Medical Alert Process Updated

Universal Testing is allowing Children’s to update our Pandemic and Standard Medical Alert Processes. Patient COVID-19 status will be indicated by smiley face door signs. These processes are effective immediately:

Red Smiley Face Door Sign:

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  • COVID-19 Positive
  • Pandemic Medical Alert Process

 Green Smiley Face Door Sign:

  • COVID-19 Negative
  • Standard Medical Alert Process

PANDEMIC Medical Alert UPDATES:

CHANGE: Documenter allowed in the patient’s room during a Medical Alert

CONTINUE established Pandemic Response including, but not limited to:

  • Most experienced provider to intubate
    • Close the door
    • Batch medication via the server door when possible
    • Follow pandemic process for intubation and extubation

STANDARD Medical Alert UPDATES:

  • Essential staff present in the medical alert are designated by the medical alert role stickers and should be present in the patient’s room.
  • Crash cart will be stationed outside of the patient’s room.
  • Batching medications
    • Epinephrine doses x 3 first
    • Prepare subsequent batches based on patient needs
      • RSI medications, cardiac medications
  • HEPA/viral filter used on ALL ambu bag set-ups.
  • Team leader decides who performs intubation based on available and qualified providers present.
  • Code team members will continue to carry N95 masks and goggles on their person in preparation for medical alerts on COVID-positive or COVID-unknown situations.
  • Intubation and extubation processes will resume standard protocol.

When COVID Status is Unknown:

  • Outpatient areas and Emergency Department
    • Assume positive status during ALL medical alerts
    • Follow pandemic medical alert policy
  • Inpatient areas awaiting test results
    • Positive screening/symptomatic
      • Anticipate PCR test
      • Red smiley face door sign
      • Pandemic medical alert process
    • Negative screening/asymptomatic
      • Anticipate antigen test
      • Green smiley face door sign
      • Standard medical alert process

Medical alert process and door signs will be updated based on test results once received

  • Any positive result will prompt a red smiley face door sign.
  • Any negative result will prompt a green smiley face door sign.

Should changes be made to our ability to perform Universal Testing, the medical alert process will change as well.

Updated Universal Masking and Eyewear Guidelines and FAQ for Faculty and Staff

Children’s has updated the masking and eyewear guidelines in an effort to provide clarification. Please carefully review the following universal masking and eyewear guidelines and related FAQ for all Children’s faculty and staff. To obtain your universal mask protection, or if you did not receive your initial eyewear protection and are a clinical staff, please contact your direct supervisor. Please note that these guidelines are relevant at this moment in time. We fully expect that eyewear guidelines will need to evolve as the situation changes within our community. Changes will be communicated via email, The Pulse and on myChildren’s. Thank you for your compliance with these guidelines and for your commitment to providing a safe environment for Children’s patients, families and team members.

Universal Masking

Employees are required to wear appropriate facemasks covering their nose and mouth at all times on Children’s property. This includes upon arriving and leaving the property, around the workplace, in common spaces and anytime away from their assigned non-clinical work space, as per ADM248 Epidemic Pandemic or Emergency Disaster Restrictions and Care Guidance 3-20 Policy.

You may remove your mask while at your assigned non-clinical workspace if you are able to maintain physical barriers or a seating arrangement per the forthcoming COVID-19 Guide for Employees. These plans are based upon CDC guidance. You must put your mask back on any time you move around the facility or are unable to maintain a social distance of 6 feet from others (e.g. patient/family approaches/enters your personal area).

Clinical areas (Locations where care or interaction with patients is occurring): Employees in clinical areas are required to wear a Children’s-approved health care grade mask (e.g. earloop, N-95, etc.).

Non-Clinical areas (cubicles, offices, cafeteria, etc.): While in non-clinical areas, employees are required to wear cloth, homemade or non-health care grade masks. If an employee is already wearing a health care grade mask, continued wear is approved per extended use guidelines.

