Testing COVID-19

COVID-19 Testing Competency Checklist

Nurse Competency Checklist for COVID-19 Testing

(12.29.2020)

(12.29.2020)

Name:______________________________ Title: ___________________________ Hire Date:_______________

 

Skill Area

Evaluation

(Check One)

Method of Evaluation

(Check One)

D = Skills Demonstration

O = Performance Observation

W = Written Test

V = Verbal Test

Verification

(Initials/Date)

 

Competency

Demonstrated/

Meets

Standards

Needs Additional Training

 

D

O

W

V

 

Policies and Procedures

Locate written infection control policies and procedures.

 

 

 

 

 

 

 

 

Verbalizes policy for

·       Specimen Collection for COVID-19 testing

·      Point of Care Antigen Testing

 

 

 

 

 

 

 

 

Describes facility policy on immediate mitigation actions with positive results

 

 

 

 

 

 

 

 

Hand Hygiene

Demonstrates hand washing with soap and water

 

 

 

 

 

 

 

 

Demonstrate hand hygiene using alcohol-based hand rub (ABHR).

 

 

 

 

 

 

 

 

Personal Protective Equipment

Nursing

Housekeeping

 

Demonstrate donning and removal (in the correct sequence) of

·       Gown

·       N95 Respirator

·       Goggles or face shield

·       Gloves

·       Who to contact if additional PPE is needed

 

 

 

 

 

 

 

 

Describes facility protocol for reuse and/or extended use of PPE

 

 

 

 

 

 

 

 

Identify location and proper storage of Personal Protective Equipment

 

 

 

 

 

 

 

 

(Insert any State specific PPE guidance)

 

 

 

 

 

 

 

 

Standard Precautions

(All Departments)

(Nurses)State how the facility identifies residents to be placed in transmission-based precautions (i.e., contact, droplet, airborne-if equipped in facility)

 

 

 

 

 

 

 

 

Respiratory Hygiene/Cough Etiquette

(All Departments)

Demonstrate cough etiquette and respiratory hygiene

 

 

 

 

 

 

 

 

Environmental Cleaning

·      Housekeeping

·      Nursing

Housekeeping Staff:

Demonstrate:

·       Demonstrates cleaning and disinfection of room used for testing

 

 

 

 

 

 

 

 

Nursing:

Demonstrate cleaning/disinfection of:

·       Testing equipment consistent with manufacturer’s recommendations and product instructions

 

 

 

 

 

 

 

 

ALL Staff

Able to identify proper use and follow label directions for each disinfectant used by employee in the facility

(EPA List N disinfectant)

 

 

 

 

 

 

 

 

Specimen Collection-Nasopharyngeal Swab (NP)

·       Gathers supplies

o   PPE

o   Sterile synthetic fiber swabs with plastic or wire shafts unless swab provided in POC testing is required for test

o   Sterile transport tube

·       Performs Hand Hygiene

·       Dons PPE in correct sequence

·       Close room door

·       Grasps swab by the end of the handle

·       Inserts swab into nostril parallel to palate until resistance is reached

·       Rolls swab gently and leaves swab in place for several seconds to absorb secretions

·       Removes swab slowly while rotating

·       If resident presents with a deviated septum or blockage, use same swab to obtain specimen from the other nostril

·       Promptly tests specimen using point of care antigen test device following manufacturer’s recommendations or places swab into sterile tube with viral transport medium for lab testing

·       If specimen is sent to offsite lab, nurse follows proper labeling and storage policy

·       Cleaning and disinfection according to policy and procedure:

o   Machine in accordance with the manufacturers directions

o   Surfaces

o   Room

·       Doffs PPE in accordance with facility procedure

·       Performs Hand Hygiene

·       Documentation of results per facility procedure

·       Reports positive testing immediately for proper mitigation efforts

 

 

 

 

 

 

 

 

Anterior Nasal Swab Specimen Collection

·       Gathers supplies

·       Dons PPE in correct sequence

·       Closes room door

·       Using a sterile flocked or spun polyester swab, insert the entire absorbent tip of the swab (usually ½ to ¾ of an inch inside the nostril and firmly sample the nasal wall by rotating the swab in a circular path against the nasal wall at least 4 times. This should take approximately 15 seconds to collect the sample. Be sure to collect any nasal drainage that may be present on the swab

·       Samples both nostrils with the same swab

·       Completes antigen test promptly following manufacturer’s recommendations

·       Cleaning and disinfection according to policy and procedure:

o   Machine in accordance with manufacture’s instructions

o   Surfaces

o   Room

·       Doffs PPE in accordance with facility procedure

·       Performs Hand Hygiene

·       Documentation of results per facility procedure

·       Reports positive testing immediately for proper mitigation efforts

 

 

 

 

 

 

 

 

Nurse

·       Demonstrates POC testing quality control and instrument calibration in accordance with the manufacturer’s instructions

·       Describes actions if calibration fails prior to use with another resident specimen

 

 

 

 

 

 

 

 

Other (Describe)

 

 

 

 

 

 

 

 

 

 

Other (Describe)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References and Resources:

Centers for Disease Control and Prevention. Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens for COVID-19, Updated Dec. 21, 2020: https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinical-specimens.html

Centers for Disease Control and Prevention. Information for Healthcare Providers about Coronavirus (COVID-19). Updated Dec. 28, 2020: https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html

Centers for Disease Control and Prevention. Guidance for SARS-CoV-2 Point-of-Care Testing. Updated Dec. 26, 2020: https://www.cdc.gov/coronavirus/2019-ncov/lab/point-of-care-testing.html

 

Centers for Medicare & Medicaid Services. QSO-20-38-NH. August 26, 2020: Interim Final Rule (IFC), CMS-3401-IFC, Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency related to Long-Term Care (LTC) Facility Testing Requirements and Revised COVID19 Focused Survey Tool: https://www.cms.gov/files/document/qso-20-38-nh.pdf

 

Centers for Medicare & Medicaid Services. Frequently Asked Questions: COVID-19 Testing at Skilled Nursing Facilities/Nursing Homes: https://www.cms.gov/files/document/covid-faqs-snf-testing.pdf

 

Centers for Medicare & Medicaid Services. CMS Updates COVID-19 Testing Methodology for Nursing Homes, Sept. 29, 2020: https://www.cms.gov/newsroom/press-releases/cms-updates-covid-19-testing-methodology-nursing-homes

Quidel. Sofia SARS Antigen FIA Resources: https://www.quidel.com/node/8736

BD Veritor™ System for Rapid Detection of SARS-CoV-2: https://www.bd.com/en-us/offerings/capabilities/microbiology-solutions/point-of-care-testing/bd-veritor-plus-system-for-rapid-covid-19-sars-cov-2-testing

 

*I certify that I have received orientation in the above-mentioned areas.

 

       
   

*Employee:

 

 

___________  _______________________________________     ____________

Initials            Signature                                                                                Date

 

 
 
 

Evaluator/Trainer:

 

 

___________  _______________________________________     ____________

Initials            Signature                                                                                Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(PLACE IN EMPLOYMENT FILE)