The Latest Column
Questions are from the latest Standards Q&A column, posted August 2020.
SERVICE INTERRUPTIONS DURING CORONAVIRUS
We are an intake facility and are quarantining all intakes for 14 days due to coronavirus concerns. Standard P-E-04 Initial Health Assessment states that initial health assessments must be completed within seven days, including a physical examination and a pelvic exam when clinically indicated. However, due to quarantine, our patients are not able to come to the health services unit. How does NCCHC advise that we handle this?
Over the past months, we have received many requests for information about how to handle changes to operations due to COVID-19. While we understand that there may be changes, we ask facilities to do their best to address the needs of their patients, follow the standards, document changes made, and return to normal operations as soon as possible. Many facilities are struggling with the same issue. In some, intake staff go to the cell or a private area close to the cell to complete the initial health assessment instead of bringing patients to the clinic. Other facilities complete a modified initial health assessment that assesses top comorbid conditions along with a brief mental health screen in the time frame set forth in the standards, with a documented plan to complete any omitted health screen items as soon as possible and schedule the pelvic exam as soon as the inmate can be seen in the clinic. Whatever you do, be sure your response is thoughtful and well-documented, and includes looking at the risks of postponing assessments or aspects of care. As always, come into compliance with standards as soon as possible.
Suicide Training Expectations for COs
I noticed a discrepancy in the 2018 standards. A compliance indicator for Standard C-04 Health Training for Correctional Officersstates, “Correctional officers who work with inmates receive health-related training at least every 2 years,” including procedures for suicide prevention. But the discussion section for Standard B-05 Suicide Prevention and Intervention states, “All staff members who work with inmates are trained to recognize verbal and behavioral cues that indicate potential suicide ... Initial and at least annual training is provided.” What is the expectation – annually or at least every 2 years?
The answer to your question is “at least every two years,” as stated in the compliance indicators for Standard C-04. The standards and compliance indicators are measurable items that are scored during accreditation surveys, while items in the discussion section are not scored but are intended to help clarify the standard’s intent. Thank you for pointing out this discrepancy; we will be sure to amend it during our next standards update.
Is COVID-19 a Mass Disaster?
Due to our recent experience with the COVID-19 pandemic, we are considering using our efforts to manage the virus in our facilities as compliance with the mass disaster drill requirement. Would this meet the intent of the standard? All our shifts and staff have been affected and play a major role in our daily efforts.
Great question! The answer is yes. This is a perfect example of how facilities can use a real-life event to meet the mass disaster requirement. Standard D-07 Emergency Services and Response Plan addresses planning for disruptions in service during emergencies and requires that mass disaster drills be conducted so that each shift, including satellite facilities, has participated in a drill over a three-year period. The drills must then be critiqued and the results shared with all health staff. NCCHC asks that staff members who are not present during a drill later review and initial the written critiques.