Cleaning and disinfection should be completed according to Children’s guidelines.

Universal Eyewear

Any employee entering a clinical, hospital or exam area for any amount of time is required to have protective eyewear on their person at all times. If a patient or family member comes within 6 feet of an employee, eyewear must be donned as per ADM248 Epidemic Pandemic or Emergency Disaster Restrictions and Care Guidance 3-20 Policy.

Cleaning and disinfection should be completed as per Children’s guidelines/recommendations. Please review Children’s universal eye protection document here. Read universal eyewear education sheet here.

Clinical areas (Location where care or interaction with patients is occurring): While in clinical areas, employees are required to have Children’s-approved health care grade, protective eyewear present at all times and wear when working/interacting or unable to maintain social distance of 6 feet from others. Independently purchased eye protection must meet ASNI certification guidelines. Refer to the attached infographic for more information on protective eyewear.

Non-Clinical areas (cubicles, offices, cafeteria, etc.): In non-clinical areas, employees are not required to wear protective eyewear; however, non-clinical employees need to obtain and don eyewear if they are entering clinical areas.

Frequently Asked Questions (FAQs)

  • Does the universal mask policy apply to every member of the workforce working anywhere?
    • Yes. Please note the differentiation of Personal Protective Equipment (mask/eyewear, etc.), required based upon clinical or non-clinical setting. 
  • Can I wear eyewear all the time while at Children’s (clinical or non-clinical settings)?
    • Yes. If you wish to wear eyewear at all times, you may do so, as long as the eyewear meets the Children’s universal eye protection document standards.
  • Should I wear my same mask or eyewear in/out of isolation rooms between patients that have been diagnosed with respiratory viruses such as RSV and bronchiolitis or are PUI/COVID-19 positive?     
    • Yes. Your Children’s-approved health care grade mask and eyewear should be used according to our extended use/re-use guidelines, which ensure careful and deliberate handling of a mask to prevent both self-contamination and cross-contamination.
    • The goal of wearing this PPE is to protect the staff, not the patient.
    • The only exception is COVID-19 patients requiring high risk and/or select aerosol-generating procedures that require Airborne Isolation and use of a N-95 mask.
  • Do I need to change my mask/eyewear if I am performing a sterile procedure (i.e. central line placement, central line dressing change, etc.)?
    • If the procedure kit has a mask in it, doff your current mask outside of the room and place it on a paper towel. For the procedure, utilize the mask provided in the sterile kit. When the procedure is complete, if the mask is not compromised, you may continue to wear the mask. If the mask is compromised, doff the mask and re-don the mask that is outside the room.
    • If the procedure kit does not have a mask, continue to wear your current one (e.g. central line dressing kit).
    • As we have limited masks to distribute, please ask families to step out of the room during all procedures where a mask would be necessary, if able.
  • How can I eat or drink when I am wearing a mask?
    • Eating is not permitted in clinical areas. If you are working in a clinical setting, follow the removal and re-use instructions as outlined in the “To Doff Earloop Mask” procedure, using a paper towel to save your mask for when you are finished eating.
    • If you need to drink, ensure you are 6 feet away from others, perform hand hygiene, remove the mask following the “To Doff Earloop Mask” procedure and then replace your mask.
  • Can staff gather in break rooms, the cafeteria and other places to eat and relax? If so, should they leave their masks on?
    • To limit the number of people in a break room, consider staggering break times.
    • Adhere to the same principles of social distancing when together in break rooms, conference rooms and other places.
    • Social distancing means allowing 6 feet of distance from others.
    • Take appropriate precautions for hand hygiene and refrain from touching the face.
    • Masks can be taken off in such areas for eating and drinking when following social distancing guidelines.
  • Should employees be wearing masks to/from home?
    • Yes. Cloth masks have been provided for employees to use entering and exiting Children’s facilities and coming and going from work locations. 
  • Can non-clinical staff wear cloth, homemade or non-health care grade masks brought from home?
    • Yes. Cloth masks are available for non-clinical staff if they do not have one at home; please request one from your supervisor if you need one.
  • Should visitors be wearing masks?
    • Yes. As part of the Universal Masking policy, all staff and visitors should wear a mask while on Children’s premises. Patients should wear masks at all times as appropriate for age/developmental level.
    • Cloth, homemade or non-health care grade masks brought from home are encouraged for visitors and patients. This practice will be continually monitored and re-evaluated as circumstances evolve.

