One of the main complications being seen with COVID-19 is ARDS; plateau pressure is a key indicator of assessing lung injury. Plateau pressure has been added to RT ventilator flowsheet to assist with trending and care of patients. 

RT Ventilator Flowsheet

In addition included are Meditech updates:

• EDM and new tracker icons for 1^st POC and COVID-19
• 1^st Point of Contact Screening with embedded QRS icon leading to Media Connect Education

ED First Point of Contact

First POC

Thank you for your Dedication to Patient Care!

Please refer to this Guidance and ensure you are safe when caring for deceased COVID-19 patient. 

Postmortem Care

Thank you for Dedication to Patient Care!

Please view COVID-19 PPE Video featuring Dr. Ken Sands, Chief Epidemiologist and Patient Safety Officer, and Sammie Mosier, Associate Chief Nursing Executive.

https://mediaconnect.medcity.net/media/3.20.20+COVID-19+Personal+Protecive+Equipment+video/1_vvmpt2x3

Thank YOU!

Extended use of N95 masks, googles, and face shields has been activated enterprise-wide.

The Goal being to keep caregivers safe and preserve the PPE supply.

At the end of each shift, all eyewear, facemasks, and N-95 respirators must be collected for future reprocessing per guidelines. 

Please ensure you review the education below.

Guidelines for Re-Processing PPE

Huddle Card

Poster for Re-Processing

FAQ's for PPE Re-Use

We appreciate your unwavering commitment and dedication to patient care! Thank you for ALL you DO!

Please review the attached education for the reuse of the N95 mask and Face Shield during the times of limited supply when performing respiratory care procedures that generate aerosols and droplets as a source of respiratory pathogens. 

COVID-19 Huddle Card: Reuse

Additional education is available in HealthStream for self-enrollment:

COVID-19 Reuse of N95 Mask

HealthStream Instructions:

1. Click Here to open HealthStream
2. Enter your 3-4 ID for your Username and Password in all UPPERCASE, then click Sign In
   1. If you cannot log in using uppercase, try using lowercase letters for your password
   2. If you are still unable to login, call 954-514-1333
3. Select your HealthTrust (HWS) Affiliation, and then click Login

Step Two:

1. Go to your Catalog tab after logging into HealthStream
2. From the Catalog tab, search course name. 

Please comment below with questions. 

Thank for your continued DEDICATION to patient care!

Please review attached document on COVID-19 PPE Selection Table. This table provides guidelines for PPE for the varying patient situations. 

We appreciate ALL your HARD work and DEDICATION to Patient Care!

PPE for COVID-19

Provided is a document of guidance for respiratory protection in reference to caring for COVID-19 patients under investigation or confirmed cases. Included are N-95 limited re-use guidelines. 

Respiratory/Eye Protection

Single Use COVID-19 PPE: Donning and Doffing Guidelines

https://mediaconnect.medcity.net/media/PPE-3-13-2020/1_ulyt6d6t

Single Use Donning and Doffing

Please comment with questions. 

Thank you for your dedication to patient care!

Important Ongoing Coronavirus (COVID-19) Information & FAQs

We’d like to take a moment to connect with you as we know the Coronavirus (COVID-19) outbreak is on the hearts and minds of each of our clinicians, team members, your families, our communities,  the nation and the entire world. This unprecedented situation is evolving quickly as more information becomes available.  We continue to operate and conduct vital business functions under the guidance of HCA Healthcare. We are tasked with the important job of ensuring the delivery of patient care, in good times and in tough times. Right now we are facing a great deal of stress and uncertainty. In an effort to effort to provide clear guidance on how we are preparing for and responding to COVID-19, we have developed several FAQs to assist during this time.

COVID-19 Response FAQs

Q: Have Coronavirus patients been treated at HCA Healthcare facilities?

A: To date, HCA Healthcare affiliates have treated patients who have tested positive for coronavirus. Our preparedness efforts are focused on the following areas: infection prevention, supplies and equipment, and staffing.

Q: 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.

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 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. While a vaccine for coronavirus is not expected to be available for at least 12-18 months, 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

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 high and medium risk exposure by the CDC guidelines will be sent home under home quarantine for a 2 week period.

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 furlough.  Your safety and the safety of our patients is our top priority, over the next 14 days you will be asked to remain at home and you will not be placed on the hospital schedule.  The hospital has determined that you may have been exposed to a patient with the new novel coronavirus (COVID-19). Since this infection can be contagious, even with mild symptoms or before symptoms begin, it is safest for patients and other staff for you to remain outside the workplace. 

What 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.

Why does the furlough last 14 days?

• The time of the furlough is based on the period of time between when someone is exposed and the longest time before they are likely to have symptoms. For COVID-19, the “incubation period” can be as long as 14 days and, as a result, you cannot be at work until that period ends and we know that you do not present an infection risk to patients or other staff.

• Being furloughed only means that you are staying away from the workplace because it is possible you could develop symptoms. It is believed that most people who get COVID-19 have a mild, flu-like illness. The department of health will be monitoring you to see if you develop any symptoms.

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.

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 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 14 days. During this time, you will receive compensation for all scheduled hours missed during this period at the base rate.  You can 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.

• Over the next 14 days you will be asked to remain at home and you will not be placed on the hospital schedule.  During this time, you will not receive compensation for all scheduled hours missed during this period.

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.

Click here to access a CDC fact sheet.

If you have any questions, please contact HWS Employee Health Nurse, Lilly Ranney at lilly.ranney@healthtrustws.com.

As the situation continues to evolve, we will provide you with additional information as we work closely with local and national health organizations. Thank you for all you do to care for our patients or support those who do.

Regards,

The Continental Division has recently updated the Nursing Meditech Menu.  The Menu will be standardized across the Division: same menu, same numbers, same status board, etc. for all facilities in Continental Division. 

Please review the attached education and comment with questions. 

Meditech Menu Update

Thank you for all you DO!

Attached is the education for the new algorithm for COVID-19 in EBCD Meditech. Added is the COVID-19 screening and three positive scenarios.

Please review and comment with questions.

Thank you for all your HARD work and DEDICATION to patient care.

We APPRECIATE and VALUE each of you!

COVID-19 Meditech

https://mediaconnect.medcity.net/media/t/1_kir3u58j