COVID-19 Q & A

Posted March 13, 2020
Updated March 27, 2020 - 3:36pm

Mary Greeley employees are asking a lot of great questions related to the COVID-19 situation. We are doing our best to get all these questions answered in a timely fashion. These questions and answers will be updated regularly.

PLEASE REVIEW QUESTIONS ALREADY ANSWERED BEFORE SUBMITTING YOUR QUESTION.

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Recently Asked Questions

PAY

I read on the news that hospitals across the nation may not be able to make payroll after a few weeks due to lack of revenue from scheduled surgeries. Is Mary Greeley in this position?

Mary Greeley is not in this position. Mary Greeley has been fortunate to have been very fiscally responsible over the years which has led to being in a strong financial position. This means we are able to weather this pandemic and focus on caring for our patients.

EXPOSURE

What are the appropriate actions to take if a patient’s visitors refuse to wear PPE to visit r/o patients?

Inform the visitor(s) of the risk they are taking by not wearing the PPE in the patient’s room. Also inform them that if they refuse to wear it in the patient’s room, they must wear it when they leave. This for the safety of staff, and other patients and visitors. Also inform your supervisor. The person may be asked to leave the hospital if they refuse to wear required PPE.

I have someone making masks for the foundation as a non-direct staff and screening at the doors can I wear a clean homemade mask at front door? It says nothing just is homemade.

No. You need to wear a standard mask, not a homemade one.

Is it a safe practice for a staff to enter a potentially positive patients room with PPE and then keep PPE on thru the halls and nurses station, take it off in the nurses station and keep it in an open garbage can in the nurses station? And or take Accucheck machine and Welch Allens in and out then use it on other patients?

No, that is not a safe practice. Please refer to the Standard Work on appropriate donning and doffing of PPE. In general, gown and gloves should be removed inside the patient room, and airway protection (mask and face shield) should be removed directly outside the patient room. Wearing contaminated PPE throughout the nurses station is dangerous and prohibited. 

Equipment that is used in a suspected or positive COVID-19 patient room should be disinfected immediately outside the room. In certain situations where that is not possible, a designated “dirty” location should be established to place the equipment and allow cleaning.

Please contact Infection Prevention and can we assist to work through best practices for unusual situations on your various units.

How many CAPR's do we have at MGMC!? Please clarify when CAPR's will need to be used!

We currently have 19 CAPR units. We have 8 CAPR Carts (with 2 units each) stored in Materials Management, as well as one unit each in ED, ACS and Lab.

CAPRS need to be used whenever you are involved in an aerosol-generating procedure and for the allotted time post-procedure (35 minutes in an airborne room or 70 minute in a standard room). Examples of aerosol-generating procedures include: intubation, extubation, bronchoscopy, nebulizer treatments, and upper endoscopy procedures.

OTHER

We are getting lots of calls about donating homemade masks and even cases of masks. Is this allowed? Who should they contact?

Story County Public Health is handling these PPE donation requests. Call 515 239 6730.

Visit www.mgmc.org/foundation for the instructions and pattern of homemade masks.

COVID-19 Questions

Pay, Benefits & PTO

There are many employees here that don't have PTO because it is used from chronic illness, babies, previously planned absences or they just don't have PTO, such as PRN and weekend package staff. Is Mary Greely taking steps to help support those staff to encourage them to stay home if they have flu/cold-like symptoms? My concern is that some cannot take unpaid time and if they don't have PTO are going to be more likely to not be honest with symptoms so as to not be sent home.

Mary Greeley will handle each situation on a case by case basis to ensure we are doing what's right in each situation. There are many different pay and benefit programs that will figure into how someone will be paid if they become ill including PTO, Short Term Disability and Workers Compensation. Iowa Workforce Development unemployment insurance may also apply for those individuals without any benefits even as an active employee. The U.S. Congress's Emergency Coronavirus Bill may also provide some help.

On Saturday, the House of Representatives passed an emergency coronavirus bill that included varying levels of paid sick leave for impacted workers. This bill now needs to run through the Senate and have the President sign it into law, which he has already indicated he is willing to do. The details on how this will be administered are still unclear.

We will continue to monitor the rapidly evolving situation to ensure we are taking excellent care of our Mary Greeley family! Any employee that feels ill should first call their primary care physician and then contact Employee Health by calling 515-239-6905.

