and move to restrict all visitors and unnecessary HCP from the facility; cancel group activities and communal dining; and implement active screening of residents and HCP for fever and respiratory symptoms.
WHO’s early investigation protocol. The recent emergence of COVID-19 means that understanding of transmission patterns, severity, clinical features and risk factors for infection remains limited, whether among the general population, for health workers or in household and other “closed” settings.
Studies to assess the epidemiology and clinical characteristics of cases in different settings are therefore critical to furthering our understanding of this virus and associated disease. They will also provide the robust information needed to refine the parameters to feed in forecasting models.
These protocols and forms have been designed so that data can be rapidly and systematically collected and shared in a format that facilitates aggregation, tabulation and analysis across different settings globally. We encourage any and all countries and study centres to contribute to this effort regardless of resource availability or patient volume. The ownership of the primary data remains firmly with the individual countries/sites. Here is a summary:
Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings by CDC:
Initial investigation of possible cases. By the UK Government.
A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus infected pneumonia (standard version). Published by Military Medical Research. 2020.
Making decisions about Covid testing and treatment. By Eric J. Rubin, M.D., Ph.D., Lindsey R. Baden, M.D., and Stephen Morrissey, Ph.D. (2020).
Experience of different upper respiratory tract sampling strategies for detection of COVID-19. By Guangming Ye, Yirong Li, Mengxin Lu, Song Chen, Yongwen Luo, Shichan Wang, Yejingpeng Wang, Xinghuan Wang (2020), The Journal of Hospital Infection.
Diagnosis of SARS-CoV-2 infection based on CT scan vs. RT-PCR: Reflecting on experience from MERS-CoV. Jaffar A. Al-Tawfiq, Ziad A. Memish (2020), The Journal of Hospital Infection.
Primary care guidance for Healthcare professionals. Last updated 25th of February 2020.
Clinical Care Guidance. By the USA’s CDC.
Disposition of Hospitalized Patients with COVID-2019. By the USA’s CDC.
🇺🇸📺COVID-19 How to Use One Ventilator to Save Multiple Lives
How to use one ventilator to save multiple lives. By Dr. Charlene Irvin Babcock.
Inpatient Obstetric Healthcare Guidance. By the USA’s CDC.
WHO’s clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected. This document is intended for clinicians taking care of hospitalised adult and paediatric patients with severe acute respiratory infection (SARI) when a nCoV infection is suspected. It is not meant to replace clinical judgment or specialist consultation but rather to strengthen clinical management of these patients and provide up-to-date guidance. Best practices for SARI including IPC and optimized supportive care for severely ill patients are essential.
Acute respiratory distress syndrome: Clinical features, diagnosis, and complications in adults. By Mark D Siegel, MD (2020).
Ventilator management strategies for adults with acute respiratory distress syndrome. Acute respiratory distress syndrome (ARDS) is a form of lung injury that is associated with a high mortality. Mechanical ventilation and supportive therapies are the mainstays of treatment. The ventilator strategies used to treat ARDS are reviewed here. In general, these recommendations are in keeping with those issued by several society guideline groups. The non-mechanical ventilation related aspects of ARDS management are discussed separately. See "Acute respiratory distress syndrome: Supportive care and oxygenation in adults". By Mark D Siegel, MDRobert C Hyzy, MD (2019)
Prone ventilation for adult patients with acute respiratory distress syndrome. Invasive mechanical ventilation is traditionally delivered with the patient in the supine position. Prone ventilation is ventilation that is delivered with the patient lying in the prone position. Prone ventilation may be used for the treatment of acute respiratory distress syndrome (ARDS) mostly as a strategy to improve oxygenation when more traditional modes of ventilation fail (eg, lung protective ventilation). The physiologic effects of, selection of patients for, and the outcomes associated with prone ventilation are reviewed here. By Atul Malhotra, MDRobert M Kacmarek, PhD, RRT (2019)
Guidance for healthcare professionals on coronavirus (COVID-19) infection in pregnancy, published by the RCOG, Royal College of Midwives, Royal College of Paediatrics and Child Health, Public Health England and Health Protection Scotland. Last update 13th of March 2020.
Information on COVID-19 for pregnant women. By the European Centre for Disease Prevention and Control (ECDPC). Update 13th March 2020.
Information on COVID-19 for specific groups: the elderly, patients with chronic diseases, people with immunocompromising conditions and pregnant women. By the European Centre for Disease Prevention and Control (ECDPC). Update 13th March 2020.
This guide covers a variety of scenarios relating to care homes, staff, and providers who care for people in their own homes to ensure older people and those with pre-existing conditions and care needs who receive support are best protected. By the UK Government. Last updated 13th of March 2020.
Evaluating and Testing Persons Under Investigation. By the USA’s CDC.
Reporting a PUI or Laboratory-Confirmed Case for COVID-19
Residential care provision by the UK Government.
Home care provision by the UK Government.
How Nursing Homes and First Responders Can Address the Threat of COVID-19.
Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Nursing Homes. By Center for Clinical Standards and Quality/Quality, Safety & Oversight Group.
