How to Meet A COVID-19 Patient ?
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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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.
- 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.
- 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 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.
- 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.
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.
- 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 services can include – the social worker, pastoral care, or counselling service available through the health service or local community service.