I have heard that short term/work comp will be decided on a person by person basis. How will this be decided? We are going to be the epicenter of illness. How will you be able to tell if someone developed illness here vs out in the community?

The workers compensation insurance carriers will be required to investigate each work comp claim to specifically tie to a patient who had active Covid-19 exposure where PPE was not being utilized. In addition to our benefit programs Congress is working on some financial relief for employees.

If my children or family have to be quarantined due to illness or suspected illness what is my expectation for work? Will I need to quarantine with them to help prevent spread? If so will I be able to get short term disability to help with financial concerns?

On Sunday, March 15, the IDPH implemented new recommendations for healthcare staff. The new recommendation states that asymptomatic healthcare workers with potential/real exposure can still work while wearing a facemask. It is recommended that these staff continue to monitor symptoms twice daily, and if they become symptomatic they should stay at home and contact their physician.

Is there any update on plans for childcare? Some daycares are already talking about temporarily shutting down.

Child care, adult dependent day care, and pet care are areas we are actively working on. We have involved community leaders and MGMC staff in to develop solutions. Please stay tuned for details.

Is there a plan for salaried employees' pay compensation if the need arises where they are working way more than 40 hours a week during a surge of patients?

In the event that we see higher than normal census and patient acuity levels due to COVID-19, we may need staff, both hourly and salaried employees, to potentially work additional hours. While we cannot say at this time what that might look like, the safety, health and well-being of our staff is of utmost importance, and we will do our best to manage staffing so employees stay well and rested.

Will we have to use our PTO if we are exposed and mandatory quarantined? Or will we be provided paid leave during quarantine?

These situations would be handled on a case-by-case basis. There are a variety of options to be considered depending on the circumstances. Please contact Employee Health if you are in this situation.

In regards to medications and our insurance since we are self-insured, are you allowing to refill our medications early in the event we have to self-quarantine or should not make extra trips out?

Yes. We have removed the limitation from our medical plan so employees can refill prescriptions early.

Will staff who have PTO be required to use it in the event of COVID illness, especially if exposure was at work? It seems that the employees without PTO will have other options but not those who have PTO saved for future use.

If an employee becomes ill they will most likely be eligible for short term disability. If not, the new unemployment compensation policies should provide needed assistance.

Clearly this crisis is causing worry. As healthcare workers, we do our best not to get scared - but we're entering uncharted territory. Has there been any thought to the mental health of our employees? I know we can access our EAP, but would it be an option to possibly bring counselors in to the hospital for staff to talk to?

The health and well-being of our employees is always top-of-mind, especially during as intense a time as we are facing now. We are looking for on-site counseling options and hope to announce a resource soon. Our Employee Assistance provider is extremely busy with client calls and do not have the resources available to come on site at this time. They are very skilled at providing counseling and guidance over the telephone. They are also available 24 hours a day 7 days a week. EAP can be reached at 515.244.6090 or 800.327.4692.

Has anything been decided on hazard pay for employees that are caring for patients with COVID or suspected COVID? Both directly and indirectly?

There will be no hazard pay. With the use of proper PPE the risk of exposure is mitigated.

I am close to maxing out on PTO and have vacations planned in order to use some of the PTO. Those vacations may now not be granted d/t our COVID emergency. Will I still lose my PTO once I reach the maximum? Is there something in place so that doesn't happen?

Unfortunately, yes, you may lose the PTO if you are unable to use it. One thing to consider, however, is donating it to staff who may need it during this critical time.

Just wondering if we have to take time off because of lack of work (as in cases cancelled for numerous days) do we have to take PTO or how would it be handled?

We will need all employees to help us through this situation. The chances of there being any lack of work is quite minimal. We honestly do not foresee that happening. We are working with department heads to determine needs and opportunities where staff can lend their skills in other departments.

Staffing

Are you requiring staff to work with COVID-19 patients if over 60 y/o or if they have co-morbidities like asthma? I feel this is an unsafe situation if the answer is "yes" as you may be causing more illness. I understand if there is no one else, otherwise I feel other staff should step up.

Staff who are considered at risk will not be assigned to care for COVID-19 patients at this time.

