April 17 Employee Huddle

April 17, 2020

Please Note: Time did not allow us to answer every submitted question, so we will get to unanswered questions at next week's KD Huddle. Submit a question now for next week by e-mailing dvolosin@kaweahhealth.org.

How many employees have tested positive and is there a way to keep our staff updated on that information? As of April 17, 22 Kaweah Health employees, clinic and non-clinic from various units and departments have tested positive for COVID-19. Three employees have recovered. All staff members are quarantined at home, and Kaweah Health is updates will be provided in the daily Command Center Update.
When will we be able to test exposed staff for COVID-19 prior to them showing symptoms? The goal is to eventually test everyone. However, they may lead to a false sense of protection. If a staff member test is negative, it does not prevent them from testing positive later.
If an employee has a known exposure outside the hospital (i.e. related to someone at Redwood Springs and in recent contact prior to confirmed positive) shouldn’t they be on the COVID-19 monitoring list and receive a badge sticker? Employees who are family members who tested positive for COVID-19 are closely monitored by the Tulare County Health Department. Kaweah Health has required family members living in the home of a positive individual to 14 day self-quarantine. Following CDC guidelines, any employee with potential exposure is required to wear a mask. If symptoms develop, they will be tested.
In yesterday’s Command Center Update we were informed that there were two employees that had tested positive and have now returned to work. What is the District’s protocol to determine that an employee is now safe to return to work after a positive COVID-19 test? Three employees have returned to work. The employee needs to be symptom-free for 72 hours, and then we test twice every 24 hours.
If an employee tests positive for the virus and needs to take a leave of absence to be quarantined do they have to use their own EIB/PTO time? First, if this question applies to you, please contact the Leave of Absence Team at extension 2274. If you test positive or required to self-quarantine, the state has changed the policy of short term disability insurance to start on day one. Kaweah Health has increased the number of hours allowed for EIB (up to 24 hours) and allows for use on day one. When EIB is exhausted then Paid Time Office will be used.
How do we foster a “Stay Home if sick” culture if our employees are having to use their hard earned PTO? Is it possible to change that policy during this time and allow employees to use their EIB? Is it possible to change that policy during this time and allow employees to use their EIB? The Paid Time Off bank of accrual includes vacation, holiday as well as sick leave time built into one. We expect employees to use PTO for short term illnesses. Once an employee enters into a leave of absence, which is three days, EIB is used. Being able to use EIB on day one for a non-confirmed COVID-19 illness is not a currently policy at Kaweah Health, however, it is a subject will can continue to review. PTO and EIB policies are currently being reviewed by Human Resources.
Has there been discussion for CNAs to have the opportunity for extra shift bonuses? At this time, Kaweah Health is not implementing an extra shift bonuses for CNAs. The decision to provide them for Registered Nursing and Respiratory Therapists was based on the number of open positions. However, this is topic that we will continue to monitor.
An employee currently has a child who goes to college in Arizona. It is anticipated they will move him via personal vehicle out of his dorm next month. Does this affect the employee’s ability to return to work? Is quarantine necessary? Travel has become less of a concern. Self-monitoring is advised. At this time, they do not need to quarantine unless there are symptoms by employee or the child or relative has been exposed.
When can employees start planning vacations/time off (especially if they are burned out)? Current statistical models indicate by late May, June, the pandemic will subside. All dates are subject to change. We anticipate by July 1 that the hospitals’ census will return to normal. We understand that employees will need rest and relaxation. We are looking at additional locations for employees to have meal breaks with better spacing, including some outdoor areas.
Who is training nurses at the swab station? What education are they being given as far as how to properly perform a swab? Is someone monitoring them to make sure their technique is good? (We’d hate to have false negative patients out there spreading the virus.) Staff are being trained by our education department or the advance practice nurses that are performing the testing and running the swab station. The technique of the staff member is verified and monitored by the charge nurses in the specimen collection areas.
Is Tulare hospital getting ready too? How will their efforts impact our operations? Our command center has a weekly call with other hospitals. Sierra View and Tulare hospitals are making efforts as well for a potential surge. Tulare hospital has the capability to handle a surge up to 46 beds. Their tower is not an option for patient care, because the space/ rooms are not suitable. Tulare hospital is working on increasing its ability to take patients. Their command center is conducted from Hanford, and they have the Adventist system to provide them with support and resources.
When can we expect our mask supply to be stocked for the reusable masks? Aren’t surgical masks and N95 masks only effective for a certain amount of time if worn? Isn’t replacing them throughout a shift more effective at protecting staff and clients from the spread/contracting COVID-19? We are not able to provide an exact day due to changes in order supplies and no longer having exact delivery dates. When Kaweah Health is fully restocked, our goal is to go back to single use mask. We have been practicing conservation. A plan has been created to increase N95 use, with the increase in supply on hand, we can provide the units with positive COVID-19 patients with N95 masks for use in direct patient care. We will continue following the CDC guidelines for those that will be in contact with patients. We have a process and a distribution order for staff that work in ICU, ICCU, and 2South, as well as any location with a positive COVID-19 patient, and we have a process for staff that are coming into those units.
Having to wear the same surgical mask each 12-hour shift for 2 weeks has many of us concerned about the safety of frontline healthcare workers. In addition, many of these masks have ripped or are completely saturated in one shift. Do public healthcare guidelines support the storage and reuse of the same mask over a two week period? Kaweah Health does not want anyone to wear a mask that is compromised, soiled or torn. Anyone who needs a new mask will get one. As we increase supply, Kaweah Health will switch to a routine to rotate out surgical masks for staff more frequently. CDC guidelines do support the reuse of masks when supply is compromised. Masks are best used for single use but use in that manner would use our supply up in 3 weeks. Without a guaranteed supply source, reuse ensures a level of protection for our health care workers throughout the pandemic.
