Journaling is an important aspect to your emergency response plan that will document your unique situations and how you adapted during a time of crisis.
Generally, organizations have leveraged existing risk management processes or even tried different techniques to ensure appropriate documentation. Due to the COVID-19 pandemic, federal agencies and states have temporarily changed or waived their guidance on personal protective equipment (PPE) usage, staffing, licensing and other requirements – some of these items are covered in the links below. It is critical for organizations to enhance their efforts and maintain accurate and thorough documentation to memorialize the efforts they are taking in light of these changes.
It is critical for organizations to enhance their efforts and maintain accurate and thorough documentation to memorialize the efforts they are taking to secure essential items such as Personal Protective Equipment (PPE) - masks, gowns, and gloves. Documenting your unique situations and the realities of operations during this time of the pandemic may help you defend yourself if faced with a regulatory survey or legal action. Journaling your action steps is a good method of documentation. Here is how:
Begin a journal of the COVID-19 pandemic, taking care to document how you responded to its many challenges specific to procurement of needed supplies. The journal should contain input from all disciplines within the facility (administration, procurement, maintenance, nursing, etc.) and should be completed at the time of request and receipt. The journal should include:
1. Date and time of Request, to whom it was made, and what was ordered. Always have the requestors and receivers noted by the entry, for example:
- 4/8/2020 10:00 am, John at XYZ Medical Supplies (or ABC Staffing Agency)
- Central Supply clerk ordered 500 face masks, stated will send 50, others on indefinite backorder
- Requested 3 RNs, and 5 Nurse Aides from ABC Staffing agency, DEF Staffing Agency, GHI staffing agency
2. Date and time of Response, name/title of responder if different from above
- 4/18/2020 11:00 am – 10 days later – Kyle XYZ Medical Supplies
3. Items provided/received, quantity received, note any discrepancy
- Received 50 face masks
- Box of masks usually $20 today was charged $350
- None of the staffing agencies had any staff to send
4. Date stamp and time stamp on packaging slip of receipt and note any time lag
- Received on time or several days later than promised
5. Track any additional comments/changes/corrections
- Made 2nd request for mask to State Department of Health, other agencies.
- My Staff worked 16 hrs. on 8 hrs. off, and administrative staff asked to fill as needed under nursing directions
6. Document how an external change to your order affected your operations and what contingencies were made.
- Began reusing masks, began using homemade masks with filters (or whatever other unique adaptations you made to provide the protection of the masks for patients and staff).
- Ordered hand sanitizer from four different locations; none found. Provided soap and water for washing and rubbing alcohol rinse to follow
- Reached out to 5 local businesses and requested donations of gloves, masks and hand sanitizers. One business sent 10 boxes of disposable gloves, 50 surgical face masks, and 5 (50 ml) bottles of hand sanitizer. All made available to staff.
7. Maintain your journal according to your organization’s document retention policy.
- Do not make corrections but note if there is a discrepancy in an entry due to governmental or CDC changes that altered known guidelines.
Journaling is an important aspect to your emergency response plan that will document your unique situations and how you adapted during a time of crisis. When memories or details might fade, your journal will always be there if information is needed at a future date. It may also guide you in the future as you update and refine your emergency response policies and procedures.
Other COVID-19-related resources:
https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf
https://www.cdc.gov/coronavirus/2019-nCoV/
https://www.osha.gov/Publications/OSHA3990.pdf
https://www.mcknights.com/news/providers-urged-to-fight-covid-19-lawsuits-by-documenting-everything/?utm_source=newsletter&utm_medium=email&utm_campaign=MLT_DailyUpdate_20200415&hmSubId=rCtMXjXuyt01&hmEmail=6o4z9F6lHRn4m5Bd9Dl_iKQ7tQPiyLV60&email_hash=75a4841d6ef9e75f6f23d68566bda317&mpweb=1326-8824-601122 (Obtained from McKnight’s website 4/15/20.)