Required Learning Resources and Activities

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Describe the basics of the epidemiology, clinical presentation, and transmition of COVID-19

Recognize considerations for COVID-19 management in special populations

Describe basic aspects regarding the pathophysiology, transmission, diagnosis, and treatment of COVID-19

Contrast the nomenclature of the virus and the disease.

Identify basic virology and transmission aspects of COVID-19.

Required Learning Resources and Activities

Recognize response approaches to COVID-19 for rural healthcare systems and communities

Recognize elements that need to be evaluated to determine Facility Readiness to respond to COVID-19

Describe the actions that need to be taken to improve infection and prevention control in healthcare facilities

Describe the concept of COVID-19 mitigation.

Describe how to interpret a mitigation, mobility, and epidemiology graph. 

Summarize recommended measures to minimize COVID-19 nosocomial infections.

Additional Resources for Optional Learning

Physical protection for healthcare workers includes PPE for workers and patients, proactive engineering and administrative practices, and proper decontamination of inanimate objects. Ideally, virus filters should be placed on all endotracheal tubes and BiPAP machines. Strong consideration should be given regarding the risk of staff exposure when intubation, BiPAP, and any aerosolizing procedure treatments are utilized. 
Please begin this module by viewing the video posted below as it provides an overview of Physical Protection for Healthcare Workers.
From the field: Some hospitals are considering deferring these treatments if staff protection is not available.

     

The following contains some information from the field.

The information surrounding personal protective equipment (PPE) is varied and ever-changing as knowledge of the virus evolves. PPE recommendations will also vary based on job function, location, facility policy, and available supply. Ideally, healthcare workers will wear a fit-tested N95 mask or powered, air-purifying respirator (PAPR) when they are working within a 6-foot radius of COVID-19-positive patients. Additional PPE, as indicated, includes face shields, shoe covers, and hair covers/bouffant caps, fluid-resistant gowns, and gloves (NIH, 2020). 

Even the N95 respirator mask is not 100% protective (the N95 filters out particles >0.3 microns, whereas COVID-19 is a 0.125-micron virus size), so it is important to utilize both engineering and administrative protection to the greatest extent possible. Surgical masks are indicated as PPE against COVID-19 as they offer some protection against the virus; the application of a surgical mask over an N95 mask reduces the risk of N95 mask soiling (NIH, 2020). 

Extension and reuse practices should be implemented to combat the shortage of this protective equipment. N95 respirator masks can safely be disinfected using low-temperature sterilization methods. (Jatta et al., 2020).

References

Required Learning Resources and Activities

Identify recommendations and risks regarding reuse and extended use of facepiece respirators

Summarize surface disinfection measures based on evidence about coronavirus persistence on inanimate surfaces

Implement the five prevention and control strategies when COVID-19 is suspected in clinical cases.

Additional Resources for Optional Learning

INCLUSION RATIONALE

Contingency and crisis standards of care differ greatly from the standard of care that health workers are accustomed to providing their patients when resources are adequate to meet the wellness needs of a healthcare facility, community, region, or nation. The disparity in these care standards, the stress associated with the fear of contracting or spreading COVID-19, and increased demand on the healthcare workforce can lead to worker burnout, overwhelm, and mental fatigue. With the heavy burden that the pandemic is placing on healthcare workers, post-traumatic stress disorder and emotional and physical exhaustion are realities. For this reason, the topic is included in the course despite its exclusion from the competency set used to support course content. This lesson equips frontline healthcare providers to manage stress and discusses strategies to deal with professional and personal demands.

Required Learning Resources and Activities

Identify methods to manage stress associated with the COVID-19 outbreak.

Apply relaxation techniques

Optional Resources for Additional Learning

Required Learning Resources and Activities

Summarize the pre-exposure and post-exposure prophylaxis recommendations for COVID-19

Additional Resources for Optional Learning

Required Learning Resources and Activities

Summarize the recommendations regarding duration of isolation and precautions along with the role of testing on them

Identify isolation precautions recommendations

Required Learning Resources and Activities

Recognize modifiable and non-modifiable risk factors for COVID-19

Identify groups vulnerable to SARS-CoV-2 infection

Additional Resources for Optional Learning

There are many challenges to studying risk factors for contracting COVID-19 in the context of a public health crisis. In this lesson, you will learn about these risk factors and how are they classified as modifiable and non-modifiable.

For more information on modifiable risk factors, view our course on Lifestyle Medicine by clicking here.

The following contains information from the field.

The need for COVID-19 testing is determined on a case-by-case basis. Testing should be considered for individuals who exhibit signs and symptoms of the disease and those with recent known or suspected exposure to SARS-CoV-2, besides special cases. (CDC, 2020)

The signs and symptoms of COVID-19 include fever, cough, shortness of breath, fatigue, the new loss of taste or smell (anosmia), and gastrointestinal symptoms. COVID-19 patients may also appear asymptomatic. 

