AONL Updates

Caring with Limited Resources during the COVID-19 Crisis: A Compilation of Resources for Your Team

Source: AONL Coronavirus Update, April 1

America's hospitals and health care leaders are doing everything possible to enhance the availability of the vital tools and resources needed to care for patients during the COVID-19 pandemic. The AHA also is working with federal agencies and with Congress to bolster pandemic response resources. However, at times during the pandemic, front-line clinicians and hospital leaders may face extraordinarily challenging decisions about how to deploy limited staff and resources.

Responding to requests from hospitals and health systems, the AHA has compiled resources, tools and sample policies hospital and clinical leaders may find helpful in developing their own organization's approach to caring for patients with limited resources or under crisis circumstances. The compendium contains resources related to capacity management, ethical decision making, equipment allocation, crisis standards care, resilience strategies and more.

Please note that the tools listed do not necessarily reflect the views of the AHA, nor do they constitute clinical advice from the AHA. Rather, they are meant to assist hospitals and health systems in devising or refining their own approaches.

Guidance, Actions Take Aim at Mask Supply

Source: AONL Working for You, March 30

As hospitals struggle to make do with a limited supply of face masks and other personal protective equipment (PPE), government and private entities are taking steps to address the problem. Academic leaders and technology executives  launched Project N95, a clearinghouse for COVID-19 medical equipment. The group is collecting  requests for PPE in order to expedite distribution to the places PPE is most needed as new stocks become available. A separate volunteer effort is calling on people with  3D printers to help produce urgently needed items. Additionally, the Centers for Disease Control and Prevention posted  strategies for optimizing the supply of face masks under conventional, contingency and crisis conditions; and the Joint Commission posted  videos on donning, doffing and disposal of PPE, along with guidance on managing critical shortages.

AONL, Nursing Organizations Propose COVID-19 Academic-Practice Partnerships

Source: AONL News, March 27

AONL joins eight other nursing organizations in endorsing a collaborative effort to propose and support academic-practice partnerships between health care facilities and pre-licensure RN and practical/vocational nursing (PN/VN) programs across the country during the COVID-19 crisis. In a policy brief, the nursing organizations propose health care facilities and nursing education programs work together to allow students to support nursing services in health care facilities while receiving academic credit toward clinical requirements. The brief notes that the participation of student nurses and faculty is voluntary and must comply with any additional requirements mandated in state emergency response provisions or through existing Occupational Safety and Health Administration requirements and the safety for all front-line providers must be safeguarded through appropriate and prevailing infection control practices.

UW Medicine Shares COVID-19 Response Algorithms, Policies

Source: AONL News, March 27

Seattle’s University of Washington health system, UW Medicine, and its affiliates are sharing resources they developed as the first providers and administrators to encounter COVID-19 on U.S. soil. The UW Medicine COVID-19 resource site provides a wealth of screening and testing algorithms, policy documents and links to regional coronavirus sites. Most of the posted documents were written since Feb. 24 and are undergoing frequent revisions as the COVID-19 pandemic evolves. UW Medicine plans to post additional protocols and flow diagrams and hopes to add a discussion board and possibly enable other health systems to add similar resources to the site. Users are invited to email questions and recommendations to covid19@uw.edu.

SCCM Proposes Tiered Staffing for Critical Care

Source: HealthLeaders Media

In anticipation of the need to create more intensive care unit (ICU) beds during the COVID-19 pandemic, the Society of Critical Care Medicine (SCCM) updated its statistics on critical care resources and put forward a strategy for augmenting staff. SCCM recommends hospitals use a tiered staffing model to enable intensive care clinicians to supervise the care of patients needing mechanical ventilation. The tiered ICU staffing model assigns one experienced critical care physician to supervise four ICU teams of experienced advanced practice professionals and non-ICU physicians. For example, teams might include anesthesiologists and nurse anesthetists, who are skilled at managing mechanical ventilation. The model also assigns experienced ICU nurses to supervise teams of non-ICU nurses or non-ICU advanced practice professionals. Training non-ICU staff who are reassigned to ICU duty is critical to the model’s success. (HealthLeaders Media story, 3/23/20)