March 26, 2020 10:28:25 AM
In the wake of a growing number of confirmed cases of COVID-19 coronavirus, hospitals in the Golden Triangle are tightening restrictions within the facilities to lower the risk of infection.
Several hospitals have restricted in-person patient visits, limited the number of entrances and isolated potential and confirmed COVID-19 patients from the other patients.
Baptist Memorial Hospital-Golden Triangle in Columbus, OCH Regional Medical Center in Starkville and North Mississippi Medical Center-West Point all have coronavirus testing supplies available, and patients are encouraged to call a physician or nurse practitioner first before walking into facilities for testing, hospital spokespeople said.
When referred by their providers for testing, patients are screened upon hospital entry, masked and brought into isolation when showing symptoms compatible with the virus, such as a fever above 100.4 degrees Fahrenheit, coughing and shortness of breath, hospital spokespeople say. Hospital staff will then triage and swab the patients for a coronavirus test. Those with mild symptoms will be sent home after the test and wait for the results.
In cases of emergency, where symptoms are life-threatening, patients will be hospitalized and isolated, hospitals officials said.
Patients at the NMMC are put in single-person rooms, while those at BMH are kept in one area away from other patients.
"We are trying to group them within the hospital in a certain area just to prevent cross contamination," said Lauri Sansing, nursing director of the emergency and trauma departments at the BMH.
"Patients with the coronavirus can be in any patient room as long as that door is shut," she added. "In the beginning, the CDC (Centers for Disease Control and Prevention) said that they need to have negative pressure rooms, but they have changed that as they are learning more and more about the virus."
At OCH, patients arriving in an ambulance are placed in a negative pressure room in the emergency room, said Savannah Brown, quality director and certified infection control registered nurse. Hospitalized patients will be placed in airborne and contact isolation.
The restrictions came as coronavirus samples collected by the hospitals yielded positive test results.
As of Wednesday afternoon, BMH has performed 82 coronavirus swabs, with seven confirmed cases, according to BMH spokesperson Ayoka Pond.
Only one of the more than 60 cases tested at OCH returned positive as of Tuesday afternoon, Brown said.
Across all facilities of the North Mississippi Health Services, which includes NMMC in West Point, a total of 434 tests have been performed as of Wednesday, with 32 positive cases, according to the NMHS's website.
Following the guidelines
The new policies were put in place following the CDC's guidelines for health care facilities to control the infection.
Patients are discouraged from walk-in visits unless necessary, according to the CDC's website. Health care facilities are encouraged to limit visitation and isolate patients by setting up physical barriers or triage stations outside.
The guidelines also recommend hospital staff place patients in single-person isolation rooms with their own bathroom, but a hospital could designate an entire area for isolated patients. Airborne isolation rooms should be reserved for those who undergo procedures that would stimulate coughing.
Hospitals should also arm their health care professionals with hand hygiene products and protection gears, such as facemasks, face shields or goggles, gloves and gowns.
The guidelines also listed recommended measures for restricted visitation, collection of specimens and staff training.
Employee screening and visitation
Visitors and employees are screened upon entry, hospital officials said. NMMC (in Tupelo and West Point) became the latest to screen its employees instead of advising them to self-monitor, starting Wednesday morning, said Melody Poole, vice president of organizational performance at the NMHS.
Both the BMH and the OCH have told The Dispatch that employees who are suspected or confirmed cases are not allowed to return back to work until they recover.
OCH started screening their employees upon entry Tuesday morning, Brown said, in the wake of an "escalating" situation. The employees will only be allowed back to work when they are fever-free without the help of medication for one day if testing negative, or three days if testing positive, she said.
Visitors with a fever would be turned away at the door and told to go home and rest, unless the symptoms are serious enough to hospitalize them.
"If a visitor is screened and their symptoms are considered high-risk or COVID-19, we do not allow them to enter the building." Brown said. "Cough and shortness of breath? That's really a risk we cannot take."
For now, visitors with chronic health conditions or with a baseline cough will be allowed to enter the OCH with a mask, Brown said. The policies may change once the facility sees positive coronavirus cases among its hospitalized patients, she said.
Hospitals have also reduced the number of entrances and visitors allowed for each patient.
Last Monday, BMH changed its visitation policy to bar visitors to its skilled nursing unit and to recommend up to two visitors per patient, according to a press release last week. The hospital also limited its entrances to the outpatient pavilion and the emergency room.
Patients infected with the coronavirus are put in isolation, behavioral health or skilled nursing units are not allowed any visitors. Others are allowed one designated visitor, except for patients in labor or in pediatrics, who are allowed two.
The steps are safety measures taken to conserve limited resources and dial down the risk of virus spread, BMH Marketing Director Megan Pratt said. With patients potentially infected by the coronavirus, she said, every visitor is at risk of contracting it.
"If you have a lot of visitors going in there, they are using a lot of gowns and masks," she said. "Not knowing what the future of this looks like, you want to conserve (these supplies) as much as possible."
Starting last Tuesday, OCH recommended one designated visitor per patient, but exceptions can be made on a case-by-case basis, according to their latest visitation policies online. Children under the age of 14 are not allowed to visit.
"We don't have any cases right now," said Mary Kathryn Kight, OCH director of marketing and public relations. "This is just precautionary measures for our staff, our patients as well as the visitors."
Restrictions at all NMHS hospitals, including the West Point location, went into effect on March 15, allowing one visitor per patient each time and barring visitors under the age of 14, according to NMHS's website.
NMHS updated its policies last Friday to specify the number of visitors allowed for different units. Patients in hospice units are allowed up to two visitors, and all other acute care patients are allowed one designated visitor per patient each time.
Patients infected with the coronavirus are not allowed visitors, according to the NMHS website. Thirteen of the 27 positive cases of COVID-19 recorded on the website were hospital residents requiring acute care.
Hospital employees received medical equipment for infection protection, such as isolation gowns, gloves, face shields or goggles and surgical and N95 masks.
The isolation area and the waiting room are separated at OCH, Smith said. BMH has closed its critical care wait rooms, and NMMC has closed all wait rooms to the general public, hospitals say.
The cafeteria at BMH remains open, said Pratt, but visitors can only order take-outs. Dine-in service is only available to employees. Tables are spaced out to be at least six feet away from each other, she said.
"Employees have to eat," Pratt said. "We have to feed our patients."
The hospital has also eliminated the salad bar and the fountain drinks at the cafeteria, Pratt said.
"Everything has to be out of a bottle now," Pratt said.
The cafeteria and the coffee shop at the OCH is now also closed to the general public.
Yue Stella Yu is the local government reporter for The Dispatch. Reach her at 662-328-2424 (ext 106) or follow her on Twitter @StellaYu_Mizzou
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