School Nurse Training for Contact Tracing Case Management

School Nurse Training for Contact Tracing & Case Management of Eileen Gavin, MSN, FNP-BC, NCSN April 20, 2020

New Jersey Administrative Codes N. J. A. C. 8: 57 -1. 10 and N. J. A. C. 8: 57 -1. 11 NJMRC “Just In Time” Training

Who is a close contact?

NJ DOH COVID-19 Isolation Recommendations: ● Those that have tested positive for COVID-19 ● Close contacts of those who have tested positive COVID-19 and are symptomatic ● Anyone symptomatic without testing *Those with a positive test without symptoms have a minimum isolation of 7 days from date of test.

Asymptomatic Close Contacts: ● Self-quarantine at home and monitor your health for fever, cough, shortness of breath or other symptoms during the 14 days after the last day you were in close contact with the sick person with COVID-19. ● Do not go to work or school and avoid public places during this time period. ● If the person with COVID-19 lives in your home, do your best to separate yourself from them until they are taken off their home isolation. ○ If you cannot separate yourself from them and continue to have close contact then you will need to remain at home and self-quarantined for 14 days after the person with COVID-19 is released from their home isolation.

Asymptomatic close contacts must self-quarantine 14 days from last contact with an individual that tests positive for COVID-19

How do I isolate from others? Isolation involves: ● Separating from others includes eliminating close contact with others in the house, not traveling or attending public gatherings and not leaving home except to seek medical care. ● Practicing good hand hygiene, cleaning and disinfecting hightouch surfaces daily in household common areas (e. g. tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, sinks, phones). ● When possible wearing a mask in common areas.

How do I quarantine from others? Quarantine involves: ● Using standard hygiene and washing hands frequently ● Not sharing things like towels and utensils ● Staying at home ● Not having visitors ● Staying at least 6 feet away from other people in your household

COVID-19 Investigation Worksheet

You’ve tested positive what’s next? You should be isolated until 7 days have passed from the start of symptoms & 72 hours afebrile without antipyretics & other symptoms improve Household contacts Quarantine starts with + test Date of symptoms? 2 day look back date? Date of last symptoms? Non-symptomatic household: If the close Symptomatic but no testing contacts were truly isolated done isolate until 7 days from the case, use the 14 have passed from the start days from last contact. If of symptoms they were not able to & 72 hours afebrile without maintain ”strict” isolation antipyretics & other then it is the 14 days from symptoms improve. discharge. Symptomatic-isolate until *Discharges from isolation for tested: 3 days (72 hrs) pass ● No symptoms-7 days from test without fever & ● 7 days passed start of improving cough, (-) symptoms & 72 hours afebrile SOB. Recommend without antipyretics & contact HCP symptoms improve Close contacts not in household <6’ >10 minutes engaged conversation Non-symptomatic if the close contacts were truly isolated from the case, use the 14 days from last contact. If they were not able to maintain ”strict” isolation then it is the 14 days from discharge. Have you been in any Healthcare Settings? Where do you work? Was work notified of your testing results? When did they say you can return to work? Offer email FAQ’s Review FAQ HCW 3/29/202 Resources NJ DOH Guideline COVID-19 4/4/20 Presentation Created by Eileen Gavin

How to avoid passing COVID-19 to newborn? ● ● ● Wash your hands before touching your baby. Wear a face mask while breastfeeding. Wash your hands and breast before breastfeeding. Wash your hands before touching any breast pump or bottle parts and clean all pump and bottle parts after use. See the CDC’s advice for cleaning a breast pump. You also can have someone who is not sick feed your breast milk to your baby after you pump.

How can we help you through this home isolation? NJ Mental. Health. Cares-866 -202 -HELP (4357) 7 days/week 8 am-8 pm Food insecurities and financial struggles Applying for unemployment and NJ. gov job site Offering documentation of quarantine for employers Telehealth, Federally Qualified Health Center (FQHC) & Home care

COVID-19 Pandemic and Re-Entry to Schools

Confidentiality and HIPAA/FERPA Concerns Examples of such good faith uses or disclosures covered by this notification include uses and disclosures to/from the CDC, or a similar public health authority at the state level, for the purpose of preventing or controlling the spread of COVID-19, consistent with 45 CFR 164. 5 12 (b) https: //www. hhs. gov/sites/default/files/notification-enforcement

Planning needs to start now for school re-entry and school nurses’ voices need to be heard! Contact me at egavin 2@icloud. com or @NMNurse. Eileen

Please raise the hand symbol or use the chat box to ask questions. Thank you for your time! Contact me at egavin 2@icloud. com or @NMNurse. Eileen

References CDC (2017). Quarantine and Isolation. Retrieved from https: //www. cdc. gov/quarantine/index. html Department of Health and Human Services (4/2020) Notification of Enforcement Discretion under HIPAA to Allow Uses and Disclosures of Protected Health Information by Business Associates for Public Health and Health Oversight Activities in Response to COVID-19. 45 CFR 164. 5 12 (b). Retreived from https: //www. hhs. gov/sites/default/files/notification-enforcement-discretionhipaa. pdf NASN (2017). The Framework for 21 st Century Nursing Practice. Retrieved from https: //www. nasn. org/nasnresources/professional-topics/framework NJ Department of Health (4/4/2020) Investigation Guidance for New Jersey Local Health Departments Retrieved from https: //www. nj. gov/health/cd/documents/topics/NCOV_chapter. pdf NJ Department of Health (March 27, 2020) Guidance for Discontinuation of Transmission-Based Precautions and Home Isolation for Patients Diagnosed with COVID-19. Retrieved from https: //www. nj. gov/health/cd/documents/topics/NCOV/COVID_Discontinuation_Transmission_Based_Precautions. pdf NJ Department of Health (3/29/2020). Close Contacts of Confirmed COVID-19 Patients Retrieved from https: //www. nj. gov/health/cd/documents/topics/NCOV/COVID_FAQs_For_Close_Contacts_People_Tested. pdf NJ Department of Health (3/29/2020) Frequently Asked Questions Healthcare Workers and COVID-19. Retrieved from https: //www. nj. gov/health/cd/documents/topics/NCOV/FAQs_For_HCW_and_COVID 19. pdf