CFS_Employee_Education_9.21

TEACHABLE MOMENT INSERVICE

1:1 or small group impromptu in-servicing done on the unit, or individual education.

DATE: ________________________

TOPIC: _APPROPRIATE SCREENING AND EDUCATION

PRESENTER(S): ________________________________________________________________________

SUMMARY OF PRESENTATION:

SCREENING OF OTHERS:
1. ANY staff member who opens the door and allows someone into the facility becomes the screener.
2. It is the screener’s responsibility to stop every person who enters.
3. The screener must guide the screening process and not allow anyone to enter who has not completed
each step of the screening process. All questions on paper form or Acushield must be answered.
4. Screener must offer education forms “Help Keep Our Campus Healthy” and “Stop the Spread of
Germs.”
5. Screener must offer education from licensed nurse for any person on first visit to include:

A. application and removal of PPE and wearing PPE appropriately
B. hand hygiene upon entry and exit and before and after touching resident or things in
environment
C. social distancing
D. cough and respiratory hygiene etiquette
E. avoiding touching face
F. cleaning and disinfection of frequently touched surfaces
G. staying home when sick, exposed, or recently testing positive for COVID-19
H. possible signs and symptoms of COVID-19

6. Screener will be at front desk from 9am to 5pm. After hours when no screener is present, the first door of
the breezeway will be open and the second door will be locked. Visitors will need to call manager phone to
be allowed in.

7. If the screener leaves the desk for any reason, door shall be locked until the screener returns.

SELF-SCREENING:

1. Any person who self-screens and has ANY symptoms of COVID-19, an exposure in the past 14 days, or
a positive COVID-19 test in the past 10 days must call the infection preventionist phone immediately at
513-267-9825. The employee must not proceed further. Employees, contracted workers, or vendors with
symptoms will be tested by the nurse manager or team leader on duty. A rapid and PCR will be obtained,
and the individual will be sent home.

2. At the start of the day, medical records/unit clerk will pull the paper screening logs and review for any
missing data. Medical records/unit clerk will then call the individual and ask the person for answers to the
missing data. The unit clerk will then fill in and initial any of the missing data and will report any responses
of symptoms, positive COVID-19 test, or exposure to infection preventionist immediately at 513-267-9825

SIGNATURE OF ATTENDEES:

____________________________

PERSONAL PROTECTIVE EQUIPMENT
DISTRIBUTION AND PROCEDURE UPDATE

TEACHABLE MOMENT INSERVICE

TOPIC: PERSONAL PROTECTIVE EQUIPMENT DISTRIBUTION AND PROCEDURE UPDATE
September 21, 2021

MASK DISTRIBUTION:
At the start of the shift, every employee will see the nurse manager (or senior nurse at the facility if no
manager on duty). Masks will be distributed for use for the day as follows:

1. Culinary staff who work in the kitchen and not the dining room, such as cooks and dishwashers,
will receive one surgical mask.

2. Staff who will care or services for RED COVID-19 positive or suspected positive residents, such as
nurses or STNAs and therapy staff, will receive ONE N95 (note: Makrite brand is NISOH approved
N95.)

3. Staff who will care or services for YELLOW quarantined residents, will receive ONE N95 MASK for
yellow rooms.

4. Staff who will care for GREEN residents will receive ONE SURGICAL MASK for green rooms.
5. Staff with more than one circumstance during their shift will receive ONE OF EACH TYPE OF

