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Hospital Preparedness 101 for 2019 Novel Coronavirus also known as COVID 19

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Coronavirus, also known as COVID19, has dominated news headlines recently. Originating in Wuhan, Hubei Province, China, the acute respiratory illness has since spread rapidly throughout the region and is now emerging around the globe. Patients presenting with COVID19 display clinical symptoms including fever, cough, dyspnea, myalgia, fatigue, radiographic evidence of pneumonia, and in some instances, decreased leukocyte counts. Severe cases may lead to organ dysfunction and death. As the 2019 novel coronavirus begins to appear in the United States, it’s important to ask, is your hospital prepared for COVID19?

Epidemics of respiratory viruses like coronavirus or influenza often begin as micro-outbreaks before spreading through larger regions. In the event of a local outbreak, emergency room intakes in affected areas could see up to a 10% increase in traffic due to the coronavirus. A sudden and sustained increase in demand for staff, supplies, and resources would put enormous pressure on most healthcare facilities. It’s essential for hospital administrators and healthcare systems to have an emergency preparedness plan in place before an outbreak emerges. Our healthcare consultants can help you develop this type of strategy.

Training and Education

A core tenant of any good hospital emergency management plan is comprehensive education. Healthcare personnel should be given clear and concise information regarding best practices, and provided with job- and task-specific refresher training on prevention and control of infectious agents. Supplemental reading and educational videos should be used in conjunction with interactive training sessions to ensure healthcare workers are familiar with contamination prevention, as well as proper use and disposal of personal protection equipment (PPE), testing kits, and other related materials. Healthcare personnel must be cleared, trained, and fit-tested for respiratory protection like N95 respirators or alternate devices before interacting with patients. Staff should be kept up to date on current COVID19 safety guidelines and related updates as they become available.

Public Relations and Outreach

A united public relations task force should be assembled to prevent widespread fear and help with community education efforts. Public panic over a potential coronavirus outbreak can make it harder for hospitals to effectively treat patients and prevent further spread of the virus. Appointing a dedicated spokesperson to make approved announcements and press releases will help keep messaging consistent and avoid misinformation. All official statements should be reviewed by appropriate administrative teams to limit hospital liability and protect patient confidentiality.

Outreach to community leaders can prove instrumental in effective emergency management. These contacts can serve as mouthpieces to groups in the area, and can be used to promote important messages regarding preventative measures, hygiene practices, self-quarantine procedures, care tips, etc. Educational materials or presentations for staff at nursing homes, assisted living facilities, rehab centers, prisons, jails, doctor offices, schools, colleges, and other organizations should be included in any public outreach plan. Training should focus on recognizing symptoms, minimizing risk factors for infection, and enforcing best practices as suspected or confirmed cases of viral outbreak arise.

Record Keeping and Core Data Sharing

Good record-keeping is essential during infectious disease outbreaks. From intake forms to visitor logs, accuracy and attention to detail are essential for tracking new and resolving cases, identifying patterns, and monitoring at-risk populations. As it becomes available, new data and core information about the virus should be shared with relevant local and state public health authorities, other medical facilities, and healthcare personnel when appropriate. As the disease is new, we are still learning details about its characteristics and possible mutations. Mutual cooperation, frequent communication, and open data sharing will contribute to a better understanding of the disease and help prevent public anxiety and misinformation.

Preventing Outbreak

A recent report from one medical center in China states that out of 138 patients treated for COVID19, 57 patients contracted the infection at the facility. Forty of these 57 were working at the hospital when they contracted the coronavirus. Following best practices and protocols for arrival, intake, admission, dismissal, and follow-up can help minimize the spread of COVID19 and mitigate the severity of a potential viral outbreak.

Intake During an Outbreak: Screening for coronavirus symptoms like fever and cough, along with risk factors like international travel or known exposure, should occur at check-in. Ensure patients with suspected COVID19 adhere to proper triage procedures as well as hand hygiene and cough etiquette. As viral epidemics emerge, it may be necessary to create different emergency room waiting areas separating people with flu or respiratory symptoms from others needing care. Ideally, those waiting would be in a well-ventilated space with a separation of at least 6 feet. Hygiene supplies should be clearly labeled, convenient, and easily accessible in all patient holding areas.

Testing: Testing for COVID19 is straightforward and relatively quick, with most results available in 30 minutes to 2 hours. Testing kits for novel coronavirus should be sufficiently stocked on-site or available for rapid delivery from centralized inventory stored in a regional distribution center. Aerosol-generating specimen collection for the COVID19 test should occur in a closed examination room. Healthcare professionals are expected to adhere to Standard, Contact, and Airborne Precautions, including the use of eye protection, at all times. Until results are confirmed, patients with suspected coronavirus infection should not be allowed to wait among other patients or in areas where exhaust is recirculated through the building without HEPA filtration.

Admissions: Common mistakes during admission include improper contaminated waste disposal and improper use of personal protection equipment. Refresher training on CDC protocols for correct donning, doffing, and disposing of PPE is strongly advised. Bio-hazardous waste bins should be conveniently located for the safe destruction of disposable gear. If washable patient gowns are used they may be cleaned according to CDC standard guidelines at high temperatures using an anti-bacterial detergent. Proper handwashing and frequent use of alcohol-based hand sanitizer is, as always, essential for all healthcare staff.

