New Health Processes to Protect Against COVID-19

October 01, 2020

Because of changes to typical health and safety protocols, school nurses may need to outfit their office differently this year. Consider:

  1. What supplies are needed to maintain the new policies and procedures (including PPE, disinfectant, hand sanitizer, soap, and paper towels)?
  2. Is there an isolated space to screen and triage everyone entering the office or facility?
  3. Are all visitors able to adhere to social distancing guidelines as much as possible? Is there seating that can be placed 6' apart or can partitions be added to separate individuals?
  4. Are facemasks, tissues, hand sanitizer, and trashcans easily accessible?
  5. Are the school nurse’s resources up to date to assist students who may dealing with emotional management issues, bullying, or lack of basic needs including access to healthcare providers, adequate nutrition, and housing security?
  6. Are there existing health services that can be managed virtually?
  7. Is the school nurse working in a space with enhanced ventilation?


Guidelines for Setting Up a Nurse’s Office or Health Facility
Here are some things to consider when reorganizing the nurse’s office and isolation room to prevent the risk of infection spread:

 

PPE and Supplies

  • Keep PPE on hand for staff and students, including N-95 masks, disposable gloves, gowns, foot coverings, and face shields
  • Stock hand sanitizer with between 60-90% alcohol
  • Place no-touch refuse containers and biohazard containers in easily accessible locations
  • Keep soap, water, and paper towels stocked up, and if possible, place a sink in the entrance

 

Isolation Space

  • When entering the office, any symptomatic individuals should wear a cloth face covering and be escorted into an isolated space to risk the spread of infection
  • Staff entering the isolated space should wear a medical-grade face mask, at a minimum
  • Any PPE used should be properly removed and disposed of before exiting the care space
  • Everyone should wash hands before and after providing care
  • Ensure the isolation space has ready access to soap and water

 

Physical Distancing

  • Maintain at least 6' between cots, chairs, or isolated individuals
  • Establish a plastic barrier between isolation spaces that is big enough to prevent direct transfer of air between spaces

 

Cleaning/Sanitizing

  • Ensure surfaces in the designated isolation space can be properly sanitized and disinfected.
  • Limit the use of cloth or other permeable materials, otherwise they will have to be washed between uses
  • Use only CDC-approved disinfection methods on surfaces
  • Disinfect the space after it has been empty for four hours
  • Wear a medical-grade mask, gloves, and isolation gown when disinfecting

 

Maintaining Student Safety

  • Offer virtual or no-contact health service when possible
  • Adjust certain protocols based on age and/or developmental abilities
  • Nurses should always maintain line of sight with an ill student
  • Clearly and calmly explain the procedures, including use of PPE and handwashing, to reduce fear, anxiety, or shame related to isolation,

 

Ventilation

  • A designated isolation space should have adequate ventilation, through either open windows or fans
  • If using fans, make sure they are feeding into the recirculated air supply
  • Vents should move the air to the building exterior or into an isolated wall or attic space

 

What To Do If Someone Becomes Sick
Anyone showing symptoms of COVID-19 should be immediately isolated in a designated space, preferably near the nurse’s office. If this space is insufficient or too small to be adapted for COVID-19 requirements, consider using a larger room with a separate entrance. Remember that this room will still need access to computers, phones, the internet, and restroom facilities.

If anyone has a fever of at least 100.4, be sure anyone who comes into contact with them uses face masks. The school nurse’s job is not to screen or identify cases of COVID-19, but to isolate and remove them from the property until they receive COVID-19 test results and meet the CDC's criteria to discontinue home isolation. Their job is to establish procedures that ensure students and staff who become sick at school or arrive at school sick are sent home as soon as possible and help ensure the safety of the other staff and students:

  • Create a decision flow chart for unlicensed staff and administrators to follow if the school nurse is not present
  • Refer parents of high-risk students to their healthcare providers to determine when school re-entry is recommended
  • Send ill staff home immediately and isolate students until they have a ride home
  • Train unlicensed assistants on the use of the flow chart, proper temperature taking procedure, and the use of PPE
  • Use N95 masks whenever possible
  • Track students with symptoms of COVID-19 and report to local public health department
  • Work closely with the local public health department for procedures regarding contact tracing and the return to school of anyone infected
  • Work with administrators to determine whether or not the school should implement short-term building closure procedures
  • Collaborate with facilities management to determine a cleaning and disinfectant plan




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