IAHCSMM Resources: COVID-19 (Coronavirus) Updated 12/2/2020
IAHCSMM understands that many of its members, certificants and others within the Sterile Processing community may have questions and concerns surrounding the COVID-19 pandemic, including how it might affect their workplace practices. We wish to be a source of support for you at this challenging time. and have compiled this resource page to help you and your facilities more easily navigate this evolving situation.
Please note: This information is provided by IAHCSMM as a resource only and should not take the place of your facility’s existing policies and procedures. Check with your facility before implementing changes to your system. Also, there is an abundance of resources available from governmental agencies (e.g., the Centers for Disease Control and Prevention, the World Health Organization, the US Food and Drug Administration, the National Institutes of Health, and the Occupational Safety and Health Administration, among others) that address COVID-19, and many are updating their recommendations and study data frequently as more data surrounding this novel virus is attained. The resources provided by IAHCSMM are in no way exhaustive and the content from the links below may change as more information becomes available. We encourage you to visit the agencies’ websites for the most current information.
ECRI Resource Page
During this pandemic, having access to the right information is critical. ECRI has developed a COVID-19 Resource Center for healthcare professionals. Check out the link here to find a wide-variety of COVID-19 information: https://www.ecri.org/coronavirus-covid-19-outbreak-preparedness-center/
OneSOURCE Resource Page
OneSOURCE has created a COVID-19 resource page for healthcare professionals who are challenged with reprocessing instructions during this pandemic. Along with COVID-19-related information from several sources, it includes access to a section of their database that contains IFUs for COVID-19-related instruments and equipment. For the full details, visit: https://https://www.onesourcedocs.com/covid-19-resources/
The Joint Commission COVID-19 Resources
On October 5th, the CDC updated its information on how COVID-19 is spread. For details, visit: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html
How do I handle items contaminated with COVID-19?
AAMI and IAHCSMM held a Town Hall on March 30th: Sterilization and COVID-19
The Occupational Safety and Health Administration addresses COVID-19 processing at: https://www.osha.gov/SLTC/covid-19/controlprevention.html#health. What follows is an excerpt from that link:
Cleaning and disinfection:
- Follow standard practices for high-level disinfection and sterilization of semi-critical and critical medical devices contaminated with COVID-19, as described in the CDC Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008.
What guidance does the FDA provide on N95 respirators and masks?
The US Food and Drug Administration addresses common questions regarding masks and gowns, and also provides specific usage recommendations and conservation strategies in light of the COVID-19 pandemic.
FDA Emergency Use Authorizations (EUA) provides information on EUAs for PPE and some other medical devices issued during the COVID-19 pandemic. Learn more at: https://www.fda.gov/medical-devices/emergency-situations-medical-devices/emergency-use-authorizations#coronavirus2019
The FDA has begun publishing a list of medical items that have been identified as possible shortage situations to help facilities plan during a public health emergency.
One of the changes that happened as a result of the COVID-19 pandemic was the CARES Act. On March 27, 2020, the CARES Act was signed into law. Section 506J provides the FDA—for the first time—with authority intended to help prevent or mitigate medical device shortages “during, or in advance of, a public health emergency. The provision includes requirements for manufacturers of certain devices to notify the FDA “of a permanent discontinuance in the manufacture of the device” or “an interruption in the manufacture of the device that is likely to lead to a meaningful disruption in supply of that device in the United States” during a declared public health emergency. One provision requires the FDA to maintain a publicly-available, up-to-date list of the devices the FDA has determined to be in shortage. In addition, the FDA will also provide a list of medical devices for which the FDA has been notified that manufacturing has been permanently discontinued. This list may be help to health care facilities as they make plans to prepare for public health emergencies. To access the list, visit: https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/medical-device-shortages-during-covid-19-public-health-emergency#shortage
On November 30, 2020, HPN carried a story about the FDA issuing a new policy for dry heat processing of certain respirators. Visit https://www.hpnonline.com/infection-prevention/disposables-kits-drapes-ppe-instruments-textiles-etc/article/21164431/fda-issues-new-policy-on-dry-heat-for-reuse-of-certain-respirators?oly_enc_id=4558C4085334E9 for the full details.