Some employees have the ability to do their jobs from home. Has there been any thought to remote access? Especially if they have to quarantine due to family or potential illness.

There are certainly some staff who could work remotely. One concern, however, is cybersecurity. It is likely the hospital's cybersecurity will be stronger than at most homes. Information Systems and Human Resources are developing action plans to respond to the potential need for some employees to work remotely and we are enhancing our ability to provide secure laptops to staff who may be designated to work remotely as a result of the current situation. Supervisors have been asked to identity positions that could work remotely.

Throughout this whole situation we have talked about at risk groups including those that are immunocompromised. Within our own staff there are people that are immunocompromised. What is the plan for our at risk employees?

Any at-risk employee should use standard precautions as they would at any time. At-risk staff would not be assigned to any COVID-19 patients. If there are special needs and considerations, please let your leader know.

The UK just announced that pregnant women are now in the 'most at risk' category. Are we doing anything to protect our pregnant staff? Should they be able to take work off to protect themselves and unborn baby?

On March 16, the UK released an extended list of people would be considered “at risk” and added pregnant women to the list. Reporting on the topic of COVID-19 risk to pregnant women is varied and the research is inconclusive at this point. Mary Greeley Medical Center is following CDC and IDPH guidance and currently there is no recommendation that pregnant women should not work in healthcare settings. With that being said we would make every possible effort to not have a pregnant employee care for active COVID-19 patients. As everyone is aware, this situation and guidance is changing rapidly. Should guidance change we will adjust our practice.

Is there a plan for a training for those of us nurses in outpatient and other areas (likely to shut down or reduce operation at peak outbreak) who would be put on inpatient units when needed? It would be great to get an update on IV pumps, EPIC inpatient charting, supplies, etc... now so we are ready instead of waiting until nurses and trainers are already over burdened.

The HR/Education team has been working very closely with the workforce committee to design a training plan for nurses who will likely be deployed to inpatient units as some of our outpatient services become limited. Daily training has been initiated as of March 18th, with prioritization given to those who have already become available or will soon become available to serve. Staff who are trained will be assigned to tiers 1-3 based upon established criteria:

  • Tier 1: Outpatient clinical RNs who have worked in the west tower in the past 6 years OR non-clinical RNs who have practiced in the west tower in the past 2 years OR nurses who believe they could serve in the capacity of a full RN.
  • Tier 2: Nurses who do not meet the above criteria, but could serve on an LPN level.
  • Tier 3: Staff from outpatient areas who are available to serve in a helper or PCT function.

Staff members from areas like Diabetes Ed, Cardiac Rehab, and Pain Clinic will likely be designated to a tier 3 function and trained as they become available.

For additional information on tasks that can be performed by each tiered staff member, please see the delegation tasks spreadsheet. The HR/Education team is here to support those who are impacted by these changes, and will gladly answer any additional questions that pertain to training.

When the time comes that they are asking outpatient nurses to help work on the inpatient units, will it be mandatory or will we have the option to say no? And if we say no due to having small children etc, would we still be compensated?

In short, yes, it will be mandatory. This really is an all hands on deck situation. We will need all employees to help us through it. As a 24/7 operation with a variety of options for both clinical and nonclinical staff, we can accommodate whatever schedule people might need to ensure their availability.

I understand that things are changing daily but I am becoming concerned regarding our plan for immunocompromised staff. A couple of days ago it was stated to limit that staff exposure and according to the CDC to try and limit exposure by reassignments/working from home etc. I am now hearing that since there are a lot of people saying they can't work with these patients that we can't guarantee a plan. Is there now plan to limit exposure now or is that still a goal. I feel there needs to be a set plan that staff has to go by or specific plans for certain risk categories as they are all different. I am worried I am putting myself in a position that is compromising to my own life as if I get sick I may not be able to recover due to a compromised immune system, low white count and ANC.

Immunocompromised staff work every day in the environment. Per CDC guidelines, an immunocompromised person with proper PPE can work in healthcare. It is considered permitted and staff. That being said, any staff who has an individual concern is encouraged to discuss it with their leader.

We have a lot of staff, at all levels, on vacation out of state and out of country coming back from spring break next week. How are we going to handle their return? I know other organizations are placing these people on administrative leave/testing for COVID-19, or wearing a mask. How are we preparing for this? People may not know if they have been exposed to this, and they could expose employees to it.