MASK that applies to their assigned duties for the day.
6. If you receive more than one mask, you will also be given the same number of brown paper bags

to store each mask cleanly to prevent cross-contamination.
For example, if you receive ONE N95 for RED areas and ONE N95 MASK for YELLOW areas, you
will receive TWO paper bags.
MASK AND FACESHIELD CHANGING AND STORAGE PROCEDURE:
• Masks still must be changed according to the room types staff are entering.
• When switching to a different mask, store the unused one in a paper bag on the PPE tables set
up in the hallways.
• At the end of the shift, DISPOSE OF ALL OF YOUR MASKS YOU WERE GIVEN FOR THE DAY as you
leave. Please do not leave them on the PPE tables or leave with them. Put on a cloth mask or
hand hygiene as you exit the building after throwing the old mask(s) out. There should be a large
waste basket near our employee exits for mask disposal.
• Masks will ONLY BE USED FOR ONE DAY AND DISCARDED.
• FACESHIELDS will continue to be cleaned between rooms and continue to be used for multiple
days. They may be stored on the mask racks or on the PPE tables. Please make sure your name is
on your face shield. Faceshields should be replaced when they become damaged, no longer fit
properly, or are too cloudy or scratched to see through. It is your responsibility to request a
new faceshield when the current or becomes damaged or unusable.
• Be certain to WEAR GLOVES and SANITIZE YOUR HANDS when changing masks and when
cleaning face shields.

CHANGES IN PPE DONNING AND DOFFING PROCEDURE:
• Masks should continue to only be worn in their designated rooms or areas (GREEN, RED, or
YELLOW). Masks should continue to be changed when going from one color area or room to
another.
• In order to be as clean as possible and to eliminate confusion, going forward, gowns will be ONE
USE ONLY IN ALL SITUATIONS AND ALL ROOM COLORS AND AREAS. When leaving the room,
please follow Emory University terminal doff procedure for removing the gown and extended
reuse of mask and faceshield. In order to doff your gown properly, you will take the following
steps IN EVERY ROOM SITUATION:

PERSONAL PROTECTIVE EQUIPMENT
DISTRIBUTION AND PROCEDURE UPDATE

1. WHILE STILL IN THE ROOM JUST BEFORE EXITING WITH GLOVES ON, cross your arms over
your chest. Grasp the shoulders of your gown.

2. Tear the gown away from your body (breaking the neck ties and the waist ties).
3. Roll the gown away from you keeping the outer surface of the gown away from your clothes

and body while you roll it into a ball.
4. As you peel the gown off, your gloves should come off as well. If not, remove them without

touching the outer surface of your gloves.
5. Discard gown and gloves in waste basket just inside the door to the exit.
6. Sanitize your hands, and exit the room.
7. You will now proceed to the faceshield station (table in the hallway) to clean your faceshield

with disinfectant.
8. Sanitize your hands again.
9. Apply clean gloves.
10. Get one or two disinfectant wipes and place them flat on the table. Get one more wipe to

clean with.
11. Remove your faceshield and put it face down on the flat wipes.
12. Wipe down the inside of the faceshield, including the foam and elastic band.
13. Turn face shield over and clean the outside of the faceshield.
14. Use the wipes to wipe down the table. This will create a clean area.
15. Place your face shield in the clean area.
16. Remove your gloves.
17. Sanitize your hands.
18. If you are moving to room or area with the same mask, reapply your faceshield.
19. If you are changing masks, do the following.

a. Apply new gloves
b. Remove your mask and place it in its own paper bag.
c. Remove your gloves.
d. Sanitize your hands.
e. Apply clean gloves.
f. Remove other mask from its own paper bag.
g. Put on different mask.
h. Remove gloves.
i. Sanitize hands.

NOTE: There should not be any gowns in the hallway now that GOWNS ARE ONE USE ONLY. The only
exception is if a quarantined or isolated person is being taken from the room for any reason and requires
a staff member to provide hands on assistance to the person.

I acknowledge that I have reviewed all of the information contained in this Teachable Moment. I have
had questions answered or have no questions at this time.