Links to the FDA Release and the Guidance are posted below. Please be sure to read the full FDA content carefully and work with your facility’s appropriate stakeholders before making any process or practice changes.
What guidance does the CDC provide on N95 respirators and masks?
The CDC addresses N95 respirators and masks in a document called: “Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings”. For more information, visit: https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html
CDC Strategies for Optimizing the Supply of N95 Respirators can be found at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/
CDC/NIOSH Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings can be found at: https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html
AAMI N95 Mask Decontamination and Reuse Webinar
On April 24, AAMI partnered with AORN and IAHCSMM to offer a webinar on reprocessing N95 masks during the shortage related to the coronavirus pandemic. Dr. Margaret L. Gardel, PhD, University of Chicago, Dr. Jill R. Crittenden, PhD, Massachusetts Institute of Technology and Dr. Samantha M. Grist, PhD University of California, Berkley, members of N95DECON a consortium of 105 scientists from 10 institutions, presented information on current N95 research and current processes in use. The webinar will be offered in an on-demand format. Watch the recording below. A link to N95DECON can be found at: https://www.n95decon.org/.
Does AAMI have a coronavirus resource? Visit: https://www.aami.org/coronavirus
How do I link to AORN’s coronavirus resources? Visit: https://www.aorn.org/guidelines/aorn-support
Which disinfectants kill the COVID-19 virus?
The Occupational Safety and Health Administration notes the following regarding disinfectant efficacy for COVID-19:
At this time, there is no EPA-approved list of disinfectants effective against COVID-19. EPA does not categorize disinfectants as hospital- or commercial-grade or keep a list of EPA-registered antimicrobial products registered for use in healthcare facilities. As a result, products effective at inactivating the virus must be determined based on data associated with inactivating similar or hardier (i.e., more difficult to inactivate) viruses. COVID-19 is a coronavirus and highly susceptible to inactivation by many commonly used disinfectants. Currently, OSHA recommends following SARS disinfection practices (see section D-10 in the linked document) for environmental areas contaminated with COVID-19.
The CDC advises the use of EPA-registered chemical germicides that provide low- or intermediate-level disinfection for SARS during general use (surface and noncritical patient-care equipment) because these products inactivate related viruses with similar physical and biochemical properties. CDC's Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 provides information on the effectiveness of germicides on coronaviruses.
The EPA provides a list of disinfectants for use against COVID-19 in Schedule N on their website: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2
Additional information can be found at the EPA COVID-19 site: https://www.epa.gov/coronavirus
Should medical waste or general waste from healthcare facilities treating patients under investigation (PUIs) and patients with confirmed COVID-19 be handled any differently or need any additional disinfection?
According to the Occupational Safety and Health Administration, “medical waste (trash) coming from healthcare facilities treating COVID-2019 patients is no different than waste coming from facilities without COVID-19 patients. CDC’s guidance states that management of laundry, food service utensils, and medical waste should be performed in accordance with routine procedures. There is no evidence to suggest that facility waste needs any additional disinfection.”
For more information, visit: https://www.osha.gov/SLTC/covid-19/controlprevention.html#health.
This is unlike any situation I have ever seen. Can you offer any tips for handling the stress?
The World Health Organization provided a graphic with suggestions to help cope with stress. It may be a nice addition to your department’s bulletin board. Visit: https://www.who.int/docs/default-source/coronaviruse/coping-with-stress.pdf?sfvrsn=9845bc3a_2
Also, the American Association of Retired Persons (AARP) also provides some good ideas in their list of “Seven Ways to Cope with Anxiety During the Coronavirus Outbreak.” Visit: https://www.aarp.org/health/healthy-living/info-2020/coronavirus-anxiety.html
What is the difference between quarantine, isolation and social distancing?
The Cleveland Clinic answered that question in its article, “COVID-19: Understanding Quarantine, Isolation and Social Distancing in a Pandemic. Plus, 3 ways to protect yourself without freaking out.” Visit: https://health.clevelandclinic.org/covid-19-understanding-quarantine-isolation-and-social-distancing-in-a-pandemic/