All employees and visitors will be screened prior to entering the facility. Per the Iowa Department of Public Health, healthcare providers are considered essential to our community. Therefore, employees that traveled internationally within the last 14 days and are not exhibiting any symptoms will be required to work with a mask. Please notify your supervisor and employee health if you have traveled internationally or have been in close proximity to an individual that has been diagnosed with Covid-19. You will be required to complete a symptom monitoring document for 14 days.

Has there been any thoughts to equipment needs for nurses getting pulled to the floor that have not been there in some time? This would include scrubs and stethoscopes. Non clinical nurses don’t all have these things and I am wondering if these will be supplied or if I should obtain these things myself.

The dress code of some outpatient clinical staff is street clothes, if/when we are reassigned to clinical positions in the hospital, such as helpers or PCTs, are scrubs typically worn for these positions? If so, does that hospital have any that we could instead of wearing our street clothes? Thanks!

You should work with your leader on your “what to wear” plan. Scrubs can be obtained from Amazon for about $25 per set. If you only have one set of scrubs you may need to wash scrubs every night. If this presents a financial hardship, please connect with your leader and they will connect you with resources. We are in the early phases of having people bring in gently used scrubs for this situation. If you work in an area in which you already wear hospital provided scrubs it is okay to continue that, but if you do not please do not make this your plan. There are not enough scrubs or capacity to keep up with the hospital wide demand.

As far as stethoscopes, this will not be necessary for most staff. In the instance that one is need, there are disposable ones available for use if that situation arises.

What consideration is being given to non-clinical staff who are 60+ to be able to work from home as opposed to going in to the labor pool? No underlying health issues, but just concerned due to age.

Leaders submitted lists of those staff member roles that may be able to be performed remotely. This list was provided to the IS department Wednesday afternoon (3-18-20) and they are currently working through equipment and connectivity needs to see what all we can accommodate. More details will follow as the plans are put in place.

As an organization, we are allowed only six sick occurrences throughout the year. With the 6th one being a written warning. What happens with those individuals that get sick with COVID-19 and have 5 occurrences as it is? Are we waiving those during this time period? I feel that many nurses may "hide" symptoms and come in any way to avoid being reprimanded.

We have complete confidence that our staff would not put our patients and their co-workers at risk for COVID-19 just to avoid our attendance policy. That being said each situation will be handled individually to ensure we are being fair and doing what’s right.

Have we reached out to any local hotels to see if they would be willing to make accommodations for staff who do not wish to go back home at the end of their shifts?

Most area hotels offer some level of discount for Mary Greeley staff and several have called during this current situation to offer support. Since discounts tend for vary, we recommend that you call the area hotel of your choice to inquire about any offers. You can find a list on the Intranet. Just to a search for “lodging.”

Facilities & Operations

I have heard that a lot of supplies are on back order. Such as PAPARS, masks, hand sanitizers. What steps are we currently taking to help insure safety of staff and patients that will be here not for COVID?

Shortages are a concern and one that we are closely monitoring. From the time we began seeing COVID-19 appear in China, MGMC has been stocking up vital supplies, including important PPE supplies. We have submitted maximum orders regularly to help ensure we have supplies available. We have also inventoried everything we have on hand and are putting steps in place to conserve where possible. We have word that a new shipment of PPE is on its way, though it will take several weeks to arrive.

Can dietary speak to what extra precautions they will be taking when preparing food for staff and visitors?

Dietetic Services always stresses safety in the preparation of food for patients, visitors and staff. It is an expectation for all Dietetic Services staff. That said, safety is being emphasized more than ever under the current situation. The cafeteria has suspended all self-service, it is take-out only. There is no seating in the cafeteria and the beverage station is closed.

Should MGMC take patients from other hospitals if they have confirmed/possible COVID-19 patients? Especially if MGMC gets patients from the ED of the hospital and patients are getting treated/diagnosed there?

If we have the capacity, we have a responsibility to accept patients who are transferred here from other hospitals and facilities. CMS has put out a statement saying that at the present time, all EMTALA regulations still apply. Thus, if we have the capacity and capability, we are obligated by EMTLA to accept these patients.

