Www.lifebridgehealth.org



4428490-52387500COVID-19?CLINICAL GUIDELINES????SUBJECT:??GUIDELINES FOR PREOPERATIVE COVID-19 TESTINGSCOPE: Sinai Hospital of Baltimore, Northwest Hospital, Grace?Medical Center and Carroll Hospital adopt the following guidelines for clinical services provided during the COVID-19 pandemic.????PURPOSE:To provide COVID19 testing preoperatively as a safety measure for patients, hospital staff and providers having surgery. It is known that COVID-19 has a negative impact on patients who undergo surgery regardless of the presence or absence of symptoms. Consequently, Surgical Services recommends the following guidelines for COVID lab preoperative testing for surgical procedures. This policy applies only to COVID-19 testing by nasopharyngeal swab. Serologic antibody testing will not be acceptable for procedure clearance.APPROVED BY:?Inpatient COVID19 Taskforce????APPROVAL DATE:?5/11/20;?LAST REVIEW DATE: 6/15/20GUIDELINES: Outpatient Surgery or Procedures: Elective/Necessary Procedures (scheduled, non-urgent and non-emergent):COVID-19 Testing is required prior to the procedure. Testing should be perfomed in accordance with Appendix B. Negative COVID test results are required before elective surgery. individual exceptions may be granted at the discretion of the care team.The patient should practice enhanced self isolation for 14 days prior to the procedure until the time of the procedure and monitor temperature twice a day for the 3 days prior to surgery, if able. (Appendix A)The patient should contact the surgeon or proceduralist with any questions or possible appearance of symptoms prior to the day of surgery or procedure for guidance. If a patient tests positive for COVID, elective surgical procedures should be delayed until the patient is no longer considered infectious, and has demonstrated recovery from COVID.In general, the patient should be symptom free for a period of fourteen days prior to the planned surgery or procedure.Urgent or Emergent Procedures: A COVID test will not be required prior to proceeding to an operation or a procedure for an urgent or emergent case in alignment with current hospital policies. It will be up to the discretion of the perioperative team evaluating risks versus benefits to the patient to proceed without a test, or with a positive COVID test.Inpatient Surgery or Procedures:Elective/Necessary Procedures (scheduled, non-urgent and non-emergent)A negative COVID test is recommended prior to an inpatient surgery or procedure.A positive COVID test will require the primary service to decide whether to proceed with the procedure while the patient is an inpatient or postpone the procedure to a future time where it may be performed on an outpatient basis after recovery from COVID. For inpatients who have recovered from COVID, two consecutive COVID negative tests at least 24 hours apart would deem these patient suitable for an aerosilizing inpatient elective surgery or procedure such as a tracheostomy or PEG tube.Urgent or Emergent Procedures: Urgent or emergent surgery or procedures can be performed on inpatients without delay for a COVID test. The patient will be evaluated by the primary service to decide on the urgent or emergent needs of the patient for surgery or a procedure in alignment with current hospital policies. A positive COVID test will not delay an urgent or emergenct surgeryPediatric PatientsParent must keep a log of the child’s temperature twice daily and any symptoms in the 3 days before surgery. Accompanying adult(s) must be able to pass COVID19 screening questions at the door each time (no fever, no respiratory symptoms, no COVID19 known contact x 14 days).Current COVID19 visitor policies remain intact. Adults Nursing Home/Acute Care Facilities must obtain COVID19 testing preoperatively and agree to accept patients with negative results back to facility after procedure has been completed. We recommend COVID19 specimens be sent via LabCorp (Labcorp: 2019 Novel Coronavirus (COVID-19), NAA test 139900 PRIORITY). Appendix A: Self IsolationPatients should practice enhanced isolation precautions prior to a scheduled surgery. Ideally this should be for 2 weeks before the procedure, if possible: Everyone in the household of the patient, including the patient should:Avoid close contact with people who are sickStay home as much as possible. For patients who must work:Wear a face mask if around otherPractice social distancing, (6 feet)Wash your hands with soap and water frequentlyMonitor your temperature in the morning and eveningContact your doctor for any symptoms or questions.Wear a face covering if leaving the houseStay 6 feet away from other people if leaving the houseNot allow any non-household members to enter the house Clean and disinfect frequently touched surfaces dailyAvoid touching eyes, nose, and mouth with unwashed handsAppendix B: How to get a patient a COVID testOptions to obtain Preop COVID19 testing include:P.A.S.S. at SinaiLocal testing facility (anywhere) LifeBridge or State-run COVID19 drive through testingThe process for making a patient an appointment to the COVID19 drive-through is as follows:The Surgeon’s office can call the COVID19 Hotline at 410-601-2222 to schedule testing. The call will be transferred to registration and then to the ordering/scheduling nurse in the virtual hospital to arrange for the COVID 19 test.Test is ordered UNDER THE CALLING PROVIDER’s NAME (as a verbal order) so that the result comes back to that provider (it is also visible to all in Cerner/CRISP).The testing sites utilized will be the three LBH testing sites: Pimlico Race Course, Carroll Hospital Medical Center, Grace Medical Center. Patients that are not local to the area will need to obtain the COVID19 Test and submit results, along with their preoperative lab work /test results to the surgeon’s office. These results must be received 72 hours before surgery, so testing 5 days before surgery is ideal (no more than 7 days). Priority results are usually available in 48 hours, but we recommend 72 hours to be sure results are available for review by the surgical team and scanned into the chart. It is the surgeon's (or in the case of a procedure under sedation, the provider performing the procedure) responsibility to check for COVID19 results prior to having the patient arrive at the hospital. This can be done on CRISP, Cerner if performed at P.A.S.S. or at a LifeBridge drive-through, or by having the patient or patient's provider provide evidence of a negative test. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download