OR Manager - June 2020 - 14

COVID-19
Continued from page 13
Patients coming in for a surgical procedure
can have two visitors. If the patient
is admitted after surgery, one visitor is
asked to leave.
Upped the age
The hospital has expanded the age limit
for patients from 21 to 30 years to help
other hospitals in the area with their
non-COVID-19 patients. " We are not admitting
their COVID-19-positive patients,
just their healthy, young adult patients, "
says Woolley.
She notes that the hospital has
always done follow-up procedures on
older patients who had congenital heart
defect repairs as infants. However, she
says, having multiple older patients is a
change for the medical inpatient units.
They have had to develop inclusion
and exclusion criteria for these patients
and perform safety/risk assessments before
admitting them to the medical units.
The units also have had to partner
with pharmacy and information technology
staff to:
* produce appropriate drug libraries
and dosing ranges for adults
* identify nursing competencies for
older patients
* coordinate simulation training to
identify gaps in caring for children
and adults.
L&D additions
The hospital has always had a 14-bed
maternal fetal care unit (MFCU) for highrisk
infants and low-risk mothers. " This
has allowed us to do fetal surgeries,
and it allows high-risk babies to be delivered
here and go immediately to the
cardiac cath lab or have other interventional
procedures, such as for teratomas.
Also, we have had conjoined twins
who needed immediate surgery once
they were delivered, " says Woolley.
Currently, the MFCU, neonatal intensive
care unit, and one of the surgical
inpatient units are taking low-risk moth14
OR
Manager | June 2020
Reprocessing N95 masks
The hospital
is reprocessing N95
masks according to the protocol that
the University of Nebraska developed
during the Ebola epidemic (https://
www.nebraskamed.com/sites/default/
files/documents/covid-19/n-95-deconprocess.pdf).
Nebraska
put forth a process to validate
that N95 masks can be used up to
four times, says Woolley.
Key to this process are " PPE protectors. "
All N95 face masks are locked
up in each unit. A staff member (ie, PPE
ACS guidelines for pediatric surgery
The American College of Surgeons on
March 24 issued " COVID-19 Guidelines
for Triage of Pediatric Patients. "
The guiding principles of the guidelines are:
➤ Provide timely surgical care to children
with emergent and urgent pediatric
surgical issues while optimizing patient
care resources (eg, hospital and intensive
care unit (ICU) beds, personal
protective equipment (PPE), and ventilators)
and preserving caregiver health.
➤ No substitute for sound surgical judgment.
➤
Perform a surgical procedure only if
delaying it is likely to prolong hospital
stay, increase the likelihood of later
hospital admission, or cause harm to
the patient.
ers from the University of Colorado Hospital
(UCH), and the labor and delivery
staff from UCH have been helping with
the staffing for this additional volume.
UCH is also on the Anschutz campus
with Children's Hospital.
" We did this because UCH had to
convert one of their inpatient units to a
COVID-19-positive unit, " says Woolley.
As of the middle of April, UCH averaged
about 100 COVID-19 patients per
day, with an average of 45 to 50 patients
on ventilators.
➤ Children who have failed attempts at
medical management of a surgical
condition should be considered for
surgery to decrease the future use of
resources.
➤ Multidisciplinary shared decisions on
surgical scheduling should be made
in the context of available institutional
resources.
➤ Telemedicine should be used for patient
and physician interaction when
available.
American College of Surgeons. COVID19
guidelines for triage of pediatric patients.
Published online March 24, 2020.
https://www.facs.org/covid-19/clinicalguidance/elective-case/pediatric-surgery
[personal
protective equipment] protector)
is designated to check out a mask
to a staff member, write it down, and
keep track of it.
At the end of the day, each staff
member puts his or her mask in a
brown paper bag. Staff members write
their names, departments, date, and
employee IDs on the bags. The bags
are dropped off in bins in dirty utility
rooms throughout the hospital.
Sterile processing department (SPD)
staff pick up the bins and take them to
the unit that has had the most COVID19
patients.
One of the conference rooms has
been converted to a workroom with
clotheslines. Masks are removed
from the paper bags and hung on the
clotheslines with clips on the loop
strings to avoid overlapping and to prevent
blocking of the UV-C energy to the
anterior and distal surfaces (photo, p
13).
" The masks go through two opposing
scrub cycles of Surfacide UV-C, so the
light reaches the front and back of the
masks, " says Woolley.
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