Where are the patients who have been suspected of Coronavirus going in the hospital? What is our plan for those patients?

We are following CDC guidelines for suspected COVID patients. When the patient presents to MGMC, they are immediately masked, and placed in a negative airflow room (if available). The door to the room will remain closed, and all staff will follow airborne precautions at this time. The Emergency Department, inpatient nursing units, and ancillary/outpatient departments will begin drilling these workflows today (many have already started this).

Should patients and families be allowed to bring outside food and/or drinks to our radiation oncology department? I think it should be advised against since we are dealing with a droplet transmitted virus and patients and family members can be asymptomatic for days prior to diagnosis.

We would not restrict patient/family bringing food as there have not been any known transmissions via food consumption. Spread is primarily person to person via respiratory droplets from sneezing or coughing.

How will shift huddle be handled as huddle rooms are very close quarters and often include 10 or more staff?

We are confident that our safety and emergency planning meetings fit within the goals of the requirement. This requirement is focused on community events, not fire, police or healthcare gatherings to plan public safety and healthcare needs.

Can we leave the medical center from any door or is that restricted too?

You should be able to exit through any door. If you exit through a door that is closed as an entrance, please do not allow people to enter through it as you leave. Also, the skywalk is closed as an entrance and we are asking that people avoid using it to exit to the parking ramp.

How are chaplain/pastoral visits being handled for patients? Are our community pastoral care teams allowed to visit, are there are exceptions to the rules (such as imminent death, wanting last rites, etc).

Current hospital visitor restrictions would prohibit visits from outside clergy or volunteer parishioners, unless the person was a patient’s designated visitor for the duration of their stay. Special circumstances as described in this question would always be considered, of course. We’ve had contact with a couple of local churches. Most seem to be practicing social distancing and clergy and volunteer parishioners have chosen not to visit patients at this time.

Our rooms have 2 patients per room and 1 bathroom for the room. What is our plan to manage this moving forward so we don't have to close beds?

At this time, it is not our plan to close BH beds or limit admissions, because backing BH patients up in our ED while others may be coming into the ED with positive viruses would not be ideal. Here are some actions we are doing:

  1. assessing vulnerable patients and determining if they should have their own room
  2. increased screening of all patients, including taking temps 3x per day
  3. screening all incoming patients
  4. maintaining (683) open in case we need to isolate a patient
  5. if any patient develops symptoms we will immediately isolate and staff implement droplet precautions and contact Infection Control

This plan is subject to change based on ongoing information from Infection Control and Incident Command

There are staff with friends/family in the community that are looking for ways they can help the organization. Community members are asking if we are needing help staffing the doors with people to screen. Are we to the point we are needing the community's help with this yet?

We anticipate a need for temporary positions during this challenging time. We will be posting temp position soon and anyone is welcome to apply.

Wondering why we can't have someone at the west doors for a couple hours like 5:30 to 7:30 and maybe for 2nd shift a couple hours? Parking ramp was already pretty full by 6:30 since no one wants to walk in the dark clear around the hospital. It seems like we could try to be accommodating to our employees a little.

We realize the changes to doors may be frustrating for some employees. We will review these safety measures to ensure everything is working effectively and efficiently. We will keep this request in mind as we review.

A scientist and friend at K State said that hospital CEOs have made formal requests to the President of the University for PPE. By doing this the President was able to ask various departs at K State to offer any PPE held in storage and not being used while classes are cancelled or on-line. Have we made a formal request to the President of ISU for PPE?

We have been working very closely with ISU, the Student Health Center (Theilen), USDA, Vet Med, and the Ames Community School district (among many others) in the recent weeks. Any and all extra PPE is being donated and allocated through our Story County Public Health department. We are also starting to work with area businesses that can help us create important PPE (think CAPR masks) and equipment pieces through 3D printing. The community outpouring of support is truly inspiring. Local construction companies and area businesses are donating their masks and protective equipment as well. 

Exposure & Transmission

If you have a negative respiratory panel, should you be tested for COVID-19 if you continue to have symptoms? Who does this?

That would be up to the physician who ordered the respiratory panel. If all tests were negative, we are holding the specimen for additional COVID-19 testing if requested by the physician. The test is sent to the state lab if it meets one of the criteria below. If it does not meet one of the criteria below, then it could be sent to Lab Corp.

