Novel coronavirus

On 1/24/2020 at 6:47 AM, CommunityRNBSN said:

Ask your patients if they’ve recently been to China!  And then that was basically all. No real guidance for screening (he listed the symptoms but of course they are common symptoms)

They should be asked immediately upon arrival if they have the common sx and have just returned from China or have a concern about exposure. If so, utilize masks, isolate them (without causing additional exposures in the process), and call your chain of command for additional guidance. [Off-the-cuff basics not official advice].

You can always call your HD to see if they have additional specific instructions.

On 1/24/2020 at 9:31 AM, 2BS Nurse said:

The symptoms are identical as far as we know.

But right now they have the symptoms +/- a reasonable concern for actual exposure (travel to area or contact with someone). As the situation changes the CDC will issue additional statements.

Here is a current statement (emphasis added):

https://wwwnc.cdc.gov/travel/notices/warning/novel-coronavirus-wuhan-china

Quote

Healthcare providers should obtain a detailed travel history for patients with fever and respiratory symptoms. For patients with these symptoms who were in Wuhan on or after December 1, 2019 and had onset of illness within 2 weeks of leaving, consider the novel coronavirus outbreak in China and notify infection control personnel and your local health department immediately.

Although routes of transmission have yet to be definitively determined, CDC recommends a cautious approach to interacting with patients under investigation. Ask such patients to wear a surgical mask as soon as they are identified. Conduct their evaluation in a private room with the door closed, ideally an airborne infection isolation room, if available. Personnel entering the room should use standard precautions, contact precautions, and airborne precautions, and use eye protection (goggles or a face shield). For additional infection control guidance, visit CDC’s Infection Control webpage.

"Health Care Providers" should obtain a detailed history. The problem is, the patient has already coughed on other patients and our clerks who are checking them in. We need someone at the front door asking patients to put on a mask.

13 minutes ago, 2BS Nurse said:

"Health Care Providers" should obtain a detailed history. The problem is, the patient has already coughed on other patients and our clerks who are checking them in. We need someone at the front door asking patients to put on a mask.

CDC website is open to the general public; they are referring to health care providers as in, the entity, the places where the patients are going to come and all the associated people/employees with whom they are going to interact at that place. They are not solely referring to licensed medical providers.

Have you been told that your idea is inappropriate/unnecessary at your place of work? If so, what rationale was given?

Yes, I have. Rationale is typically an eye roll.

1 hour ago, 2BS Nurse said:

"Health Care Providers" should obtain a detailed history. The problem is, the patient has already coughed on other patients and our clerks who are checking them in. We need someone at the front door asking patients to put on a mask.

In my area most, if not all, physicians offices, urgent care centers, and emergent departments have a box of masks with a sign asking all, patients and visitors alike, with a fever, cough, and or respiratory symptoms to don one.

1 hour ago, 2BS Nurse said:

Yes, I have. Rationale is typically an eye roll.

What exactly have you suggested your facility do?

22 minutes ago, chare said:

In my area most, if not all, physicians offices, urgent care centers, and emergent departments have a box of masks with a sign asking all, patients and visitors alike, with a fever, cough, and or respiratory symptoms to don one.

What exactly have you suggested your facility do?

SEE ABOVE. Ask about recent travel before they get to the waiting rooms. Coughing patients are allowed to refuse a mask. They should be asked to leave the clinic if they refuse.

During the Dallas Ebola 2014 we were woefully reactive at the community level. But we sure did stock up on PPE. I am wondering how much of that stuff is still good and how much breakdown you'd have in six years...