What precautionary actions are being taken to safeguard our facilities?

 A: We are taking measures to have a more controlled environment in our care sites that will limit entry into hospitals and clinics. This will help ensure screening occurs prior to entry into patient care areas so that masks are provided to patients with respiratory symptoms. As we often do during heavy influenza outbreaks, visitor restrictions will be instituted in patient care areas. Colleagues will be included among those who will be screened before entering our hospitals and other care sites. In addition, universal masking and social distancing are implemented at workplace. Employees are to keep the mask on at all times during work hours and to eat lunch alone or 6 feet away from others.

Q: How can the infection of healthcare workers be prevented?

 A: Our caregivers are skilled and experienced in caring for patients with flu-like illnesses and we are re-emphasizing infection prevention protocols and the latest guidance from the CDC. The experience of treating coronavirus in the U.S. and other first world countries has shown that the use of standard respiratory precautions has prevented the infection of healthcare workers, who we count on to stay healthy to take care of all patients.

Q: What does infection prevention entail?

 A: Infection prevention includes processes for screening potential coronavirus patients, and the proper use of isolation procedures. Additionally, our facilities are reinforcing effective environmental cleaning and visitor policies that support infection control. 

Q: How is the virus impacting the distribution and conversation of Personal Protective Equipment (PPE)?

 A: Because so much of the Personal Protective Equipment (PPE), such as gowns and masks used to protect our patients, colleagues and visitors from the spread of infections, is made in China where this virus originated, this is another area of emphasis. We are promoting the conservation of these important supplies, preparing to share supplies within our markets to help ensure continued availability while also actively working to identify alternative sources of PPE.

Q: How can I personally prepare myself to avoid exposure/infection?

A: When considering personal preparedness, it is important to keep a few points in mind. First, infectious disease experts are emphasizing that coronavirus causes an illness that is similar to the flu. Everyday habits that protect us from common respiratory illness are even more important now. We all can protect our own health as well as the health of our family members and community by remembering:

• Avoid close contact with people who are sick
• Avoid touching your eyes, nose, and mouth
• Stay home when you are sick
• Cover your cough or sneeze with a tissue
• Practice good hand hygiene by washing your hands often, using either soap and water or alcohol-based hand gel for at least 20 seconds
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe
• Avoid areas with large crowd and practice social distancing-keep 6 feet away from others.

Q: What is the protocol if a patient presents as a potential COVID-19 case?

A: Under the new CDC guidelines, the patient will be immediately tested and isolated. Potentially exposed employees will be identified. Those who are deemed exposed per the CDC definition of “exposure” will be contacted by employee health to monitor themselves for 14 days from the date of exposure. Symptomatic employees will be removed from workplace and be tested. 

COVID 19 FAQs for Furloughed Clinicians

 I understand that I am being asked to remain home from work, why?

In exposures we follow a process called quarantine.  Your safety and the safety of our patients is our top priority, it has determined that you may have been exposed to a patient/coworker with the new novel coronavirus (COVID-19) and is experiencing symptoms. Since this infection can be contagious, even with mild symptoms, it is safest for patients and other staff for you to remain outside the workplace. For additional questions regarding exposure to COVID-19 from work or community, please contact employee health for further instructions.

hat does it mean to be under quarantine?

Typically, being under quarantine means that you must limit your travel and contact with others, including potentially staying within your home.  Your hospital is working with the local department of public health, which is the entity that requires quarantine, to get further details.  The Department of Health will be in contact with you and provide specific details of its expectations.

What about other members of my household – can they be with me?

 The Centers for Disease Control (CDC) recommends no special actions for those sharing a household for someone under quarantine.

What about if I was exposed outside of work?

Please report to HWS immediately if you believe that you have been exposed outside of workplace to COVID-19 positive individuals. Please report to HWS immediately if you are experiencing any symptoms concerning COVID-19, even if your source of exposure cannot be identified at the time. Employee Health will be notified and will reach out to provide you information on next steps to safely return to work.

Will I be paid while I am being furloughed?

 Were you infected while working?

• If you test positive to COVID-19 as a result of a documented work-related exposure to any patient, visitor, contractor, vendor or fellow employee that is positive for COVID-19, you will be asked to remain at home and you will not be placed on the hospital schedule over the next 10 days counting from onset of symptoms or date of testing (please follow specific instructions from employee health regarding quarantine time frame). During this time, you will receive compensation for all scheduled hours missed during this period at the base rate.  Your employer will also file a workers comp medical claim to cover expenses after the defined quarantine period is over if necessary. However, you must be COVID-19 positive with a confirmed positive source.

Will someone be in contact with me while I am away from work?

