How did we adapt of change our processes to overcome the challenges of COVID-19?
The first few weeks of spring last year were a time of continuous change. Everyday there was something new that needed to be addressed. Infection Preventionist were at the forefront of every change. I am the only certified IP at our hospital so I was looked to for recommendations and opinions on nearly every process change that occurred.
Two specific processes that changed stand out in my mind. The first was developing cohort units for the positive patients we care for. Our hospital, as of the first week in March has housed 15% of the total hospitalized patients in our state. The maximum number of positive COVID patients we had a one time was 160, with a total census of around 550. We converted 7 different units to total COVID units during the heat of the pandemic. We trained staff, designed signage, answered airflow questions, and spoke to our bed board staff daily about patient placement. We wrote guidelines based on CDC recommendations for discontinuation of isolation. We became an integral part of keeping patient and staff safe from exposure. In the beginning of the pandemic, testing of patients was also a challenge that was handled by the IPs. We had to call our state health department to get approval for every test, and make sure each unit had the supplies and education to test patients. As time when on the testing procedure changed and once again, IPs were the educators. So Infection Prevention was essential in the total process of patient placement and staff and patient safety from COVID exposure at the hospital.
The second process that had to be developed from the ground was the reporting. We had to make sure all mandatory reporting requirements were disseminated out to the people that could help make it happen. We informed the lab and made sure every COVID test result was sent to our state health department. The IPs reported every positive result to our local health departments for contact tracing. We also developed a spread sheet that had all the information required by our state health department and HHS concerning census, COVID census, ICU bed availability, ventilator availability, ethnicity, county numbers of hospitalizations, etc. The spreadsheet has the information for our whole system, 6 hospitals and numerous clinic, and is updated daily. This spreadsheet is sent to all administration, and all directors that would be impacted by the information. IP also oversees the reporting of all deaths from COVID to our state health department.
Every day was a new adventure and sometimes we felt we were barely holding on to our sanity. But we survived and grew through this trial. Everyone has a new appreciation for Infection Prevention!