CDC Warns About Possible Acute Flaccid Myelitis Outbreak This Year

Researchers at the CDC reviewed the acute flaccid myelitis (AFM) outbreak in 2018 and found that more than 50 percent of the cases ended up in intensive care and almost one in four needed a ventilator to survive after the child’s muscles grew too weak to breathe properly. The findings in the CDC’s Morbidity and Mortality Weekly Report also showed that the number of confirmed cases of AFM had increased with every-other-year outbreaks, with 120 cases in 2014, 153 in 2016 and 238 in 2018. This cadence means a new outbreak could strike hundreds of youths in the U.S. within the next few months.

Read more

Renewals Are Currently on Hold for Some License Types

Renewals are currently on hold, per Executive Order 20-10, for the following professions:

  • Medicine and Surgery (M.D.)
  • Osteopathic Physicians (D.O)
  • Advanced Practice Nursing
  • Emergency Medical Services
  • Mental Health and Social Work
  • Nursing
  • Osteopathy
  • Pharmacy
  • Perfusion
  • Psychology
  • Respiratory Care
  • Surgical Assistants

If you hold a license in one of the above professions, you will not be receiving a renewal notice at this time, and your license will not expire on the original expiration date. Expiration dates for these professions will be extended to Dec. 31, 2020. This date may need to be adjusted if the state of emergency continues longer. You will soon be able to print a wallet card to verify the extended expiration date at dhhs.ne.gov/lookup.

When the state of emergency is lifted, the Licensure Unit will send renewal notices to all licensees. You will then have 90 days to renew by:

  1. Completing the renewal application and paying the renewal fee (online or via paper).
  2. Attesting that you have completed or will complete the continuing competency by the expiration date; or
  3. Requesting a waiver of the continuing competency and submitting documentation to support your waiver request. 

Policy Update on Restraints

Recently, the Centers for Medicare & Medicaid Services (CMS) changed its stance on who can order and manage restraints.  They have changed “licensed independent provider” to “licensed practitioner.” This allows physician assistants to order and manage restraints moving forward. The new verbiage is:

Licensed Practitioner (LP) For the purpose of ordering restraint or seclusion, an LP is any practitioner permitted by State law and hospital policy as having the authority to order restraints or seclusion for patients.

Read the policy

Remote Work Task Force Update

When the COVID-19 pandemic began in the spring, Children’s made the decision to transition a large group of employees to remote work. As the pandemic has evolved in our community, Children’s has assembled a dedicated team of leaders to monitor the situation to support everyone working onsite and offsite during these unprecedented times.

In previous communication, the timeline for remote workers to return to the office was the fall. At this time, Children’s senior leadership believes that a more realistic timeline is the end of the year. The pandemic continues to evolve in unpredictable ways, and the task force is monitoring developments closely to make the best possible decisions for our workforce. The end-of-year goal is something the organization will continue to reassess as we get closer to that date. Employees who are working remotely will always be given at least 30 days notice before they are asked to return to the campus.

Two other large Omaha employers are extending remote work. Remote Nebraska Medicine employees will continue to work at home through the end of year. Mutual of Omaha employees will work remotely for the foreseeable future.

If you are currently working from home, please continue to do so until further notice. If you are working remotely, please note that you should not be coming on campus unless you have previously communicated with and cleared that request with your supervisor. Remote employees who have a business need to be onsite should get approval from their supervisor in advance.

