PPE is in short supply across the world and so we thank you for being conscientious in your use of supplies. That said, never let a desire to preserve PPE hinder patient care – if you need to see a patient, see the patient!

• For COVID patients - please wear an N-95 mask, face shield, gown and gloves

• For all other patients - please wear an N-95 mask and face shield, otherwise following the directions of any other precautions they are on.

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Where to get PPE?

• Face shields, surgical masks, and N-95s are now on the wards - ask the nurses to let you into clean storage. Otherwise, note that 3E's clean utility code is 1,2,4; 4C's clean utility code is 2+4,3, and 4BE clean utility code is 1+5,3

Where do I eat?

Eating in the same room with multiple people without masks on is a big risk. Please reduce this risk by taking turns eating and putting on your face-shield when your team-member is eating. Please keep more than 6 feet apart. Medical students are invited to eat elsewhere in the conference room such that they can all spread out. You can also eat outside (on the 2nd floor outdoor deck) and zoom into noon conference on your phone. Call or come to the chiefs office if you have any questions.

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Universal Masking

Starting 4/06, the VA requires universal masking for all employees and rotators. You may obtain a surgical mask from the Chief's Office in the Medical Service Offices (4A-162). Please wear this mask at all times while in the hospital (including into and out of non-COVID-19 patient rooms). We have supplies for everyone to obtain a new surgical mask every day or as needed if the mask is soiled for any reason.

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Reduce, Reuse, Recycle

If you are seeing multiple COVID-19 positive patients in a row, keep your N-95 and face-mask and eye-shield on, and change your gown and gloves between COVID-19 positive patients. Make sure to practice hand-hygiene between each encounter. If you then are seeing a non-COVID patient, then you should change your face-mask and not wear the same one into that patient's room.

Face shields should be cleaned after seeing your patients, the units, team rooms, and chiefs office all have bleach wipes available for this cleaning.

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There are now two possible precaution orders:

• “Covid-19 testing pending” or COVID negative patients

  • for “low risk” patients who are asymptomatic

    • this applies to all admissions who are not deemed high risk as well as patients requiring testing prior to transfer to their next phase of care, i.e. SAR, LTC, CLC

• “Enhanced Droplet Precautions”

  • for COVID positive patients or “Persons Under Investigation” aka those with high suspicion of COVID positivity

     

• Aerosol generating procedures include: non-invasive positive pressure ventilation, bronchoscopy, cardiopulmonary resuscitation, intubation, suctioning, and nebulizer therapy

Order any of these precautions under the Nursing Care subsection of the Orders tab by selecting “27: Isolation Precaution Menu” —> and then select the appropriate precaution

Enhanced Droplet Precautions

PPE Requirements: Gown, Gloves, N-95, Face shield (reusable, please clean with a purple-top wipe once done)

Note: You may wear the same mask and faces shield between rooms without doffing but will need to doff and don new gowns and gloves between each patient room. You may doff the N95 mask when you have completed seeing a string of PUI or COVID patients

 

 

COVID-19 Testing Pending (low risk) / COVID negative Precautions

PPE Requirements: Surgical mask for patient and provider, Face shield for provider

Patient should preferably be in a private room with a private bathroom, but otherwise, the beds should be at least 6 feet apart with a separating curtain

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When you get a new N95 mask, please write your name, “med” and date on the exterior of the mask in permanent marker. When you have finished wearing the mask, place it in a paper bag and deposit the mask in a red biohazard container. This is so N95s may be disinfected and stored for reuse in case of a PPE “crisis” mode, which we are not at.

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PPE Donning and Doffing

 

Appropriate PPE donning and doffing is critical to your health and safety! This means that you should NEVER enter the room of a known or suspected COVID-19 patient before correctly donning all PPE. Please also pay close attention when doffing your PPE by ensuring that you remove gown and gloves while still in the patient’s room and then removing your faceshield and mask outside of the room (remember, you may leave the faceshield and mask on between COVID patient rooms). You should perform hand hygiene every time before approaching your head/face to doff PPE.