Face Shield Cleaning COMPETENCY

Employee Name: _________________________________ Date: _______________

Measure/Action Met Not N/A Comments
Met
Sanitize hands
Apply gloves
Lay wipes down on table
Place face shield on top of wipes
Cleanse all areas of face shield front and
back
Discard wipes on trash can
Remove and dispose of gloves
Sanitize hands
Place face shield back on face

Pass/Fail: _____________

Comments/Corrections:_________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
_________________________________________________________________

Auditor Signature: __________________________________________

putting What You Need View the PPE video at
med.emory.edu/PPE
ONPPE

(ACE)

Contact gown N95 Respirator Face shield or goggles Gloves

1 2 Gown + Gloves 3 4 Put on gloves
Remove any personal over the cuffs
items and jewelry and Sanitize Put on contact of the gown.
put in secure location, hands. gown outside room.
not in pockets.

Open-end faces
your back.

Tie the back of
the gown.

5 Put on N95, 6 Respirator 7
ensuring proper Sanitize gloves.
seal. Place hands over
Ensure straps the front of the
are not crossing. N95. Breathe an
easy deep breath
in and out.

If you feel air
escape the
edges, refit
and repeat.

8 9 Eyes + Entry 11
Put on face Sanitize Do not touch face or re-
shield. gloves. 10 adjust N95 or face shield
inside room.
ENTER
room

DO NOT enter the room if
you do not achieve a proper
respirator seal.

© 2020 Emory University, created by Visual Medical Education. Updated March 24, 2020

Creative Commons Attribution-NonCommercial-NoDerivs

COVID-19 Unit - INSIDE patient room

taking (ACE)

OFFPPE

Is your next patient COVID+ ?

COVID+ = “Extended Wear” NO = “Terminal doffing”

1 Sanitize gloves. 1 2 Reach back and re- 3 Untie the waist.
Sanitize gloves.
lease the neck portion.

2 4 5 Pull the bare hand into 6 Using the hand in the
Remove gloves. Take off the first glove. the sleeve of the gown. sleeve, remove the
other glove.

3 Sanitize hands. 7 8 9
Remove Sanitize hands.
EXIT patient room Use hands into bin
inside the for reuse
gown to without
scrunch touching
or pull outside of
sleeves off. gown.

2020 Emory University, created by Visual Medical Education. Updated April 3, 2020

EXIT patient room

`Observer/Wearer Procedure
Airborne Contact Precautions with Eyewear (ACE)

Meticulous sequencing and attention to detail during both donning and doffing of personal
protective equipment, or PPE, are crucial to preventing the transmission of pathogens.

The observer/wearer process allows each team member to be as safe as possible and to learn
from each other. This process is constructive and not punitive. Everyone should be open and
kind to one another in giving and receiving constructive feedback. Remember, the goal is the
safety of our residents and patients we serve and the team members we stand beside every
night and day.

Every employee wearing equipment who is entering and leaving a precaution room during their
shift will use the observer procedure for the first don (putting on PPE), the first extended reuse
into the next COVID-19 room, and the first terminal doff (taking off PPE) of their shift.
Admittedly, this is more time consuming than doing it on your own, but the safety rewards make
it well worth it.

The observer will read each step aloud and will watch very closely to make certain that each
step is completed with great care. Completion of steps should be slow and methodical.

If a mistake is made, the observer will immediately interrupt the process and instruct the
employee how to correct the mistake. Examples might be instructing the employee to sanitize
hands or gloves, or it might be instructing the employee to remove a piece of damaged or
contaminated equipment and replace it with new equipment.

Ensure that the employee has met their hydration and restroom break needs prior to starting.
Ensure that all jewelry, name badge, cell phones, pens, etc. have been removed and secured
and are NOT in pockets. Hair must be pulled back and away from the face. Nails must be no
longer than ¼ inch in length, so they do not damage the gloves or harbor pathogens.

Putting on Airborne Contact Precautions with Eyewear (ACE)
CONSERVE PPE – First patient

OUTSIDE THE PATIENT ROOM

1. We are now going to work together to put on your personal protective equipment. I am
going to be here with you to help you and guide you. We are going to do this slowly and
methodically. If you have any issues or questions, just stop, and feel free to ask me
whatever you need to.