 Our Employee Health Nurse, will call you to check in and assist with answering questions that you may have. This conversation will include checking in on how you are feeling and if you are having any symptoms that may need medical treatment – fever, shortness of breath, body aches, runny nose, etc.

 Where can I get more information about my potential exposure?

 Please go to https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html for comprehensive guidance.

Should you have questions while you are away from the hospital, contact our Employee Health Nurse @ Lilly.Ranney@HealthTrustWS.com

Corporate Information Technology Group (ITG) has deployed new eSAF “Core Access” functionality that automates provisioning of Direct Care Nursing Access for Meditech users in North Florida Division.

This new eSAF functionality solves the challenges of new direct care nurses being “hired” into a new or existing Lawson Position Code that is not setup for role-based/entitled system access.

Adoption of standardized Meditech access templates for direct care nurses will provide noteworthy relief to nurses, managers, and ITG personnel. 

Additionally, adoption of standardized Meditech MIS user mnemonics will make it easier to “share” nurses across markets and divisions and eliminate the need to change MIS user mnemonics.

Standardized Meditech access templates for the Division will include more options on the main Meditech menu and some menus may look different, resulting in a period of adjustment as nurses become accustomed to the new access. A minimal adjustment period is expected, with most nurses achieving a level of comfort within hours.

Nursing staff will also be granted access to all facilities in their Division/market.

The deployment of the project is the week of September 1.

Please see attached education. 

NFD DCNA

Please review the attached ECMO Huddle Card detailing:

• ECMO Documentation
• The Importance of ECMO Documentation
• ECMO Modes
• ECMO Family Meeting Process

Additional resources on ECMO can be found on Atlas Connect and by Scanning the QR Code. 

ECMO Huddle Card

Thank you for your DEDICATION to Patient Care!

Please ensure all GE Dash Patient Monitors are being tested before use on each patient. An issue has been identified indicating a potential issue with the audio alarm not functioning properly. 

Recommendations

1. Test each device one time per shift, at a minimum.
• Refer to the Dash™ 4000 Operator's Manual for the location and operation of the SILENCE button.  The Dash™ 4000 produces an audible beep tone when the SILENCE button is pressed. This confirms the audio function of the Dash monitor is working properly.
• The Dash monitor should be verified it is in correct working order and operating condition before use and the functions of the alarm systems verified at regular intervals per the Operator's Manual. 
• If only a "clicking" sound or no discernible audible sound is produced when the SILENCE button is pressed, the audible alarm function of the Dash monitor may not be working properly. 
• Lastly, any functionality issues involving the audio alarm will not affect the visual alarm functionality of the Dash, or the audio and visual alarm functionality of the Central Station (if connected to the Dash). 
• Additional information can be found in Chapter 2 “Equipment Overview” and Chapter 4 “Alarms” of the attached Operator’s Manual.  
2. If the audible alarm is found to not function properly, immediately remove the monitor from service and return it to the BioMed Department.
3. Report any similar occurrences to the PSO where a patient was harmed or a near miss.

Dash Operator Manual

Thank you for your dedication to patient safety!

Meditech has been recently updated with two new proning therapy order entry screens. This will allow for standardized documentation of the therapeutic intervention. 

Please review attached education regarding screen updates as well as Proning Therapy guidelines for both manual and device assisted (bed) proning therapy. 

Meditech Proning Therapy Orders

Proning Guidelines

Thank YOU for you continued DEDICATION to patient care!

• Everyone in the hospital environment will be masked
• Patients will wear level 1 masks when outside of their treatment rooms or when face to face with HCPs during care
• Visitors will wear personal masks or be provided with a level 1 if needed
• Non-clinical staff will wear level 1 masks at all times
• Clinical staff will wear the appropriate level of mask for the clinical situation
• Staff - universal eye protection for ED, ICU, and other high risk areas
• Staff - eye protection when face to face care and patient cannot mask
• Staff - fit tested N95 with full face shield for ALL AGP

Please review attached education-Mask Level Required and Huddle Highlights.

PPE Guidance

PPE Huddle Care

Thank you for your HARD WORK AND DEDICATION to PATIENT CARE!

Please use the link below as guidance from the CDC for infection prevention and control recommendations.  The guidance is based on the current available information/situation in the United States for COVID-19.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html

Thank you for your continued DEDICATION to patient care!

The East Florida Division is increasing Meditech timeouts.  The current setting is 6 minutes for screen, menu, and suspend session. 

The new Time Ous are as follows:

• Screen Time Out-15 minutes
• Menu Time Out-30 minutes
• Suspend Session-30 minutes
  
  Meditech Time OutsThank you for all your HARD work and DEDICATION to patient care!

The Far West Division and The Mountain Division are standardizing the Meditech Menus. 