Long-term care facilities and nursing homes guidance to deal with COVID-19. By the USA’s CDC.
Nursing Home Infection Control Program Characteristics, CMS Citations, and Implementation of Antibiotic Stewardship Policies: A National Study. By Patricia W. Stone, PhD, RN, Carolyn T. A. Herzig, PhD, MS, Mansi Agarwal, PhD, MPH, Monika Pogorzelska-Maziarz,PhD, MPH, Andrew W. Dick, PhD (2018).
How might Coronavirus affect residents in nursing facilities. By Priya Chidambaram (2020). Kaiser Family Foundation (KFF).
Protecting Vulnerable Residents From Coronavirus. By Long Term Care Community Coalition.
Supported living provision by the UK Government.
Your Facility has COVID-19: What You Can Do Now. By Dr. John Lynch and Dr. James Lewis. UW and King County Response Team. (12 March 2020). Washington Society for Post-Acute and Long Term Care Medicine.
Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings by CDC. Guide is from 2007.
WHO’s Considerations for quarantine of individuals in the context of containment for coronavirus disease. The purpose of this document is to offer guidance to Member States on quarantine measures for individuals in the context of COVID-19. It is intended for those responsible for establishing local or national policy for quarantine of individuals, and adherence to infection prevention and control measures.
Duration of quarantine in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: a question needing an answer. Andrea Lombardi, Giorgio Bozzi, Davide Mangioni, Antonio Muscatello, Anna Maria Peri, Lucia Taramasso, Riccardo Ungaro, Alessandra Bandera, Andrea Gori (2020), The Journal of Hospital Infection.
WHO’s guidance for home care of patients with suspected novel coronavirus (nCoV) infection presenting with mild symptoms and management of contacts
WHO has developed this rapid advice note to meet the need for recommendations on the safe home care for patients with suspected novel coronavirus (2019-nCoV) infection presenting with mild symptoms and public health measures related to management of asymptomatic contacts.
Implementing Home Care of People Not Requiring Hospitalization. By the USA’s CDC.
Preventing COVID-19 from Spreading in Homes and Communities. By the USA’s CDC.
The UK’s NHS guidance on latest self-isolation. It applies to everyone, including NHS (Healthcare) staff.
Makeshift hospitals for COVID-19 patients: where health-care workers and patients need sufficient ventilation for more protection. Chen Chen and Bin Zhao (2020), The Journal of Hospital Infection.
Inside Wuhan: Makeshift coronavirus hospital
What to say to your patients about corona. By Nurse.com
A sample briefing from Professor Diana Egerton-Warburton. It’s an evolving document, please to do adapted from your reality:
Coronavirus Visitation Signage. By the USA’s Statewide Program for Infection Control and Epidemiology (SPICE).
Sharing is caring and that’s what this document is about.
Here’s a Whatsapp group https://chat.whatsapp.com/EVAlHrt8b9JF6BHtpwBlIr
This group is for sharing and caring, sharing nursing care strategies and self-care strategies. Express yourself.
WHO’s Mental Health Considerations during COVID-19 Outbreak.
For Healthcare staff:
For Team leaders or manager:
Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control. Published 10 March 2020. A large number of medical staff was sent to Wuhan city and Hubei province to aid COVID-19 control. Psychological stress, especially vicarious traumatization caused by the COVID-19 pandemic, should not be ignored. To address this concern, the study employed a total of 214 general public and 526 nurses (i.e., 234 front-line nurses and 292 non-front-line nurses) to evaluate vicarious traumatization scores via a mobile app-based questionnaire. Front-line nurses are engaged in the process of providing care for patients with COVID-19. The results showed that the vicarious traumatization scores for front-line nurses including scores for physiological and psychological responses, were significantly lower than those of non-front-line nurses (P < 0.001). Interestingly, the vicarious traumatization scores of the general public were significantly higher than those of the front-line nurses; however, no statistical difference was observed compared to the scores of non-front-line nurses. Therefore, increased attention should be paid to the psychological problems of the medical staff, especially non-front-line nurses, and the general public under the situation of the spread and control of COVID-19. Early strategies that aim to prevent and treat vicarious traumatization in medical staff and the general public are extremely necessary.
Factors Influencing Emergency Nurses' Burnout During an Outbreak of Middle East Respiratory Syndrome Coronavirus in Korea. Asian Nursing Research. Emergency department (ED) nurses suffer from persistent stress after experiencing the traumatic event of exposure to Middle East respiratory syndrome coronavirus (MERS-CoV), which can subsequently lead to burnout. This study aimed to assess ED nurses' burnout level during an outbreak of MERS-CoV and to identify influencing factors in order to provide basic information for lowering and preventing the level of burnout.
Mental Health of Nurses Working at a Government-designated Hospital During a MERS-CoV Outbreak: A Cross-sectional Study. Published by Archive of Psychiatric Nursing. February 2018. Highlights:
Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak perceptions of risk and stress evaluation in nurses. MERS-CoV caused a relatively significant level of distress among nurses. There was a difference in the worry and fear scale of contracting the MERS-CoV infection between participants who worked in areas likely to admit and have MERS-CoV suspected or positive cases. After the campaign, the level of confidence got higher and the participants were more adherent to the infection control precautions. Published by the Journal of Infection in Developing Countries. October 2015.