Screening and testing for COVID-19 should occur based on local health advisement agencies and clinician judgment. Priority testing information is provided in this module. Infection with both SARS-CoV-2 and with other respiratory viruses has been reported, and detection of another respiratory pathogen does not rule out COVID-19. (CDC, 2020)

References

Required Learning Resources and Activities

Determine the indications for each form of COVID-19 testing according to clinical presentation.

Determine the priority for COVID-19 testing in clinical cases

Describe recommendations for laboratory diagnosis along with the rationale for them

List recommended measures for people under contact tracing process

Differentiate patients with asymptomatic, mild, moderate, severe, or critical COVID-19 illness

Identify symptom clusters of COVID-19 and their relevance on prediction and treatment

The following contains information from the field.

CT may show lung findings (such as ground-glass opacities) before the development of symptoms. In a setting of pandemic, assume that COVID-19 is the cause until proven otherwise, even if a patient is not symptomatic with COVID-specific symptoms. Ferritin, elevated IL-6 levels, C-reactive protein (CRP), d-dimer can be related to COVID-19 severe infection.

Procalcitonin and prolactin are elevated in patients with bacterial co-infection. White blood cell (WBC) count is normal or low in COVID-19-only patients but sometimes elevated in patients with co-infection. (Auwaerter, 2020).

References

Auwaerter, P. G. (2020). Coronavirus COVID-19 (SARS-CoV-2). In Johns Hopkins ABX Guide. The Johns Hopkins University. Retrieved from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540747/all/Coronavirus_COVID_19__SARS_CoV_2_ 

Required Learning Resources and Activities

Associate clinical signs and additional test results with critical illness

Additional Resources for Optional Learning

This module examines the treatment protocols for patients across the entire COVID-19 spectrum, including medication and supportive care. Please begin this module by viewing the video posted below as it provides an overview of the Treatment on COVID-19 patients.

The following contains information from the field.

Patients with asymptomatic or mild illness should stay home, avoid others, and employ proper hygiene and decontamination of surfaces. In moderate illness cases, given that pulmonary disease can rapidly progress in patients with COVID-19, close monitoring is recommended. Hospital infection prevention and control measures should be implemented and available therapy must be considered on a case-by-case basis. (NIH, 2020)

Regarding oxygen delivery devices, a high-flow nasal cannula is recommended over over noninvasive positive pressure ventilation (NIPPV). A trial of awake prone positioning to improve oxygenation can also be helpful if mechanical ventilation is not indicated. (NIH, 2020)

Finally, we will discuss common complications of COVID-19. Common complications are: Bacterial Superinfection of COVID-19-Associated Pneumonia, Septic Shock, Thromboembolic Events, progressive respiratory distress (including ARDS), Renal and Hepatic Dysfunction Due to COVID-19 and several others. (NIH, 2020) 

References

National Institutes of Health. (2020). COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Retrieved from:  https://www.covid19treatmentguidelines.nih.gov/

Required Learning Resources and Activities

Interpret evidence regarding the efficacy and safety of COVID-19 potential treatments

Additional Resources for Optional Learning

Contrast invasive and non-invasive ventilation between COVID-19 patients and regular patients

Additional Resources for Optional Learning

Required Learning Resources and Activities

Identify medications and procedures for rapid sequence induction

Recognize common complications of COVID-19 and their implications for the patient

Determine when a patient is eligible for ICU admission or discharge

Summarize recommendations for the care of Critically ill patients with COVID-19

Describe general considerations for the treatment of complications of COVID-19

Identify factors associated with COVID-19 -related death

Additional Resources for Optional Learning

Interactive Tools

Describe general recommendations for COVID-19 treatment in adults

Integrate knowledge from treatment guides to solve clinical cases

Summarize the updates on COVID-19 treatment guidelines

Additional Resources for Optional Learning

Required Learning Resources and Activities

Identify the symptoms that persist after recovery of Covid-19 infection according to frequence.

Describe the proper management of post-COVID-19 recovery symptoms

Summarize COVID-19 cardiovascular complications and the possible long-term sequelae.

Required Learning Resources and Activities

Integrate knowledge from treatment guides to solve clinical cases

Additional Resources for Optional Learning

Many factors must be considered when providers face a decision of whether or not to cease the implementation of life-saving measures in critically ill and coding COVID-19 patients. These factors include, but are not limited to, the prognosis, suffering, quality of life, and dignity of the patient, along with the safety of the staff caring for the patient. This module offers resources to support clinicians in providing end-of-life care. 

Describe common interventions to improve palliative care for COVID-19 patients at the end of life

Differentiate special considerations for effort cessation in COVID-19 patients

Describe practices to mitigate grief

Additional Resources for Optional Learning

Describe different types of study designs

Interpret levels of evidence and grades of recommendation of medical research