All personnel should be informed on proper treatment care plans for each patient affected by the coronavirus while adhering to standard, contact, and airborne precautions. According to information being released from China, people in their 50’s who smoke and have diabetes seem to be the most at risk of being fatally affected by the virus. These patients may need more aggressive care regimens to ensure a positive outcome.

Quarantine: Once the novel coronavirus has been confirmed in a patient, it’s important to take steps to restrict access to the affected individual and ensure the virus does not spread to others. Visitors should be managed or restricted based on the results of screening, safety to the patient, risk to the visitor, and healthcare provider discretion. Visitors should be trained on proper hand hygiene, and all visits should be logged for record-keeping purposes. Advise individuals to monitor and report any symptoms for at least 14 days following contact with infected individuals.

Healthcare personnel who interact with COVID19 affected patients should wear and dispose of appropriate protective gear in alignment with current CDC guidelines. Until more information becomes available on viral shedding after clinical improvement, releasing a patient from quarantine needs to be decided on a case-by-case basis alongside local, state, and federal health authorities. Among other factors, the length of illness, presence of symptoms, complications like C-difficile, and other pertinent clinical findings should be considered alongside alternatives to inpatient quarantine like safe recovery at home.

Dismissal Protocol and Monitoring: Follow recommendations from local, state, or federal health agencies for appropriate dismissal protocols. Assign dedicated staff for follow up calls or scheduled home visits to confirm no new symptoms and proper compliance with any home care plans.

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Cleaning and Disinfecting Coronavirus

Environmental services personnel should be properly trained on using personal protective gear, including how to properly put on, remove, and dispose of it. Refresher training on proper cleaning materials and methods is recommended for all support staff to ensure procedures are followed consistently and correctly. Hard surface disinfectants like Lysol, Clorox, or their generic equivalent, are appropriate for COVID19 in healthcare settings, including patient-care areas in which procedures are performed. Places people touch that may get overlooked, such as doorknobs, door opening and closing buttons, restroom soap dispenser knobs, hand air dryers etc. should be disinfected properly and frequently during an outbreak. Dedicated medical equipment and disposable devices should be used whenever possible for affected patient care, while non-dedicated, non-disposable medical equipment should be cleaned and disinfected according to manufacturer instructions and facility policies. Cleaning supplies should be well-stocked and readily available for support staff. Hospital consulting may be beneficial for those looking for new or innovative cleaning methods such as UV technology, hydrogen peroxide mist, and more. 

Food Preparation in Hospitals During an Outbreak

Food preparation staff in your facility should follow federal, state, and CDC guidelines in regards to preparing meals for patients in the hospital. Staff members are required to wear protective gear such as gloves and masks when handling food and supplies, and they should practice good respiratory and hand hygiene at all times. All workspaces, food storage containers, and eating utensils should be cleaned and sterilized at proper temperatures regularly. Food carts, including surfaces and metal frames, need to be thoroughly cleaned after returning from patient areas. Cleaning procedures should be done with high-temperature water and should incorporate appropriate agents and chemicals for sterilization. For more information regarding safe food handling during an infectious viral outbreak, contact Soriant Solutions.

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Is your facility prepared for staffing issues?
In the event of an infectious disease outbreak, the possibility of healthcare staff not showing up for work due to fear of catching or spreading the virus becomes a concern. Combined with an increase in patients seeking diagnosis and treatment, understaffing can cause bottlenecks and lead to chaos in medical facilities. To avoid this, preplanning for additional support personnel should be included in your hospital coronavirus preparedness plan.

Prepared for gear shortages?
Gear shortages have been one problem frequently seen in China as hospitals deal with an influx of suspected coronavirus patients. From personal protection equipment like N95 respirator masks to proper cleaning supplies and testing kits, it’s essential to maintain ready access to sufficient resources and materials that will help reduce the spread of viral pathogens. Gloves, gowns or hazmat suits, N95 respirator masks, appropriate eye protection, and other recommended protective gear should be stocked, stored, utilized, and disposed of or cleaned in accordance with all applicable CDC guidelines. Patients and visitors should have well-supplied access to alcohol-based hand sanitizer and face masks, accompanied by easy to understand multilingual signage on proper use and disposal. If on-site storage is an issue, a regional distribution center should be designated for rapid delivery if needed.

With a hospital emergency preparedness plan in place, healthcare facilities can help mitigate a potential novel coronavirus outbreak and minimize risks to healthcare personnel and the public. Coordination between public relations and community outreach teams are important for leveraging additional resources outside the healthcare setting and reducing public panic. Adherence to recommended guidelines and procedures is essential in maintaining a safe, clean healthcare setting.

Soriant provides hospitals and health systems with consultation services to manage resources more effectively and improve patient outcomes and overall satisfaction. Partnering with healthcare providers and administration, Soriant works as a vendor-neutral agent to provide convenient, reliable access to solutions, services, and supplies while lowering overhead costs and expenditures. In a rapidly changing outbreak situation, we can help implement immediate solutions to improve healthcare efficiency and efficacy. From food and nutrition services to environmental management and client-focused consulting, Soriant aims to reduce operating expenses while delivering sustainable, proven results. If you have questions about how your medical facility is prepared to deal with novel coronavirus COVID19, contact Soriant today.

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