The Centers for Medicare & Medicaid Services (CMS) recently released surveyor guidance and tracking tools to assist surveyors to observe signs of H1N1 and proper facility respiratory hygiene/cough etiquette. The cover memorandum to state survey agency directors is dated May 6, revised on May 8. According to the memo, the guidance was prepared in collaboration with the Centers for Disease Control and Prevention (CDC). The guidance is effective immediately.
The guidance states that during the survey process, surveyors should look for the following:
Visual Alerts
- Facilities should have signage at entry points instructing patients/residents and visitors about facility policies, including the need to notify staff immediately if they have signs and symptoms of febrile respiratory illness.
- Facilities should have signage emphasizing appropriate respiratory hygiene/cough etiquette and hand hygiene.
Adherence to respiratory hygiene/cough etiquette
- Facilities should ensure the availability of materials for adhering to respiratory hygiene/cough etiquette including:
- Tissues and receptacles for used tissue disposal.
- Conveniently located dispensers of alcohol-based hand rub and/or adequate soap and disposable towels where sinks are available.
- Staff, patients, and visitors should cover their nose/mouth when coughing or sneezing (the insides of elbows are preferable to hands when covering noses and mouths).
- Staff, patients, and visitors should use tissues to contain respiratory secretions and dispose of them in the nearest waste receptacle after use.
- Staff, patients, and visitors should perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand rub, or antiseptic handwash) after having contact with respiratory secretions and contaminated objects/materials.
Patient Placement/Transport/Personal Protective Equipment (PPE)
- Facilities should have a plan in place to appropriately manage patients with confirmed, probable or suspected cases of H1N1 virus infection.
- Nonsterile gloves, gowns, eye protection, and fit-tested disposable N95 respirators or equivalent.
- Facilities should have a policy for communicating information about confirmed, probable or suspected cases of H1N1 virus infection to other facilities.
Management of ill healthcare personnel
Facilities should have a policy for management of ill healthcare personnel. Guidance related to H1N1 virus infection can be found at http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm.
To access the memo, guidance and tracking tool, please go to http://www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter09_36.pdf.