COVID-19 information for providers

March 24th, 2020

Clinical Practice Documents (March 26)

Providers, please click here to find Clinical Practice Documents.

COVID-19 UCHealth Update

(Updated March 24, 2020)

As health care workers, our communities are looking to us for leadership during this pandemic. It is imperative that we all are equipped with facts. We hope you find the below information helpful as you care for your patients and interact with your staff members.

Facts:

  • COVID-19 is a virus transmitted by droplets. Appropriate precautions include contact/droplet with eye protection.
  • COVID-19 does have the potential to be transmitted by airborne particles when performing aerosol generating procedures or treatments. Appropriate precautions include airborne/contact with eye protection when performing aerosol generating procedures or treatments. All of UCHealth’s N95 respirators, half face piece respirators, and PAPRs are approved for use when performing aerosol generating procedures or treatments.
  • UCHealth has a sufficient stock (inventory) of PPE as of today.
    • Conservation efforts are helping us protect our supply against ever-growing needs. Conservation is important since we have no way to predict how long this pandemic will affect us.
    • Health care workers (HCW) who perform direct patient care including operative and procedural areas will be provided one surgical/procedural mask per shift and as needed for clinical circumstances.
  • Used PPE is being collected now as a potential safeguard for the future.
    • Through connections with hospitals already seeing a surge in patients, UCHealth is learning best practices and planning for the possibility of a surge in patients here.

COVID-19 Testing Criteria

(Updated March 21, 2020)

As there is now evidence of community transmission in Colorado, we are recommending only testing health care workers and hospitalized patients with symptoms of acute respiratory infection (e.g. fever, new cough, new shortness of breath). Patients who do not require admission should be encouraged to stay home and be given guidance on home isolation. Neither infectious diseases consultation service nor public health official​s need to be notified if you are considering testing.

Health care workers

Health care workers who have a fever or other symptoms consistent with COVID-19 should call 720.787.3321 to be evaluated.

Hospitalized patients: At least 7 days after hospital discharge, even if treated with antiviral medication UNLESS cleared from isolation during hospitalization. Patients with more severe illness may have prolonged viral shedding and isolation may be extended in discussion with public health.

CDC issues new recommendations for non-essential travel

(Updated March 16,2020)

The U.S. Centers for Disease Control and Prevention has recommendations for non-essential travel. For more information: https://www.cdc.gov/coronavirus/2019-ncov/travelers/map-and-travel-notices.html

Travel to Eagle, Summit, Pitkin or Gunnison counties

On March 15, the Colorado Department of Public Health and Environment announced that visitors to Eagle, Summit, Pitkin, or Gunnison counties in the past week should minimize all contact  with other people due to evidence of community spread.

  • Employees, providers and trainees who traveled to these areas in the last week will not be required to quarantine at home, but must wear a face mask while in any UCHealth facility.
  • Practice hand hygiene at all times and practice social distancing when feasible.
  • One face mask can be worn for an entire shift, unless becomes soiled and needs to be replaced.

When talking to patients:

  • Reassure patients, always, that UCHealth care providers are vigilantly evaluating every patient that enters our facilities. If someone exhibits COVID-19 symptoms, we will provide appropriate care.
  • If patients have questions about COVID-19, suggest that they phone the CDPHE phone line, CO-Help at 303.389.1687 or 1.877.462.2911 or email COHELP@RMPDC.org, for answers in English and Spanish (Español), Mandarin (普通话) and more.
  • Remind patients they can help slow the spread of the disease by:
    • Washing their hands often with soap and water for at least 20 seconds.
    • Staying home when they are sick, and keeping children at home when they are sick.
    • Covering a cough or sneeze with a tissue.
    • Cleaning and disinfecting frequently touched objects and surfaces using a regular household cleaning spray or wipe.

Please see the dedicated COVID-19 information page for providers on the UCHealth website or the dedicated page on The Source for detailed information on COVID-19 and the most recent information. Thank you for your continued vigilance and your dedication to keeping our patients and employees safe.

Lab Tests Required for COVID-19

(Updated March 14, 2020)

The SARS-COV-2 NAAT order set includes COVID-19 and a respiratory viral panel (RVP) if not done in the last 48 hours. Positive RVP results will no longer resulting in cancellation of COVID-19 testing.

 Materials Needed:

1 swab for NP collection

1 tube of M6 or M4-RT viral transport media

 Examples of swabs and viral transport media

 Proper Specimen Collection

The quality of the specimen collection is critical, and the correct collection of the specimen is directly linked to the sensitivity of the test. Collect one NP swab for both the RVP and COVID-19 tests. Follow these steps:

  1. Perform hand hygiene before and after patient encounter.
  2. Don appropriate PPE.
  3. If the patient has nasal congestion or a moderate-large amount of rhinorrhea, ask them to clear their nose into a tissue.
  4. Tilt their head back slightly (70 degrees)
  5. and ask them to close their eyes, if possible.
  6. Insert the swab into the nostril parallel to the palate until resistance is met by contact with the nasopharynx.
  7. Leave swab in place for 2-3 seconds then rotate completely around for 10-15 seconds. Note: Although not painful, patients generally feel very uncomfortable with this procedure. Be prepared for them to pull their head and/or body away. This procedure may also generate a cough so prepare to move to the side if possible, especially after completing the process.
  8. Remove swab and repeat the same process in the other nostril with the same swab.
  9. After the second swab is completed, immediately
  10. place into the sterile vial containing the universal transport media.
  11. Ensure that cap is closed tightly and label is on tube.
  12. Place the tube into a biohazard bag.

Transport

Please walk specimens to Clinical Laboratory, do not use the tube system

Questions?

Contact local Clinical Laboratory

CDC Resources

https://www.cdc.gov/coronavirus/2019-ncov/index.html
https://apps.who.int/iris/bitstream/handle/10665/330375/WHO-2019-nCoV-IPC-v2020.1-eng.pdf

Patient Privacy

Please keep in mind that patient privacy remains a top priority. Do not share information or speculate about illnesses, especially in the presence of patients and visitors.

UCHealth’s Compliance & Privacy Department conducts audits of the accesses made to patients’ records.

Referring or triaging patients

(Updated March 10, 2020)

If a patient calls and reports COVID-19 symptoms or possible exposure, and needs to be evaluated/triaged, there are two options:

  • A dedicated COVID-19 RN triage team being operated by UCHealth’s Patient Line is available from 7a.m.-7p.m., Monday through Friday. Operators are prepared to transfer these patients directly to the RN team who will evaluate and determine the best course of action for the patient. Ambulatory clinic leaders, staff and operators have information for these referrals.
  • UCHealth’s Virtual Visits team now has capabilities and protocols for providers to virtually screen patients for COVID-19 symptoms and exposure, and if needed, refer patients for testing. Patients can quickly set up virtual visits through the UCHealth mobile app or through the Virtual Visits website.

UCHealth continues to actively monitor COVID-19 developments and is taking measures in accordance with local and national guidelines to ensure the health and safety our community; this information may be subject to change based on evolving conditions.

Thank you for your partnership in caring for each other and being safe.

 

 

About the author

UCHealth is an innovative, nonprofit health system that delivers the highest quality medical care with an excellent patient experience. With 24,000 employees, UCHealth includes 12 acute-care full-service hospitals and hundreds of physicians across Colorado, southern Wyoming and western Nebraska. With University of Colorado Hospital on the Anschutz Medical Campus as its academic anchor and the only adult academic medical center in the region, UCHealth pushes the boundaries of medicine, providing advanced treatments and clinical trials and improving health through innovation.