Go Live Dates:

MTN – Eastern Idaho – June 16,  Brigham City and Cache Valley – June 18, Ogden Regional – June 22-23, Mountain View – June 24, Lakeview – June 25, Timpanogos Regional – June 29, West Valley – June 30

FWD – Good Samaritan – July 13-14, Regional SJ – July 15, Southern Hills – July 16, Los Robles – July 20-21, West Hills – July 21, Riverside – July 22-23, Sunrise – July 27-28, Mountainview – July 29-30

Please review attached huddle cards.

MNT Huddle Card

CA/NV Huddle Card

Thank you for all you DO!

At HCA Healthcare, nurses are the cornerstone of patient care and considered the lifeblood of the organization

HCA Healthcare’s Senior Vice President & Chief Nurse Executive, Jane Englebright, Ph.D., RN, CENP, FAAN, says that because nurses are with patients and their families during some of the most important and vulnerable moments in life, it means they have a unique opportunity to make a difference. And they can positively impact both outcomes and the care experience for every patient.

Englebright recently provided her thoughts through an executive Q&A.

Why is it important for nurses to have a voice in their profession?

ENGLEBRIGHT: In the United States, nursing is the largest healthcare profession, with more than 3.8 million registered nurses nationwide. I’m also a nurse. Many of us pursue this profession because we care deeply about improving peoples’ lives. Nurses are insightful, creative and passionate about patient care, and their perspective is invaluable because they spend more time with patients than anyone else in a hospital. As we advocate for patients, our voices influence positive changes for the practice of nursing and, ultimately, that improves patient care. So it’s important for healthcare leaders to create open environments where nurses’ voices are heard and acted upon because it can lead to exciting advancements in patient care.

Listening to nurses through surveys and focus groups helps leadership understand what nurses need to advance their careers as well as to build and maintain a realistic worklife balance to care for their families. Giving a voice to nurses has significant benefits to the organization and its mission to care for and improve human life, but also to the amazing people who deliver that care with compassion and expertise.

How do healthcare organizations benefit when nurses are heard and supported?

ENGLEBRIGHT: Historically, the voices of nurses have led to better patient care. From Florence Nightingale to Clara Barton, we’ve seen that some of the greatest success stories in healthcare occur when nurses are given latitude in guiding decisions that affect patients. That’s the approach we’ve taken at HCA Healthcare for many years now, and it has unlocked possibilities that we and others in care delivery hadn’t yet realized.

For example, 10 years ago, through our CNO Council, nurses asked for a tool to electronically document patients’ vital signs. Documentation was done at that time mostly room-to-room with pen and paper. Automation would create significant time savings for nurses, and would lead to better and safer care for our patients. Companies were asked to present their vital sign solutions to a group of nurses from HCA Healthcare who tested the tools and chose the right technology for them. The tool they selected didn’t exist until these nurses told us what they needed, and that probably wouldn’t have happened if we weren’t actively seeking their perspective.

More recently, we surveyed more than 800 of our nurses for their feedback on advancing nursing practice at our hospitals. Through the survey, we found that a large portion of documentation was neither efficient nor effective. Thanks to our nurses, Evidence-based Clinical Documentation (EBCD) was born.

The EBCD tool helps nurses spend more time with their patients and less time documenting the encounters. The patient-centered focus of EBCD minimizes the time spent inputting data, and at the same time, allows the information that has been entered into the medical record to be extracted in a more meaningful way. As a result, we’ve seen our nurses save at least 30 minutes on documentation, per shift.

Besides the surveys you mentioned previously, what are some additional ways HCA Healthcare ensures nurses’ voices are heard?

ENGLEBRIGHT: We have a number of ongoing vehicles and venues to give voice to our nurses:

• Professional Practice Councils. Every hospital within HCA Healthcare has these councils, which exist to proactively identify issues and opportunities to improve care. They are venues for bringing forth new ideas and for testing innovations in care delivery. The councils systematically raise the bar on nursing performance.
• Advisory Councils. These specialty councils govern how best practices are shared across the health system and include nursing representatives from each division and various clinical roles, including direct care nursing staff and nurse leaders.
• Nurses at every level of our organization. While nurses are best known for being on the front lines of care, they are stepping beyond nurse director and CNO titles and into positions such as CEO and COO. Nurses in C-suite roles are helping to shape business and operational decisions across the enterprise.
• Vital Voices. Through this program, which utilizes a continuous listening approach, colleagues actively seek conversations to solve problems and generate ideas. This allows nurses to provide real-time feedback and see real-time improvement.
• Inspire App. The app is an easy way for nurses to recognize excellence, chart professional growth, and connect with mentors and peers.