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Testing for Inpatient Admissions and Observations

All newly admitted and observation patients will be tested for COVID-19. 

We will be going live at the following facilities in this order: 

  • Kettering/Sycamore: Monday, June 29 at 9 a.m.
  • Soin: Tuesday, June 20 at 9 a.m.
  • Grandview: Wednesday, July 1 at 9 a.m.
  • Fort Hamilton: Thursday, July 2 at 9 a.m.
  • Southview: Tuesday, July 7 a.m. 9 a.m.

Note: Greene Memorial and Troy: TBS

Emergency Department (ED) Admission, Non-PUI

  1. In the ED, SARS-CoV-2 test will be ordered by the ED provider. 
  2. The ED nurse will swab the patient prior to transfer to the admitting unit. As with all COVID swab collection, RN will don gown, gloves, goggles, PAPR/N95 mask. 
    • Kettering: Hand deliver specimen to the lab immediately (do not use tube station). 
    • All other campuses: ED will receive a cooler of swabs along with courier times.
  3. The patient will be transferred to the assigned, non-designated unit.  

Emergency Center – Franklin Admission, Direct Admission, Non-PUI

  1. Network Operations Command Center (NOCC) will contact attending physician for SARS-CoV-2 test order. 
  2. Patient will be placed on the assigned, non-designated unit. 
  3. The admitting nurse will conduct the SARS-CoV-2 test. As with all COVID swab collection, RN will don gown, gloves, goggles, PAPR/N95 mask.
  4. Hand deliver specimen to the lab immediately (do not use tube station). 

Scripting – RN to Patient for Testing

“Due to the increasing incidence in the community and as an added protection for you, your family, and our employees, your physician has ordered a COVID-19 test for you. We ask that you wear your mask when staff or visitors are in the room with you while we are waiting for your test results.”

Personal Protective Equipment

On the assigned, non-designated unit, all employees caring for the patient with pending results will: 

  1. Follow standard precautions 
  2. Wear an isolation mask 
  3. Practice strict hand hygiene 
  4. Practice social distancing  

The patient will be given a surgical mask, which will be required during any transport throughout the facility and can also be worn in the room when others are present. 

Result Process

Negative result = care will be continued on current unit

Positive result = the critical lab value notification protocol will be followed

  1. Lab will contact the direct care RN or charge nurse on the unit with the positive test result. A read-back verification is required.  
  2. RN will notify the admitting physician with the positive result and obtain order to transfer to designated unit. 
  3. Nurse manager/supervisor to be notified of COVID-positive result. 
  4. RN to change patient to droplet with contact precautions. 
    • PPE = N95, Gown, Goggles, Gloves 
    • Place isolation precaution sign on door. 
    • Update isolation status in Epic to flow into TeleTracking. 
  5. The attending physician will notify and/or be available to the patient to discuss positive test results. Physician or nurse to share positive test results using the following messaging: 
    • “As part of your admission order we tested you for COVID. Your test results have come back positive for COVID.  
    • At this time, we will be adding additional safety measures to care for you. These include additional personal protective equipment and transferring you to a Specialty Unit.  
    • Please note that your care is extremely important to us, and we will be providing you with exceptional care.  
    • To help prevent spread to your loved ones, you will not be able to have visitors in person. I recognize that this can be a challenge for you and your family.   
    • We are committed to help you connect electronically with your loved ones and help keep them informed.”  (See below for additional FAQs.)  
  6. RN to provide the following COVID education: https://www.cdc.gov/coronavirus/2019-ncov/downloads/sick-with-2019-nCoV-fact-sheet.pdf 
  7. RN to notify NOCC of transfer for designated unit. Once clinically ready for transfer, the RN will mark the RTM button. 
  8. RN will facilitate transfer to designated unit.  
  9. Once transferred, Environmental Services will be called to do a terminal cleaning through TeleTracking. As a reminder, isolation sign to be kept in place as a visual reminder for Environmental Services. 
  10. Employee Health Notification 
    • Manager or RN to put in a Midas incident report for exposure 
    • Infection Prevention to send COVID-positive result log to Employee Health   
    • Employees caring for the patient can contact your campus Employee Health office (during normal office hours) for additional instruction. Otherwise, Employee Health will contact employees. 
    • Employee Health will assess risk and provide the employee with instructions for next steps. 

Additional FAQs and Messaging

Q: Should I be concerned?  

A: While some patients do not experience signs or symptoms of COVID-19, we are moving you to a designated unit and will continuously monitor you for signs and symptoms. Let me reach out to your physician to help answer your question.  

Q: Are you going to treat me or what will my treatment be for COVID-19?  

A:  All treatments are based on signs and symptoms. Let me reach out to your physician to discuss your treatment plan.   
 

Q: Why am I being transfer to a designated unit when I have no signs or symptoms?  

A: Some patients do not experience signs or symptoms of COVID-19, such as fever or other respiratory symptoms. For your safety and for the safety of those around you, we need to move you to a different unit. You will still experience the same great care and attention to your needs.  

Q: Will my loved one be able to visit?  

A: For the safety of your loved one, they will not be able to visit. Do you have a cell phone device to help connect you with your family? Also, the number to the unit is #_________________.  We also can connect you with your family through technology (Doxy.me). 

Q: Can you test my loved one?  

A: Your loved one and anyone else in your immediate household are encouraged to contact their primary care provider for further evaluation. 

Q: What if a patient refuses the test?

A: You have the right to refuse testing. However, we want to put your best interests at the forefront. Knowing whether you have been infected will help us provide the best care for you.

Assess and Ask:

  1. What are some concerns we may help address?
  2. Can we answer questions you may have about the test?
  3. Is there more information we can provide you?

Escalate the patient’s concern to the physician and ask that he/she speak with the patient to explain the importance of testing for their protection as well as the protection of the staff. 

If patient still refuses the test:

Because you do not feel the need to be tested, please understand that we will take necessary precautions to safely care for you. You will be transferred to our designated COVID-19 unit. For the safety of your loved one, they will not be able to visit. Do you have a cell phone device to help connect you with your family? Also, the number to the unit is #_________________.  We also can connect you with your family through technology (Doxy.me). 

Q: What if a patient refuses to wear a mask?

A: Your safety and our staff’s safety are most important to us during these times. What concerns do you have about wearing a mask?

July 2, 2020