How many masks do we need to have in stock before our staff have access to one surgical mask per day? We would have to have a quantity to allow one a day for 90 days for each of 4,300 employees.
Can you explain why wearing gloves in public is more harmful than good? An individual wearing gloves is protecting their hands, however, the surface of the gloves are not clean and contaminating everything touched by the gloves. This can cause a false sense of security. The most effective method of protection is to clean hands prior
When will the outer office areas be receiving more Super Sani-Cloth wipes? Dates to receive an order are not available at this time. This topic will continue to be discussed and an update will be reported in the daily command center communication as soon as we know when they will be available for the outer offices. Please reach out to central supply or EVS to obtain cleaning spray.
We hear talk of ventilators being in short supply. Do we have enough ventilators for our case projections? Are they even effective? Yes, Kaweah Health has enough ventilators to meet the projected need. We review current ventilator counts each morning. Every morning we have 60-70 available ventilators for patients. The ventilators are our normal supply. We have received 4 ventilators from the state. We are anticipating an additional 5. We confirmed with Respiratory Therapy this afternoon, we have a total of 96 adult ventilators and 7 neonatal ventilators here at Kaweah Health, all effective for use with our patients.
Could we possibly have had COVID-19 last year in Nov or Dec if we had some of the symptoms? (dry cough, fever) This is a topic that continues to be studied. We understand that individuals may believe that if you have had COVID-19, then you are not going to get the virus again. At this time, we don’t have the evidence to state this idea is true. Until anti-body testing is available, there will not be an answer to this question.
Is it true that blood transfusions are better than ventilators for treatment of COVID-19? It is unknown at this time. We will research and provide an update at a later time.
Given the poor quality of evidence regarding treatments for COVID-19, and the potential for some treatments (especially combination of hydroxychloroquine and azithromycin) to cause harm to patients, what guidance is being provided to physicians? How is this guidance being updated due to new literature that is reported? Our physicians are working closely with their medical societies, researchers and contacts to gather the most recent information to provide the most aggressive care. There is not enough information about the virus, however, everyday there is more information being shared on how to fight COVID-19. Our intensivist and hospitalist are working well together with getting new treatments on board to assist COVID-19 patients.
I’m curious about the isolation process for the patients on the floors. Can someone talk briefly about the process and what staff is doing to keep the patients in good spirits? District staff are prepared for this; patient isolation isn’t something new at Kaweah Health, so the Help Desk Department have provided the resources for patients to connect with their families while they’re in isolation rooms. Medical staff ensure to keep a friendly, calm environment to keep every patients and family member positive. Kaweah Health ensure that the physical, mental and emotional needs are met.
Is there someone that can pray with them if they would like that? Do we have a volunteer program or are the hospital clergy allowed to use an iPad to FaceTime them to pray with them daily? Yes, chaplains are available and devoted to offer support for patients and staff at Kaweah Health.
Do positive COVID-19 patients have to be escorted out through Acequia lobby? Or is there an area they can be escorted out that provides the least amount of exposure to patients and staff? What instructions are given to positive patients when discharged to a home where others reside? Prior to leaving their rooms, COVID-19 patients are masked and they’re put in wheel chairs, so they’re transported through the halls and don’t come into contact with anything. Once discharged home, patients can use the platform for discharge education that teaches them about self-quarantine and self-monitoring. The Interpreter Services Department ensures the information fits the needs of every patient.
If we’ve had patients discharged that have recovered from Covid-19, do we have something like other hospitals have posted online, like staff lined up clapping or holding signs up wishing them well? Not at the moment, however, we want to engage with units doing the care, because they are the staff that should be celebrated for all the hard work and effort placed to bring patients to better health.
I would like to know if there’s an antibody test here at Kaweah or do you have a projection for when we will be seeing one? Kaweah Health does not have it yet, but as soon as one becomes available, it will be informed to the public.
Is there a way to test all discharging patients for COVID-19 so we can be sure we are not sending cases out? At this time, this is not case. However, this topic is continuously being reviewed to increase the testing capabilities of Kaweah Health. Patients are discharged with continued instructions on social distancing, hand hygiene and continued protection in the community.
What is being doing to keep patients at Mental Health separated and prevent an outbreak there? Are staff members masked? Are new admits quarantined for 2 weeks, are staff screened? This is a very difficult population to keep from close contact. Staff are conducting screening based on any symptoms. Additionally, staff are wearing masks and performing frequent hand hygiene and environmental cleaning. Any patient that has symptoms or is suspected of having the virus is being tested before being admitted and being held until the test results are returned. If a patient is positive, they will be moved to a different inpatient location within the hospital with a team of mental health providers to assist.
What is done with positive COVID patient’s meal trays when bringing them out of the rooms? Kaweah Health unit staff remove the trays using gloves and put them in the carts to be taken back to the hospital’s dietary kitchen. Next, the dietary kitchen staff use gloves to wash them.
Are chaplains able to interact with patients? Yes, chaplains are available and devoted to offer support for patients and staff at Kaweah Health.
How can the district provide stress support for Kaweah Health employees during this pandemic? Is there a support group?Kaweah Health publishes the resiliency resources on our sites to support all district staff. Plus, internal social workers and chaplains are available. Kaweah Health is looking to provide new strategies to create staff support and unity during this difficult time—all of which will be shared as soon as they’re ready.