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Abbott Ordering Update: For Labor and Delivery Testing

There are no changes to the patients and visitors screening process for COVID -19 upon entering a KHN Facility.  The below items detail the changes to the COVID-19 ordering and reminders of PPE.  

  1. Pre-testing scheduled C-sections and scheduled inductions  
    • Physician orders either in Epic or on paper script PCR SARS COVID -19 LAB98416  
    • Patient can self-schedule a COVID-19 testing appointment online at the following locations three (3) days prior to admission: 
      1. Fort Hamilton Hospital patients can schedule at  
        • Fort Hamilton Emergency Department 
        • Middletown Emergency Department  
        • Southview Medical Center drive-thru testing  
      2. Soin, Kettering, and Southview medical center’s patients can schedule at  
        • Southview drive-thru testing 
    • Results will be in the patient’s chart for the physician to review 
    • The physician would then have conversation with the patient regarding the test and decide on next steps 
  2. Patients being re-admitted who have not been tested  
    • Physician orders an inhouse PCR SARS COVID -19 LAB98416 for antepartum, same day inductions, C-sections, and active labor.  
    • Abbotts are no longer available 
    • PPE Requirements for asymptomatic patients pending a PCR SARS-COVID-19 
      1. Stage 1 Laborasymptomatic patients pending a PCR SARS-COVID-19 = Standard precautions  
        • Standard precautions: Isolation mask at all times, goggles are optional, and glove care based on standard precaution practices 
        • Optional N95: As community testing increases, we are seeing asymptomatic cases. The incidence is about 1%. To alleviate concerns related to caring for potentially asymptomatic patients who are pending test results, we are providing the option for clinicians to wear an N95 mask.  
      2. Stage 2 Laborasymptomatic patients pending a PCR SARS-COVID-19 = airborne precautions 
        • Airborne precautions: PAPR or N95, goggles/face shields, gown, and gloves   
      3. Stage 3, 4, and Postpartumasymptomatic patients pending a PCR SARS-COVID-19 = standard precautions  
        • Standard precautions: Isolation mask at all times, goggles are optional, and glove care based on standard precaution practices 
        • Optional N95: As community testing increases, we are seeing asymptomatic cases. The incidence is about 1%. To alleviate concerns related to caring for potentially asymptomatic patients who is pending test results, we are providing the option for clinicians to wear an N95 mask.  
        • Infant care: standard precautions 
          • Mother and support person to wear a mask  
    • PPE Requirements for symptomatic patients pending a PCR SARS-COVID-19 and Positive COVID patients 
      1. For any stage and postpartum and infant= airborne precautions 
        • Airborne Precautions: PAPR or N95, goggles/face shields, gown, and gloves   
    • PPE Requirements for negative SARS-COVID-19 Test: standard precautions  
      1. Standard precautions = Isolation mask at all times, goggles are optional, and glove care based on standard precaution practices 
    • See below for N95 and Goggle Practices  
  3. Readmitted Patients 
    • Patients who have never been diagnosed with COVID-19 and are readmitted to the hospital should be tested for SARS-CoV-2 if it has been more than 72 hours since their last negative test.  
    • Patients who have a documented COVID-19 infection do not require repeat testing for SARS-CoV-2 if within 90 days of the initial test. Isolation requirements remain as such:  
      • Standard precautions if disease was mild/moderate and it has been more than 10 days since the initial test or symptoms began.  
      • Standard precautions if disease was severe or the patient is severely immunocompromised, and it has been more than 20 days since the initial test or symptoms began.  
    • If the above time frames are not met then the patient should be admitted with airborne precautions.  

N95 MASK PRACTICES  
Guidelines and Best Practices for N95s: 

  • One (1) mask per caregiver per day unless replacement is needed due to visible contamination or mask becomes moist. 
  • Once you place on the mask, it can be worn in multiple patient rooms. 
  • Not everyone is able to wear an N95 due to medical conditions that may be made worse when breathing through a respirator. Please contact Employee Health if you have a health condition that would limit your ability to wear an N95. 
  • A fit seal check should be performed before each use: 
  • Remove during eating/drinking: 
    • Doff your mask by the straps, grasp mask on inside, fold in half with inside of mask facing outward, place in brown paper bag or envelope when not in use, see video: https://youtu.be/k7b_nhTtN4M  

End of Shift N95 Collection 
General Instructions: 

  • EVS will collect all N-95 respirator masks from soiled utility areas minimally twice per day, at approximately 8:00 a.m. and 8:00 p.m. 
  • If soiled utility area is overflowing with N-95 masks before regularly scheduled pick-up time, please contact EVS for additional pick-up. 
  • All N-95 respirator masks are to be placed in a container with the N-95 Collection signage affixed to it (see page 2). 
  • These containers are for the collection of N-95 respirator masks only. 
  • Preferred placement for these containers is inside soiled utility areas.   
  • All N-95 collections outside of soiled utility areas must be moved inside soiled utility areas for EVS pickup. 

GOGGLE PRACTICES  

  • Goggles are to be used for the duration of the shift. 
  • Goggles are reusable, and not be to discarded unless damaged. 
  • Goggles will be returned at the end of shift for reuse. 
  • Clean your goggles using Oxivir Tb wipes or hospital-approved disinfectant spray 
  • OR, return your goggles to HUC or designated team member for cleaning. 
  • Clean goggles will be placed in specified bin and ready for reuse. 
  • Clean your hands before and after touching your goggles. 
  • Clean your goggles at the beginning of every shift, and anytime you put on your goggles. 
  • Handle goggles by touching the ear pieces. 

Eyeglasses do not replace goggles. Goggles should be worn over regular eyeglasses for added protection. 

August 18, 2020