2. I am going to give you verbal instructions, and you’re going to acknowledge them back
to me.

3. Now we are going to look at your PPE to make sure everything is here and intact.
4. Sanitize your hands thoroughly to ensure that your equipment goes on clean.
5. Make sure to sanitize all surfaces including wrists, back of hands, fingertips, palms,

around and under nails, between fingers, and thumbs.
6. Now we are going to put on your gown. Make sure there are no holes or tears. Take

your time. Put the gown on slowly and methodically.
7. Slip your arms through your gown.
8. Tie the gown at the neck first. Then tie the gown in the back and not in the front.

(Observer may help with first don of the shift.)
9. Don your gloves, ensuring that the cuff extends over the cuff of the sleeve of your gown.
10. Next, remove your respirator from its container, and put on your respirator.
11. Hold the mask with one hand. Adjust the straps with your other hand.

12. Put on the lower strap first. The lower strap goes on the back of the neck below your
ears. Put on the upper strap towards the crown of your head. Make sure the straps do
not cross.

13. Pinch the nose piece of the mask to the bridge of your nose.
14. Cup both of your gloved hands over your nose and mouth to test your mask. Breathe in

and out to check the respirator for leaks.
15. Adjust straps for a tighter seal if leaks are present.
16. Sanitize your gloves very, very well.
17. (If they are available…) Put on the hair bouffant. Make sure all hair is covered.
18. Sanitize your gloves very, very well.
19. Now put on the faceshield. Do this by putting the strap behind your head, making sure

that the foam is resting on your forehead.
20. Now I am going to make sure that the front and sides of your face are covered and that

no skin remains exposed.
21. Sanitize your gloves very, very well.
22. Can you please hold your arms out to your side and turn around for me? I am going to

make sure that all of your skin is covered, and you are able to move comfortably.
23. Prepare to enter the room.

INSIDE THE PATIENT ROOM

24. Sanitize your gloved hands.

Reusing Face and Eyewear PPE
EXTENDED WEAR CONSERVE PPE – Next patient

(All steps are repeated for every subsequent COVID-19 patient on COVID-19 unit, but only the
first extended wear reuse of the shift must be observed)

INSIDE THE PATIENT ROOM

1. Sanitize your gloves very, very well. Make sure you get your fingertips, thumbs, and in
between your fingers.

2. To remove a disposable gown, cross your arms, and grab the shoulders of your gown.
Pull until you feel it break. Roll it away from you into a ball and over your hands until you
remove your gloves. Avoid touching the outside of the gown. Discard gown into the
waste basket.

3. Sanitize your hands very, very well.
4. Exit the room.
5. Proceed down the hall to the next closest COVID-19 room without touching anything.

Avoid touching your face, the walls, the handrails, or any other surfaces or people as
you go.

OUTSIDE THE NEXT PATIENT’S ROOM

6. Sanitize your hands very, very well.
7. Keep your face mask, hair bouffant, and eyeshield on if they are not visibly soiled.
8. Get a disposable gown and tie the neck in secure knot by reaching behind you. Avoid

touching your mask and face shield.
9. Slip your arms into the sleeves.
10. Adjust the gown so that it covers as completely as possible.
11. Tie the gown at the waist with the tie in the back and not in the front.
12. Put on fresh gloves over the cuffs of your gown.
13. Sanitize your gloves very, very well.
14. Enter the next patient room with a suspected or confirmed COVID-19 patient.

Taking Off Airborne Contact Precautions with Eyewear (ACE) EXTENDED USE
TERMINAL DOFF - Next patient IS NOT in precautions

INSIDE THE PATIENT ROOM

1. I’m here to help you through the doffing process. You will hear me give you directions
that are not normal protocol but are based on current PPE supply shortages. These
directions are designed to keep you safe under contingency or crisis PPE situations.

