COVID-19 Visiting Guidelines at Grove Creek Medical Center

PURPOSE

To protect our staff, patients, and community during the outbreak of COVID-19, visitor restrictions are in effect. Routine visiting is limited at Grove Creek Medical Center until the transmission is no longer a threat to our patients, staff and community.

AUDIENCE

This document applies to all healthcare professionals involved in the delivery of care or treatment of patients admitted to the facility.

DEFINITIONS

Healthcare Personnel (HCP): For the purposes of this document, HCP refers to all paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including: body substances, contaminated medical supplies, devices, and equipment, contaminated environmental surfaces, & contaminated air

Facemask: Facemasks are PPE and are often referred to as surgical masks or procedure masks. Use facemasks according to product labeling and local, state, and federal requirements. FDA-cleared surgical masks are designed to protect against splashes and sprays and are prioritized for use when such exposures are anticipated, including surgical procedures. Facemasks that are not regulated by FDA, such as some procedure masks, which are typically used for isolation purposes, may not provide protection against splashes and sprays.

PROCEDURE

Visitors will be screened at specified entry points for symptoms of respiratory illness. Only asymptomatic visitors will be allowed into hospital facility based on the parameters outlined below:

  1. Each patient may have two designated visitors (over the age of 18); except for those deemed necessary (see below). Each visitor must wear a mask in accordance with the Universal Masking Policy. Each visitor will be banded upon admission.
  2. HCP should explain the rationale for wearing a facemask, which includes the inability to social distance in the hospital setting.
  3. Identified visitors over the age of 18 which will be banded at admission, these people cannot switch out with others. They must be asymptotic of respiratory/COVID-19 symptoms will be expected to stay in pt rooms (no walking around the hospital). They will also be required to wear a mask at all times.If the patient is COVID-19 positive, we will only allow the one designated support person- cannot leave facility at all and obviously has to wear mask.
  4. Before visitor enters patient room, review diligent hand hygiene, limiting surfaces touched, and expectation to not go to common spaces in the hospital.
  5. Staff should encourage use of alternative mechanisms for patient and visitor interactions such as video-call applications on cell phones or tablets.
  6. Visitors may not change during patient’s stay (to minimize the number of people coming into the hospital).
  7. Visitors may be asked to leave the unit to facilitate addressing clinical needs.
  8. Visitation may be further restricted at the discretion of the attending HCP and as the outbreak evolves.

Necessary visitors:

  1. Pediatric (under 18) patients are restricted to two designated visitors (over the age of 18), apart from the father of the baby being a minor, at the bedside.
    1. If the patient is a laboring patient who wishes to have their significant other present, the pediatric patient may have two support persons at the bedside given that one of the support person is deemed the responsible adult (over the age of 18) for the purpose of obtaining consents.
    2. If the patient is a newborn born to an inmate mother, this patient may have two additional support persons given that one is the temporary guardian (verified by ID) once the inmate is out of the building.
    3. If the patient is a newborn admitted to facility for any other reasons besides newborn cares, they will be allowed to have two designated visitors given that one is the responsible guardian.
  2. Patients who are at end-of-life may have 2 visitors.
    1. End-of-life is defined by a patient who is likely to die in the coming days and is not restricted to patients on a comfort care pathway.
    2. Visitors must stay in the room
  3. Those legally authorized to make decisions for the patient whether by operation of a Durable Power of Attorney (DOPA) or conservatorship, or a surrogate decision-maker as recognized by the provider team for patients who lack decisional capacity.
  4. Support persons for patients with developmental disabilities who require assistance.
  5. Family and legal advisors to update a patient’s will or other legal papers.
  6. Support persons for patients with delirium and or dementia where the presence of the visitor is necessary to reduce the patient’s delirium, reduce the risk of falls, and otherwise reduce the risk of medical or clinical harm.
  7. Others to be discussed on a case-by-case basis.
  8. If the patient is on ‘Novel Respiratory’ isolation or ‘Respiratory Illness’ isolation:
    1. No additional visitors, other than the 1 designated support person, will be permitted at this time.
    2. Explain the rationale for wearing PPE in the patient room including that it protects the wearer from infection, offer PPE (surgical mask with eye protection, gloves, and gown) to be used while in the patient room, and give instructions for donning and doffing.
    3. N-95 masks should not be offered because the visitor is not medically cleared or fit tested

REFERENCES

Coronavirus Disease 2019 (Covid-19). Retrieved June 12, 2020 from https://www.cdc.gov/coronavirus/2019-nCoV/index.html

Centers for Disease Control and Prevention. Interim Infection Prevention and Control

Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings. (May 18, 2020). Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html

Centers for Disease Control and Prevention. Considerations for Inpatient Obstetric Healthcare Settings. (May 20, 2020). Retrieved June 12, 2020 from
https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html?deliveryName=FCP_3_USCDC_1052%20DM22033

Puopolo, K.M., Hudack, M.L., Kimberlin, D.W, & Cummings J. (April 2, 2020) Management of Infants Born to Mothers with COVID-19. Retrieved from https://downloads.aap.org/AAP/PDF/COVID%2019%20Initial%20Newborn%20Guidance.pdf