Socially distant home visit

[KalipsoRed21, BSN, RN]

So how is every preforming visits now that COVID is here? I am currently off on maternity leave. I’m looking for a remote work position because my husband is 60 and I would feel terrible to bring it home to him and our new baby (plight of every healthcare worker at this time; I know). I really like home care though and am trying to come up with a plan to go back to work safely while reducing risk of exposure. On top of the basic wear PPE and strip when I get home before I talk to or touch my family.

I like my company, but like most they are changing requirements daily and very inconsistent with responses to questions.

I use to preform visits by going into the patient home with my computer and bag. Sitting in the home, assessed the patient, reviewed concerns, reviewed medication, performed procedure and provided education.

Now I’m thinking, unless they are demented or deaf or have phone issues, that maybe I should drive to the home. Let the patient know I will do the interview portion from my car, review concerns and education from my car, then go in and assess the patient, preform procedures, and review their med bottles. I think that would really cut down on the time spent in the home but still preform to standard.

Anyone else have ideas on how to best socially distance but preform home visits?

[vampiregirl, BSN, RN]

Hospice nurse here so a few differences in visit format but many similarities...

I try to position myself 6 feet from the patient/ caregivers except when performing hands on assessment. This can even be maintained for med rec. Masks are worn by all agency personnel (all disciplines) for every visit; mask remains on. We have a procedure for mask selection if any COVID-19 risk factors/ symptoms identified (N95).

We performed an initial COVID-19 screen on all patient/ residences and have a brief screen we complete each visit. We also provided education to all our patients so no one has gotten excited/ offended about the social distancing. Hard of hearing has been a bit challenging but we've made it work.

[amoLucia]

OP - your system of doing pre-visit 'car work' is what my homecare provider is now doing for my visits. Anything that could be done remotely by them is done so. It then minimizes the actual 'en face' time spent.

The nurse/therapist (in my case) & CNA telephone me when they are on the way. Upon arrival, they wash first, then set up a 'work field' to lay down equip that stays on the field. Only equip nec for my use is laid out. And they distance as much as able.

The therapist and CNA wear masks and gloves at all times. And they use their bottle of sanitizer freq. Everything is provided by their employer. Any trash they generate they bag and dispose of outside. The PT sanitizes equip after usage.

Staff is NOT supposed to bring their computers/electronics inside, and the CNA was concerned re leaving that equip out in a hot car. Had a brilliant idea just as I started to answer this post - they might want to buy a cheap Styrofoam cooler from the Dollar Store to store equip in the car.

The therapist jots down notes and any documentation is finished after she leaves. Same for the CNA.

The new norm, I guess. And I think it keeps the visit time to a minimum.

[amoLucia]

Just revisiting the post - my CNA's employer provided her a nice thermal carry bag to protect the equip. She and others.

Some folk are open to suggestions, esp when it serves a purpose to save them money and/or equip. And also when the concern comes from a client, like myself.

[NRSKarenRN, BSN, RN]

HH agency visiting my husband even stopped getting signature on EMR visit note, uses patients own BP cuff, pulse ox and thermometer when present in home.

[KalipsoRed21, BSN, RN]

On 6/25/2020 at 9:41 PM, NRSKarenRN said:

HH agency visiting my husband even stopped getting signature on EMR visit note, uses patients own BP cuff, pulse ox and thermometer when present in home.

I wanted to start getting my patients their own vital sign equipment, but my employer is only allowing every patient their own thermometer right now. The BP cuffs and Stethoscopes are on back order right now. So I still am reusing equipment.