I work private duty home care. Our city has not yet had any coronavirus cases. These are the questions I have put to my agencies:
What kind of PPE is available if we have a client diagnosed with coronavirus?
How many masks and gloves are available? Any N 95s?
How long do the droplets stay in the air after a cough? Does nebulizing a medication cause it to stay in the air longer?
When a client with coronavirus gets Xopenex per nebulizer, what kind of PPE should we be wearing? We have to be right there with the client - 6 feet away isn't possible when suctioning.
What is the policy for isolation when a client has coronavirus? Keeping the client in their bedroom helps, but I'm referring to the nurses. Do we go home at the end of the shift? What about our families? Do THEY have to then stay at home (self-isolate)?
I normally wash my hands when I get home, grab a clean shirt, wash at least my hands, arms, and face, and put on a clean shirt. Maybe I'll start changing my slacks, too. Is this sufficient for coronavirus?
So, are there any other questions I should be asking?
Maybe I should post this under HIPAA, but, I'm curious. On the surface, this makes sense. BUT... HIPAA is based on need to know. Don't I need to know if I were exposed to the virus/disease? Wouldn't the patient need to know if they were exposed to it?
Exactly. If I am exposed and have to self-isolate, I will of course tell my employer. I will also tell my client's parents (I'm a peds nurse). If I know that I did not expose their child, I will tell them so they won't worry. And if I DID expose their child, I will most certainly tell them!
Is it not reasonable to say that infection is more likely from a spray to the face?
I remember in microbiolgy my professor telling us the biggest/main portal of entry for airborne and droplet viruses is the eyes. We touch our eyes with our hands repeatedly throughout the day. I'm also envisioning this scenario. I'm suctioning my patient and he gleeks/spits out of his mouth and onto his blankets. Later I think nothing of it as I pull his sheets up for him. Gross ? Then I touch my eyes. I have gotten way too lax in home care with few supplies.
It does help that I wear glasses. This is not as much protection as goggles, but, again, every little bit helps.
I also have a full face mask for taking care of clients who spray with each cough. It has been well-decorated. I clean it with soap & water. It does not touch my face except for the headband; it sits in front of my face.
It does help that I wear glasses. This is not as much protection as goggles, but, again, every little bit helps.
I also have a full face mask for taking care of clients who spray with each cough. It has been well-decorated. I clean it with soap & water. It does not touch my face except for the headband; it sits in front of my face.
Healthcare personnel caring for patients with confirmed or possible COVID-19 should adhere to CDC recommendations for infection prevention and control (IPC)
Fortunately, home care patients are already isolated within their homes and communities by their health condition...making them less likely to be a risk to you and more likely to be vulnerable because of visitors. COVID 19 patients self quarantined shouldn't need nursing visits.
My agency employer has sent all employees two emails to date basically stating that the company "has a plan" and that department heads are hashing out "the plan" and they will keep us informed. Other than that, which is actually nothing, we field nurses, are discussing the matter with our client families, and taking measures to increase infection control on our own in the meantime.
Second this. We are doing the educating in the house. Limiting outings too.
In another blog I follow I discussed the law of unforeseen consequences. What is such an obvious concern to the home health nurses Is most likely not even considered by many others. Truthfully I never considered the perils of home care. I did my share of it way back when.
I really don't think HIPAA would apply as to your need to know ALL diagnoses in order to provide appropriate care for a patient.
On the patient developing new symptoms, that of course needs to be addressed by whoever writes his orders. On you developing symptoms shortly after your patient did it is presumptive to assume that you contracted what ever it is you have from him. ON the other hand it is likely. But if you are symptomatic you might be the one with an oncoming severe illness putting your patient who might have a less severe illness at risk. Should you be off of the case? Hard questions and they need to be addressed with family and your employers. You have my sympathy.
In another blog I follow I discussed the law of unforeseen consequences. What is such an obvious concern to the home health nurses Is most likely not even considered by many others. Truthfully I never considered the perils of home care. I did my share of it way back when.
I really don't think HIPAA would apply as to your need to know ALL diagnoses in order to provide appropriate care for a patient.
On the patient developing new symptoms, that of course needs to be addressed by whoever writes his orders. On you developing symptoms shortly after your patient did it is presumptive to assume that you contracted what ever it is you have from him. ON the other hand it is likely. But if you are symptomatic you might be the one with an oncoming severe illness putting your patient who might have a less severe illness at risk. Should you be off of the case? Hard questions and they need to be addressed with family and your employers. You have my sympathy.
I think an educated guess is more accurate. Luckily I don't have to worry about it as I scheduled time off and don't have to be back for a week.
So far, one agency has told me that they can't get their hands on any hand sanitizer. The other agency told me that if the client has COVID 19 in their home, the nurse is not to go in.
The client and his family are on their own!?
I hear there is a recipe for home made hand sanitizer using 70% alcohol and aloe vera gel. Does anyone have this recipe? And does it work?
Specializes in NICU, PICU, Transport, L&D, Hospice.
4 minutes ago, Kitiger said:
So far, one agency has told me that they can't get their hands on any hand sanitizer. The other agency told me that if the client has COVID 19 in their home, the nurse is not to go in.
The client and his family are on their own!?
I hear there is a recipe for home made hand sanitizer using 70% alcohol and aloe vera gel. Does anyone have this recipe? And does it work?
Kitiger, RN
1,834 Posts
Exactly. If I am exposed and have to self-isolate, I will of course tell my employer. I will also tell my client's parents (I'm a peds nurse). If I know that I did not expose their child, I will tell them so they won't worry. And if I DID expose their child, I will most certainly tell them!