To our highly esteemed Members of the Medical Staff, Nurses, Respiratory Therapists, Community Health Aides, and anyone else who might take care of our patients:
I’d like you all to take the time to review this document if you can. Near the middle of the page there is a chart that describes your risk if you are taking care of a patient who eventually tests positive for COVID. It is sort of confusing, but here’s how we have interpreted this in conjunction with State Section of Epi:
1. You need to wear a mask at all times. For those of us providing direct patient care, this needs to be a surgical mask, not a cloth mask.
2. All of our patients need to wear a mask at all times, unless they are too young or have some other condition that prevents wearing a mask. This includes all escorts of all patients at all times in our facility.
3. If the patient is NOT wearing a mask (they are too young or have some other condition that prevents wearing a mask) you must also wear eye protection – a face shield or goggles, your personal eye glasses are not considered eye protection.
4. If you are performing an aerosols-generating procedure, you must have full PPE on: gown, gloves, eye protection and an N95 respirator.
We had an exposure in our hospital recently that helped many of us learn some lessons about this new guidance. We often cannot exclude our health care workers from work for 14 days because of staffing issues, so we have to use other CDC guidance for return to work that involves testing and symptom monitoring, which is less than ideal but still acceptable. But if we are all diligent and remember to use eye protection when the patient can’t wear a mask, we can avoid inadvertent exposure.
A couple of important notes:
1. The second stage of labor is an aerosols-generating procedure. If the patient can’t wear a mask, the health care workers need to wear eye protection and at least a simple surgical mask.
2. For our hospital admissions and labor and delivery admissions: I would remind you that the Abbott ID Now rapid test, if negative, is a preliminary negative. We send all those to the State of Alaska for confirmation. While we have not had a false negative as of yet, I wouldn’t want any of you to be exposed inadvertently if there comes a time when we have one. The confirmatory test takes about three to five days to return.
3. It just so happens that face shields are the one type of PPE that we still have a somewhat inadequate supply of, so you will need to unfortunately reuse them as much as is practical. I recognize that is not best practice. For those “splash” masks with the elastic around the back of the head and the foam that goes on your forehead, you can disinfect those between patients but don’t use the Optim 1 wipes on them; use the sani-hands or soap and water. The Optim 1 dissolves the plastic a little bit and makes them cloudy. I’d recommend you write your name on those and re-use them as needed.
4. We have supplied some of our dental colleagues with a more sturdy non-disposable version of this that is easier to disinfect and there are a few of those left for those of you who work in areas where you might often be testing patients who can’t swab themselves and need eye protection often (I’m looking at you, ED staff…)
5. We also have a few goggles for use – same principle – these are not disposable and can be disinfected between patients.
Thank you all so much for your continued patience with the changing guidance, policies and procedures. I know this is frustrating and can be demoralizing. But I am so honored to work with such an amazing team of health care professionals. You have done so well in these stressful and trying times. I am grateful to all of you for your dedication and the sacrifices that have been made and will be made as we confront this pandemic. Thank you for taking the time to keep our patients and each other safe.
Ellen Hodges, Chief of Staff