Coronavirus Patients dance at makeshift Wuhan hospital.
Iran’s coronavirus nurses, doctors keep patients upbeat by dancing.
Nurses' experiences of care for patients with Middle East respiratory syndrome-coronavirus in South Korea. Highlights:
Chinese nurses share pictures of how their faces look after countless hours of fighting the COVID-19
Factors influencing emergency nurses’ ethical problems during the outbreak of MERS-CoV. The objective of this study was to explore emergency nurses’ ethical problems and to identify factors influencing these problems during the outbreak of Middle East respiratory syndrome–coronavirus in Korea. By Jeong-Sil Choi and Ji-Soo Kim (2016).
People who are dying of COVID19 will need first-rate palliative (hospice) care. This is going to be especially the case for people who are denied ventilators or who are taken off of them (i.e., who are “extubated”). Let’s talk about this painful and poignant fact.
Italy’s guidance on who should be prioritised for treatment published by The Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care originally. Translated by @Yascha_Mounk
“A week ago, Italy had so few cases of corona that it could give each stricken patient high-quality care.
Today, some hospitals are so overwhelmed that they simply cannot treat every patient. They are starting to do wartime triage. Here’s the guidance for that.It may be necessary to establish criteria of access to intensive care not just on the basis of clinical appropriateness but inspired by the most consensual criteria regarding distributive justice and the appropriate allocation of limited health resources. This scenario is substantially comparable to the field of 'catastrophe medicine,' for which ethical reflection has over time stipulated many concrete guidelines for doctors and nurses facing difficult choices. In a context of grave shortage of medical resources, the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care.
It's a matter of giving priority to 'the highest hope of life and survival. Recommendations:
A collection of articles and other resources on the Coronavirus (Covid-19) outbreak, including clinical reports, management guidelines, and commentary. All Journal content related to the Covid-19 pandemic is freely available.
Published papers from HIS Journal on COVID-19
Provides Royal College of Nursing members with the latest information and resources. As of 17th of March much of the individual mentioned resources has been included in this document.
Global Health Now newsletter by John Hopkins Bloomberg School of Public Health.
National Foundation for Infectious Diseases.
Washington State Society for Post-Acute and Long-Term Care Medicine (wa-paltc).
BE🔗 http://www.siznursing.be/ (French)
Specialized ICU/CCRN nurses in Belgium
Braving Novel Coronavirus: More stories of bravery and dedication emerge as medical workers continue the fight to save lives. By Wang Hairong. 27 February 2020.
Emerging respiratory viruses, including COVID-19
Highly Pathogenic Infectious Disease Training and Exercise Resources. slides and recorded webinar – from ASPR TRACIE (Free).
1 contact hr. Middle East Respiratory Syndrome (MERS). Middle East respiratory syndrome (MERS) is a lethal pulmonary disease caused by a newly emerged coronavirus. It is believed to have originated in bats before it was transmitted to camels. Since human contact with bats is limited, evidence (serological and molecular) suggests that camels are the likely animal reservoir for MERS and the primary zoonotic source for human infection. MERS coronavirus (MERS-CoV) was first identified in Saudi Arabia in 2012. As of October 2018, there have been 2,266 lab confirmed cases of MERS with 804 deaths. The virus has been found in 27 countries. ($12)
Special Pathogens of Concern: MERS. May 2019. By NETEC. (Free)
1 contact hr. Emerging Infectious Diseases. Emerging infectious diseases have become a global phenomenon. There are many causal factors for the presence of these diseases, including evolution and adaptation as viruses learn to evolve and recombine, and increased international travel and exportation. As these factors combine, a dangerous situation emerges. This activity will address West Nile virus, Ebola virus, and Zika virus. ($12)
Science Matters: Let's Talk About COVID-19
🇬🇧🔗London School of Hygiene and Tropical Medicine
COVID-19: Tackling the Novel Coronavirus
Keep It Clean: Hand Hygiene and Skin Antisepsis. Whether at the surgical site or on the hands of the healthcare provider, skin is laden inherently with resident and transient flora. Inadequate hand hygiene allows opportunistic pathogens in varying life stages to transfer between patients and other surfaces during everyday activities. Yet many healthcare workers across various disciplines continue to have poor hand hygiene despite best-practice evidence about microbial transfer between people. Proper preoperative patient skin antisepsis and hand hygiene can minimize surgical site infections, and healthcare professionals across disciplines should collaborate to enhance adherence. ($12)
Infection Prevention and Control (IPC) for Novel Coronavirus (COVID-19)
Identify, Isolate, Inform: Assessment, Management, and placement of PUI. By NETEC (Free).
COVID-19: Operational Planning Guidelines and COVID-19 Partners
Behavioral Health Considerations for Patients and Healthcare Workers. June 2019. By NETEC. (Free).
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NHS’s Digital Home
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