  • Hospitalized patients with fever, pneumonia or ARDS with no alternate diagnosis.
  • Older adults (>60 years of age) with fever or respiratory symptoms (cough, difficulty breathing) and chronic medical conditions (e.g., diabetes, heart disease, immunosuppressive medications, chronic lung disease, or chronic kidney disease).
  • Any persons (including healthcare providers) with household contact with a laboratory confirmed case of COVID-19 in the 14 days prior to becoming ill with fever or respiratory symptoms (e.g., cough, difficulty breathing).
  • Any persons with a history of international travel from an affected geographic area or have taken an international cruise in the 14 days prior to becoming ill with fever or respiratory symptoms (e.g., cough, difficulty breathing).

Can COVID-19 be transmitted to animals?

There is no indication that companion animals can spread COVID-19 according to the CDC. It is recommended that you wash your hands after being around animals.

How long does COVID-19 stay on surfaces?

According to research reported in the press, the virus is most likely spread from person to person. However, it may remain on surfaces for several hours to several days. It depends on the surface. This is one more reason to regularly clean surfaces with a disinfectant cleaner and regularly wash your hands. High-touch surfaces need particularly attention. These include countertops, keyboards, doorknobs, and bathroom fixtures. And don't forget your cellphone.

So, I was around a person this weekend and now find out they were around someone a few days before that who has tested positive for COV-19. I know I'm supposed to wear a mask and be able to work but wonder how long I need to do that if I don't have any symptoms.

If you were in close proximity to the individual who tested positive and are asymptomatic, you can return to work but must wear a mask. In the scenario described above, you do not need to wear a mask if you are asymptomatic. If you become symptomatic, you should go home and contact your provider.

If staff were to develop any symptoms of COVID-19: Fever, cough, etc. How long are we required to stay home? Do we need to come in and be tested?

If you develop symptoms of COVID-19, do not come into work. Contact your provider. You will also need to notify your supervisor and employee health for further instructions.

I've noticed that the amount of Purell our hand sanitizer's dispense dries in 5-10 seconds rather than 20. Should they be adjusted to dispense a larger quantity? It seems like the ones at McFarland Clinic do.

The dispensers are set to provide an effective amount while conserving supplies and avoiding waste. People are welcome use the dispenser twice to ensure they get an amount they feel confident about.

Why is this Pandemic different than the one in 2009?

Complicated question to answer in this space. There is a lot of reporting on this issue. A Google search on the topic should provide some enlightening information.

Once Mary Greeley has confirmed patients in house that have tested positive, are we considered "exposed" to coronavirus? My concern is with elderly parents, how do we make sure that we don't inadvertently expose them as they already need help on a daily/weekly basis and are not leaving their homes.

You are only considered “exposed” if you have close personal contact with a patient for an extended time, and are not wearing appropriate personal protective equipment. Per CDC and IDPH, close contact is defined as:

a) being within approximately 6 feet (2 meters) of a COVID-19 case for a prolonged period of time; close contact can occur while caring for, living with, visiting, or sharing a healthcare waiting area or room with a COVID-19 case

– or –

b) having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on)

In addition, it is thought that transmission is primarily through droplet spread so, as a healthcare worker, it’s very important to self-monitor for early signs and symptoms. If you experience any, contact your personal care provider and MGMC employee health to assess.

We have a lot of staff, at all levels, on vacation out of state and out of country coming back from spring break next week. How are we going to handle their return? I know other organizations are placing these people on administrative leave/testing for COVID-19, or wearing a mask. How are we preparing for this? People may not know if they have been exposed to this, and they could expose employees to it.

All employees and visitors will be screened prior to entering the facility. Per the Iowa Department of Public Health, healthcare providers are considered essential to our community. Therefore, employees that traveled internationally within the last 14 days and are not exhibiting any symptoms will be required to work with a mask. Employees who have traveled internationally should notify their supervisor and Employee Health. This also applies if an employee has been in close proximity to an individual who has been diagnosed with Covid-19. These employees will be required to complete a symptom monitoring document for 14 days.

