Basic Patient Care Activities – Information for Clinicians
Dear UConn Health clinicians and clinical staff,
As the COVID-19 epidemic evolves, clinical leadership is working closely with Infectious Disease and Infection Control, as well as state agencies and the Connecticut Hospital Association, to help provide guidance regarding patient care activities at UConn Health. We have to anticipate the future probability of patients with COVID-19 in our state, and potentially at our facility.
There are several overarching principles to consider when providing care for patients with possible COVID-19 infection. Based on data from other countries, most patients with COVID-19 will receive care in ambulatory settings. Only a small proportion require Emergency Department-level care and a very small percentage will warrant admission to the hospital.
Testing for COVID-19 remains regulated by the CT Department of Public Health, and at this time is focused on hospitalized patients. Based on the current testing procedures, most ambulatory patients would not meet testing criteria. As testing becomes more readily available, we anticipate that this testing criteria will expand.
When patients with possible COVID-19 call or present to outpatient clinics with symptoms that warrant non-emergency outpatient medical management, they should not be referred to the Emergency Department. Referral to the ED will not facilitate laboratory testing. Rather it will force the ED to reallocate resources to patients who do not require emergency care and will potentially unnecessarily expose patients and ED staff to COVID-19 and other respiratory infections.
Staff in the ambulatory setting should follow the following steps when encountering a patient with symptoms of possible COVID-19 infection (fever and/or acute respiratory symptoms such as cough, shortness of breath).
- Ensure the patient is provided a mask and wears it when he/she is in the healthcare facility.
- Segregate the patient from other patients by placing him/her in a private room. If a private room is not available, segregate the patient from other patients in the waiting room.
- Inform the clinic nurse or physician/PA/APRN, who should then call Infection Control for guidance (can be reached through the page operator).
- Inform the clinic manager or director.
- Perform hand hygiene and then don the appropriate personal protective equipment (PPE). PPE guidance will be provided by Infection Control on a case-by-case basis.
- Minimize direct patient contact as much as possible – try to maintain a distance of at least six feet away from the patient, if feasible.
- Exercise caution when doffing and disposing PPE as usual precaution in the red bin, as this is a time when contamination risk is highest.
- Perform hand hygiene following doffing and disposing of PPE.
- After the provider and patient exit the room, ensure the room in which the patient was evaluated is cleaned using routine cleaning and disinfecting processes.
Patients with mild symptoms should be advised to self-care at home for the duration of symptoms with guidance to seek care or reevaluation if their symptoms worsen. Consider close follow-up through telecommunication.
We will be posting additional signage throughout the institution to provide instructions to patients on infection prevention strategies. Additionally, processes to direct patients who call for appointments with symptoms are being finalized and will be distributed to outpatient staff.
We appreciate your flexibility as guidance from public health agencies and UConn Health changes. We will keep you updated on these changes. Please see the following websites for additional information on COVID-19.