Download Healthcare worker Preparedness Checklist for MERS-CoV

HEALTHCARE WORKER PREPAREDNESS CHECKLIST FOR MERS CO-V
KFSH & RC: INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY
JULY 2016
DATE:
Department:
Reviewers:
Compliant
Non-compliant
Comments
MERS CoV Screening & Isolation
1. HCW demonstrates how to access
KFSH&RC MERS CoV policy
2. HCW verbalizes appropriate
isolation precautions for patients
who meet MERS CoV definitions
3. HCW verbalizes MERS CoV adult
case definitions
4. HCW verbalizes MERS CoV pediatric
case definitions
5. HCW demonstrates how to locate
and complete SARI form
6. The HCW verbalizes what actions to
take for suspected MERS CoV
patient
PPE
7. HCW verbalizes where to locate PPE
supplies (gown/gloves/mask)
8. HCW verbalizes where to locate face
protection and goggles
9. HCW verbalizes which mask to give
to the patient
10. HCW has been fit tested and knows
which N95 mask they are fitted for –
fit testing card is available on their
ID badge holder
Negative Pressure & AIIR
11. The HCW explains negative pressure
12. The HCW verbalizes the use of the
monitor outside the AIIR
13. The HCW demonstrates how to
conduct a tissue test to check the
functioning of the AIIR
14. The HCW verbalizes how to
determine if the AIIR is appropriate
ICHE
15. The HCW demonstrates where to
locate the ICHE staff covering their
unit AND the ICHE staff on call
References: CDC http://www.cdc.gov/coronavirus/mers/downloads/checklist-provider-preparedness.pdf
CDC http://www.cdc.gov/coronavirus/mers/downloads/checklist-facility-preparedness.pdf
IPP Middle East Respiratory Syndrome Coronavirus (MERS CoV) MCO-MC-INF-04-077