Health systems nationwide are already experiencing or preparing for a surge in patients stemming from the COVID-19 pandemic. Rather than adding to the information overload, I want to share the general guidance and safety checklist we’ve created for our more than 4,100 Vituity providers nationwide.
This checklist is geared toward emergency clinicians but appropriate for anyone with patient contact. As always, stay alert for specific direction from your medical director, health system, or local public health authorities.
COVID-19 Safety Checklist
(Updated April 16, 2020)
Clinical Knowledge
- I know detailed clinical information about COVID-19.
- If I need to intubate a patient, I understand recommendations around NIPPV and protective gear.
- I know to follow appropriate precautions when providing respiratory care and intubation for COVID-19 patients.
- I understand the interim guidance for CPR and emergency cardiovascular care issued by the American Heart Association.
Intake
- I know how our front end/triage/intake/RME process is changing to adapt to possible COVID-19 patients.
- I understand my hospital’s policy on the use of telehealth for patient diagnoses and treatment.
- I know how our EMS intake process is changing to adapt to possible COVID-19 patients.
- I know where these patients will be placed during their visit for testing.
Critical Care Admission
- I know my hospital’s criteria for admission.
- I know my hospital’s criteria for transfer to the ICU.
- I know my hospital’s criteria for intubation.
Testing
- I know which patients should be tested.
- I know whom at my hospital to contact 24/7 if I have questions about whom to test (e.g., infection control RN, on-call consult, administrator on duty).
- I know what type of testing is necessary.
- If I am allowed to order a test on my own, I clearly understand who is responsible for following up on a positive test result.
Personal Protective Equipment (PPE)
- I know what type of PPE I need to wear. Note that some hospitals are following CDC guidelines; others are following the WHO guidelines.
- I know how to correctly don/doff PPE.
- If I am working in RME/intake/triage, I am typically wearing a mask for all encounters.
- If I am working in RME/intake/triage, I know which patients need to be immediately screened and isolated, and I know where the masks are located for those patients.
- I understand the strategies for optimizing supply of PPE and equipment.
Quarantine/Work Restrictions
- I know my hospital’s guidelines around work restrictions for staff caring for COVID-19 patients.
- Note there is a difference between “work restriction” and “quarantine.” Most exposures should only result in work restriction and not social isolation/quarantine.
- I know which discharge instructions to give when patients are to self-quarantine.
Self-Care
- I am following the recommended hand hygiene at all times, inside and outside the care setting. Wash hands with soap and warm water for at least twenty seconds, not just before and after every patient encounter, but frequently throughout each shift.
- I have stocked up on supplies like food, medications, and hygiene products if I must self-quarantine or fall under community quarantine.
In Conclusion
COVID-19 is rapidly evolving, and many of these recommendations will likely change. To stay up to date, refer to CDC guidance for healthcare professionals. Be sure to wear gloves, wash your hands, don’t touch your face, and use masks for all patient encounters!
Reading this checklist may be sobering. Know that the hard work you are doing under tough circumstances to care for patients truly makes a difference. We all chose a medical career to relieve suffering and bring healing to our communities. For our profession, this unprecedented time can also represent our finest hour.
