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30 | Bulletin vol. 34 no. 1 by Andrea Wahlberg, Ph.D. Tips and Strategies for Resuming In-Person Clinical Neuropsychological Services As parts of the country begin to ease restrictions related to the Covid-19 pandemic, many clinical neuropsychologists are returning to in-person services. Practitioners in all settings should strive to strike a balance between mitigating the risk of virus transmission and providing a high level of clinical care and other related services. The following suggestions are provided to assist providers who are transitioning back to seeing patients and families in-person for clinical neuropsychological evaluations, with additional considerations provided for those who supervise. Tips for Providers in Resuming In-Person Clinical Care: Implement and adhere to additional screening measures at your facility. Many institutions have implemented screening tools such as a "Daily Symptom Assessment," some of which require completion, submission, and clearance before entering the facility. Typically, all individuals including practitioners, staff, patients, and family members are required to complete the assessment. The assessment typically consists of questions regarding common Covid-19 symptoms and potential exposure to the virus, either through known contacts or recent travel. The symptom screener can be completed verbally, in writing, or electronically via app or webpage submission. If your facility does not require this upon entry, consider completing and documenting your own symptom assessment each day and for each individual with whom you come in contact. The following are commonly asked questions in symptom screening tools: • Have you experienced fever (either a measured temperature of 100 degrees Fahrenheit or subjective fever) within the last 24 hours? If feasible, consider actively taking your temperature and the temperature of every individual who enters your facility. • Are you experiencing breathing difficulty? • Do you have a cough, congestion, or sore throat that is different from your baseline? • Do you have new loss of taste or smell? Should an individual answer yes to any of the screening questions, entry into the facility should be restricted and the individual should be encouraged to be tested for Covid-19. Importantly, these individuals should be provided with information on various testing locations in the community. Use Personal Protective Equipment (PPE) and use it consistently. Due to the potential for asymptomatic/ presymptomatic transmission of the virus, the Centers for Disease Control (CDC) recommends all individuals aged 2 years and older wear a facemask or cloth face covering (with certain exclusions noted on the CDC website). The facemask or face covering should completely cover the mouth and nose and should be worn upon arrival and throughout their stay in the facility. Clinical neuropsychologists and psychometrists might consider using a clear face mask or a mask with a clear panel, particularly when working with patients who are deaf, hard of hearing, or at times when reading lips and visualizing facial expressions is important. Practitioners should continue to wear their facemask in breakrooms and other shared co-working spaces. In addition to a face mask, providers should also consider the use of goggles, gloves, and/or a face shield. Practitioners may also wish to consider wearing scrubs as they are easier to sanitize. When laundering items, use the warmest water setting appropriate and dry items completely. Keeping nails trimmed and pulling back long hair are additional hygiene considerations that can help reduce virus transmission. Provide hygiene products for patients and clean hands frequently. Alcohol-based hand sanitizer, soap and water, tissues, and no-touch receptacles for disposal should be made available at multiple locations within your facility. Encourage your patients to use these products. Hands should be washed or sanitized often, particularly after coughing, sneezing, or blowing your nose, before and after eating, before and after providing care for someone who needs assistance, and after removing gloves. Hands should be washed with soap and water for 20 seconds, and hand sanitizers should contain at least 60% alcohol. Use more extensive sanitation procedures in physical spaces. Providers should make sure they have several sanitation products available for immediate use for both hard and soft surfaces. The CDC suggests cleaning surfaces with soap and water to reduce germs, dirt, and impurities on the surface, followed by disinfecting to kill germs on surfaces. EPA-registered • Do you believe you have had a potential exposure to someone with Covid-19? • Have you recently traveled to any areas deemed "hot spots" for Covid-19? CDC and state and local officials may be able to provide updated guidance on communities with high transmission rates. • Have you been advised to self-quarantine by a medical provider, regulatory agency, or otherwise?

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