Interventions implemented by the outbreak response team
| Intervention | Date of implementation |
|---|---|
| Patient-related | |
| Patient symptom screening twice per shift*† | June 4, 2020 |
| Creation of a dedicated COVID-19 unit | July 5, 2020 |
| Development and implementation of an approach to managing patients with unrecognized SARS-CoV-2 infection who wandered | July 5, 2020 |
| Dual sign-off requirement for the removal of contact and droplet precautions from patients with suspected COVID-19 who tested negative‡ | Aug. 9, 2020 |
| Staff-related | |
| Training and deployment of PPE coaches | June 30, 2020 |
| Training and deployment of PPE auditors | June 30, 2020 |
| Addition of continuous eye protection to continuous masking for all staff with patient interactions | July 5, 2020 |
| Fit-to-work screening online questionnaire twice per shift | July 8, 2020 |
| Break room and locker room sign-ins and physical distancing in break areas | July 12, 2020 |
Note: PCR = polymerase chain reaction, PPE = personal protective equipment.
↵* Evaluation for new or worsening symptoms of core symptoms (cough; fever [> 37.8°C], chills or rigours; shortness of breath; increased oxygen requirement; decreased oxygen saturation; difficulty breathing; sore throat or painful swallowing; runny nose or nasal congestion; loss of or change to sense of smell or taste), gastrointestinal symptoms (vomiting or diarrhea), or expanded symptoms (headache; muscle or joint pain; fatigue; extreme exhaustion; nausea; sudden loss of appetite; conjunctivitis or red eye; conjunctival edema; additional COVID-19 symptoms at clinician’s discretion) and altered mental status. Identification of any of these resulted in a review with the attending physician to discuss ordering a new or repeat SARS-CoV-2 nasopharyngeal swab PCR test.
↵† Patients were given education on how to use the surgical mask and hand sanitizer by their nursing teams. Extra masks were provided upon patient request. Hand sanitizer was not provided to patients where it was felt that it may pose a health hazard; instead, these patients were asked to perform hand hygiene with assistance whenever interacting with health care staff.
↵‡ The dual signature requirement for the removal of precautions included the patient’s most responsible physician (or nurse practitioner) and a senior nurse in charge on the unit.