How to Meet A COVID-19 Patient _

How to Meet A COVID-19 Patient ?

      HEADLINES:

Patients with COVID-19 shouldn’t have to die alone. Here’s how a loved one could be there at the end.How to Meet A COVID-19 Patient ?

      WHY IN NEWS:

Australian College of Critical Care Nurses have come up with specific guidance and recommendations

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      LEARNING: 

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      ISSUE: 

The COVID-19 pandemic is challenging healthcare systems worldwide, none more so than critical and intensive care settings.

HOW TO MEET A COVID-19 PATIENT ?

  • Significant attention has been paid to the capacity of ICU’s during COVID-19.
  • Particularly in relation to beds, ventilators, staffing, personal protective equipment, and unparalleled increase in deaths in ICUs associated with COVID-19 seen internationally.
  • While death is not uncommon in critical care.

The international experience demonstrates that restrictions to family presence at the end of life result in significant distress for families and clinicians

  • As a result, the Australian College of Critical Care Nurses have come up with specific guidance and recommendations for practice for this emerging priority area.
  • This is to provide practical guidance to critical care nurses in facilitating next-of-kin presence for patients dying from COVID-19 in the ICU.

BEFORE THE VISIT

  • Family visitation should ideally be limited to one person, nominated as next of kin.
  • The person should be deemed fit and well, not self-isolating due to COVID-19 exposure, and not currently COVID-19 positive.

Any limitations to the duration of the visit should be explained.

  • Where possible, the dying person should be located in a single room within the ICU.
  • This will ensure maximal privacy for the family and limit exposure to other patients.
  • The visit should be scheduled at a mutually convenient time.
  • It will ensuring the ICU leadership are aware of the visit, and so an ICU staff member is available to assist.

THE VISIT

  • The visit should be scheduled a minimum of at least 30 min after any aerosol-generating procedure.
  • Next of kin must be able to drive directly to and from the hospital to limit potential exposure to others, to dress in single-layer clothing that is suitable to hot machine wash.

It is suggested to remove jewellery, and minimise valuables (e.g., suggest phone and car keys only). 

  • On arrival, next of kin should be prepared for what they will see on entering the critical care unit, what they may do, and what they may not do.
  • Next of kin should be instructed to wipe over valuables and wash hands for at least 20 s.
  • With the assistance of the ICU staff member, next of kin should be assisted with PPE (gown, surgical mask, goggles, and gloves).
  • The next of kin should be instructed not to remove or touch the front of their mask at any time during the visit.
  • If death is imminent, and a visit within 30 min of an aerosol-generating procedure is imperative, the next of kin must wear an N95 mask (instead of a surgical mask)
  • Where feasible, the next of kin should be provided with time alone with the dying person.
He/She should be given instruction on how to use the call bell to seek staff assistance. 
  • At the cessation of the visit, the ICU staff member should assist the next of kin to remove PPE, ensuring it is disposed of properly.
  • The next of kin should be instructed to wash their hands, leave the unit, and head directly home.

      IASbhai WINDUP: 

  • Upon return home, the visitor should be instructed to wash their clothing in a hot machine wash.
  • When necessary, immediate emotional support.
  • It can be provided by the ICU staff member appointed to support the visitor.

The visitor should also be provided with details of support services.

  • The services can include – the social worker, pastoral care, or counselling service available through the health service or local community service.
SUGGESTED READING : https://www.australiancriticalcare.com/ 
     SOURCES:Australian College of Critical Care Nurses | How to Meet A COVID-19 Patient ?

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