2. We need to check for any tears or contaminants on your clothes. (Visualize.)
3. Sanitize your gloves very, very well. Make sure you get your fingertips, thumbs, and in

between your fingers.
4. To remove the disposable gown cross your arms, and grab the shoulders of your gown.

Pull until you feel it break. Roll it away from you into a ball and over your hands until you
remove your gloves. Avoid touching the outside of the gown. Discard gown into the
waste basket.
5. Sanitize your hands very, very well.
6. Now exit the patient room.

OUTSIDE THE PATIENT ROOM

7. Sanitize your hands very, very well.
8. Put on a new pair of gloves.
9. Use a disinfectant wipe to create a clean mat. Place the wipe flat on the top of the cart.
10. Sanitize your gloves.
11. Remove the faceshield by the strap and pull it way over your head without touching your

skin.
12. Place the faceshield on the disinfecting wipe.
13. Sanitize your gloves.
14. Remove the respirator.
15. Grab the lower strap and pull it back and then up and over your head without touching it

to your face.
16. Do the same with the upper strap slowly until your respirator comes off. Place the mask

in the bag or disinfected container.
17. Sanitize your gloves.
18. Use disinfectant wipe to wipe the face shield thoroughly on both sides. Include the strap

and the foam pieces.
19. Lay the face shield down in the area designated as clean.
20. Sanitize your gloves.
21. Remove your hair bouffant and discard in the waste basket. Take care to avoid touching

your face and hair if possible.
22. Sanitize your gloves.
23. Disinfect the top of the cart.
24. Remove your gloves.
25. Now thoroughly wash your hands.
26. Turn on the water.
27. Adjust water to a comfortable temperature.
28. Use plenty of soap.
29. Wash your forearms, wrists, backs of hands, palms, fingertips, under and around

nailbeds, thumbs, and in between fingers.
30. Rinse off the soap.
31. Dry with paper towels.
32. Use paper towels to turn off the water, and dispose of them.

I agree that:

• Each step of the ACE donning and doffing process was completed upon the first
donning, first extended reuse, and first terminal doffing of the PPE wearer’s shift.

• Each step was read aloud by the observer. The observer verified each step was
completed properly. If any issues were identified, the procedure was stopped, and the
issue was corrected before moving forward.

• The equipment wearer was able to ask questions or stop the process any time
clarification was needed, if applicable.

• Both parties were courteous, attentive, and professional. Both observer and wearer
acted with great concern for each team member’s health and safety.

____________________________________________ _________________
Signature of Observer Date

_____________________________________________ _________________
Signature of PPE Wearer Date

Resources:
Centers for Disease Control and Prevention. (2014, November 17). Ebola: Personal protective equipment (ppe)
donning and doffing procedures. Retrieved from https://www.cdc.gov/vhf/ebola/hcp/ppe-
training/comprehensive-ppe-training.html
Emory University School of Medicine. (2020, March 31). COVID-19: Conserving ppe. Retrieved from
(https://med.emory.edu/departments/medicine/divisions/infectious-diseases/serious-communicable-diseases-
program/covid-19-resources/conserving-ppe.html

HAND HYGIENE COMPETENCY

Employee Name: ___________________________________ Date: ____________

Alcohol-Based Hand Rub Hand Hygiene Met Not
Met

1. Hand rub used is 60-95% alcohol. (Purell Foaming hand sanitizer is 62%.)

2. Applies alcohol-based hand rub product to one hand according to
manufacturer’s directions (3g of Purell foaming hand sanitizer).

3. Rubs hands together covering all surfaces of both hands, between fingers,
and around and under nails until fingers feel dry, approximately 15 to 20
seconds duration.