Essential Services Personnel includes the following categories:

  • Healthcare providers
  • Law enforcement
  • Fire & EMS personnel
  • Long Term Care personnel
  • Residential Support Facility personnel

The Q&A page states that you do not have to wear a mask if you have a known exposure but are asymptomatic. However, it has been proven that this can be spread for up to 2 weeks before a carrier would show any symptoms? Shouldn't anyone with a known exposure be wearing a mask for 14 days regardless of symptoms?

The question referred to concerns being around a person who was exposed to another person who had COVID-19. This is not a direct exposure situation, but one with a degree of separation. An employee could return to work without a mask. The answer to that question was correct. To review, though: If an employee has traveled internationally the last 14 days or has been in close proximity to a person diagnosed with COVID-19, they are to return to work if asymptomatic but are required to wear a mask. They will also have to contact employee health and complete the symptom monitoring document.

Are there any recommendations of what staff should be doing at the end of their shift to avoid bringing transmissions of Covid-19 home with them?

Bringing an extra set of clothes (including shoes) you can change into before you leave work or before you enter your home is one recommendation. The clothes you wore to work should go into some sort of bag and then into the wash once you get home.

Wipe down your phone, badge and anything else you might have had at work with you – a purse, backpack, etc.

Wash your hands before you leave work and again when you arrive home.

Could we increase the frequency of cleaning of the nurses stations on the units with rule out COVID-19 patients to decrease risk to staff? There seems to be little to none disinfecting done on night shift unless done by nurses and we don't always have time until after we have all used the stations multiple times.

Environmental Services is scheduling systematic cleaning of the nurses stations on all shifts. As the activity increases; so will frequency. It is highly suggested, however, that staff wipe down areas between uses of computers and other station areas.

Why now have we decided to just have COVID-19 rule out patients only being put on droplet and contact where in the beginning we were doing airborne precautions. Doesn't the WHO say airborne I know Italy uses that.

Current evidence is that person-to-person transmission of COVID-19 occurs primarily during close exposure via large droplets produced when coughing or sneezing. A procedure mask/facemask is appropriate for this type of transmission. The contribution of small respirable particles (i.e. aerosols), which require an N95 for protection, is currently uncertain. In addition, we are experiencing shortages of certain types of masks. As such, we have elected to prioritize use of respirators to aerosol-generating procedures (e.g. intubation/extubation, nebulizer treatments, etc) where the risk is higher.

If patients get tested days after being admitted and were not considered a potential COVID patient before (therefore no PPE used) and test positive, then what? Those rooms did not require PPE and staff was told to save PPE for potentials and patients with COVID before, leaving staff exposed.

New procedures are being put in place today (Monday, March 23) to treat any patient with influenza-like, upper respiratory symptoms (e.g. cough, shortness of breath, fever) as a potential COVID patient. A Contract Precautions/Droplet Precautions sign will be placed at these patient rooms, directing staff to use proper PPE.

While the screening process is still new, should we be thinking about asking more detailed questions regarding symptoms a person has been experiencing (visitors & staff). Several employees I know have become ill in the last couple of weeks and they have not been questioned regarding their own health symptoms which may or may not be related to COVID-19. I believe these types of questions are being asked in several other establishments (govt buildings, clinics, hospitals).

We have staff and physicians that have been gone for spring break traveling state wide and out of the country will self-quarantine be mandatory for those individuals?

We continue to review and revise the screening process. Staff and providers who have traveled out of state and who are asymptomatic will be asked to wear a mask. If they are symptomatic, they will be asked to return home.

What are the changes being made to environmental service for cleaning COVID-positive rooms? Do the curtains need to be changed out if another COVID-positive patient is immediately going into that room? Or do we need to use paper curtains that are easily and quickly changed out?

We will continue to change out curtains with each isolation room turnover. Some areas have removed isolation curtains if not absolutely necessary.

When sitting one-to-one with a potential COVID patient with proper PPE for 4 to 8hours, is that consider prolonged exposure? Does that mean I’ve been exposed?

If you are wearing proper PPE for the described period of time, you would not be considered exposed.

The question came up this morning as to whether or not we should be bringing our own cups from home to work still?

There is no evidence that bringing your own cup from home is an infection control issue. You just need to keep this sort of thing in your break areas and away from patient care areas. It is also recommended that you periodically wipe the cup down, just as you would want to do with other items that you have with you at the hospital, including your phone and name badge.