4. Goes directly to resident/patient without touching anything or placing hands
in pockets.

Soap and Water Hand Hygiene Met Not
Met

5. Pushes watch up on arm out of the way if applicable

6. Turns on water and wets hands

7. Applies liquid soap to hands

8. Rubs hands together vigorously using friction.

9. Interlaces fingers together and points hands downward

10. Washes all surfaces of hands and wrists, between finger, and under
fingernails with liquid soap for at least 15 seconds

11. Rinse hands thoroughly under running water with fingers pointing .
downward

12. Avoids “flicking” fingers or shaking hands

13. Dries hands with clean paper towel (water still running)

14. Turns faucet off with paper towel

15. Discards paper towel in trash

16. Does not re-contaminate at any point during procedure

17. Natural nails only and are less than ¼ inch in length.

Auditor’s Signature: ____________________________________________________

Observed consistent use of World Health Organization’s My 5 Moments of Hand Met Not
Hygiene Met
1. Before touching a patient/resident
2. Before Clean/aseptic procedures Met Not
3. After body fluid exposure/risk Met
4. After touching a patient/resident
5. After touching patient/resident surroundings

Knowledge

1. True or False?
The preferred method of hand hygiene is alcohol-based hand rub except
the following instances:
Candida auris
Clostridioides difficile (known or suspected),
Norovirus (known or suspected),
When hands become visibly soiled
After using the restroom
Before and after eating or handling food
Mark as “Met” if answers, “True.”

2. True or False?
The World Health Organization Five Moments for Hand Hygiene are:
Before touching the resident (ex: vitals or care)
Before clean or aseptic procedure (ex: changing catheter)
After body fluid exposure (ex: toileting, wound care, FSBS)
After touching a resident
After touching resident’s surroundings (ex: bed, linens, over-bed table, bed
rails, curtain)
Mark as “Met” if answers, “True.”

3. True or False?
Just as it is important for employees to wash their hands, it is also important

to wash residents’ hands to prevent infection after toileting and before and

after eating.
Mark as “Met” if answers, “True.”

Pass: _________ Fail: ________

Comments:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Auditor’s Signature: ____________________________________________________





Universal Masking and Eyewear Audit

Facility: _________________________Unit: _______________ Date: ___________

Measure/Action Met Not N/A Comments

Skill Met

1. Employee wears face covering when

entering and leaving the facility (can

verbally verify if audit occurs mid-shift)

2. Employee wears faceshield or lab style

goggles at all times in care areas, resident

hallways, nurses stations where there is not

a closed door, and common areas

3. Mask is appropriate for task (examples:

KN95 or N95 for direct resident/patient

interaction, surgical mask permitted for

kitchen work that is not in direct contact with

residents/patients)

4. Mask extends over the chin

5. Mask covers nostrils at all times

6. No cloth face coverings except when

arriving and leaving work

7. Mask is not soiled, wet, or damaged

(Instruct employee to get new mask from

screener table if so)

8. Employee wears green mask into green

rooms and yellow mask into yellow rooms

9. Employee wears different mask into

Airborne + Contact Precautions with

Eyewear (ACE) precaution rooms if

applicable

10. Mask is not dangling from ear at any time

11. Mask is not hanging around the neck

12. Employee avoids touching outside of mask.

If employee does touch mask, hand hygiene

is immediately performed with ABHR.

Pass/Fail: _____________

Comments/Corrections:_________________________________________________

Auditor Signature: __________________________________________

*Please report willing violations of universal masking protocols to the
employee’s manager immediately (such as wearing wrong kind of mask or
wearing mask inappropriately).

I have read and understand all of following education documents.

• Teachable Moment Screening
• Teachable Moment PPE Distribution & Procedure Update
• Emory ACE Doffing Inside Room
• Emory Ace Donning
• Face Shield Cleaning
• Face Shield Cleaning competency
• Hand Hygiene Competency
• Airborne Contact Precautions with Eyewear Observer PPE Wearer
• Core Principals of Infection Control
• Universal Masking Audit

In addition, I have passed my competency/demonstration: *

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