The task force is creating a set of policies and procedures to fully support the entire organization as we all adapt to new and different ways of working during a pandemic. These will be shared once they are finalized this fall. The task force is also discussing what work life might look like after the COVID-19 pandemic has passed. It is exploring all options and having in-depth conversations about what is best for the organization and what is best for Children’s employees as individuals.

“This pandemic has provided us with a unique opportunity to find new and creative ways to support our employees, as we all navigate uncharted waters and find our way through a new normal,” says Janel Allen, senior vice president & chief Human Resources officer. “In this time, our focus as an organization is keeping our employees safe and supported as they face ongoing uncertainty at home and at work. Children’s is deeply committed to caring for our employees as we all move forward together.”

The Task Force members are:

  • Janel Allen, Senior Vice President & Chief Human Resources Officer
  • Amy Bones, Senior Vice President & General Counsel
  • Jerry Vuchak, Senior Vice President & Chief Information Officer
  • Marty Beerman, Vice President, Marketing
  • Megan Connelly, Vice President, Community Pediatrics & Child Health
  • David Fett-Jones, Vice President, Clinical & Ancillary Services
  • Heather Smith, Vice President, Pediatrics
  • Alyson Krings, Audit & Advisory Services Manager
  • Amy Kutz, Construction & Property Manager
  • Jaime Mukherjee, Senior Performance Improvement Clinical Services Manager
  • Melissa Paradis, Director, Quality & Patient Safety
  • Bernadette Tate, Staff Counsel

Listen to the Latest Just Kids Health Podcast

Just Kids Health, a podcast from Children’s, has been created to help keep children healthy, safe and strong. During this unprecedented time, Children’s experts discuss families’ concerns in these podcasts, intended as a resource for families.

In this podcast, Children’s Physicians pediatricians Tina Scott-Mordhorst, M.D., and Brandi Reeve-Iverson, M.D., provide guidance for parents working from home, juggling both child care and work responsibilities

Listen here. The podcast is also available on Apple Podcasts and Spotify.

Make Plans to Attend These Important and Informative Sessions

Pediatric Trauma Grand Rounds
The presentation, “Pediatric Genitourinary Trauma,” takes place on Monday, Aug. 17 from noon to 1 p.m. via Zoom. The speaker is Claudia Berrondo, M.D., Pediatric Urology. CME/CNE and trauma credits are available.

Adult Congenital Heart Disease Symposium
Children’s and Nebraska Medicine present “Adult Congenital Heart Disease Symposium: Improving Continuity of Care.” The symposium will be held online on Friday, Aug. 21 from 8 a.m. to 4 p.m. CME and CNE credits are available.

Topics include:

  • ACHD Imaging
  • ACHD Catheter Intervention
  • Non-Cardiac Admissions & Anesthesia
  • Systemic Right Ventricle
  • Transitioning Complex Patients
  • The Past & Future of ACHD

See the agenda.
Registration is $25 for all attendees. Register by Aug. 20 at noon. A link to join the live virtual conference will be emailed to registrants the week of Aug. 17. Contact CME Coordinator, Sara Olsen or CNE Coordinator, Rebecca Jenkins with questions.

Sports Medicine Symposium
Registration is open for the annual Sports Medicine Symposium, scheduled for Saturday, Nov. 14. The symposium will be held online from 7:45 a.m. to 12:30 p.m. The target audience is athletic trainers, nurses, physician assistants, nurse practitioners and physicians. 4.0 CME, CNE & EBP CEUs pending. See the flier.

Topics include:

  • Orthopedic X-ray Techniques and Procedures
  • Knee OCD Diagnosis, Treatment and Recovery
  • Shoulder Injury Rehabilitation
  • Cardiac Prescreening and Prevention of Sudden Cardiac Death

Registration fee: $25 for all attendees. For more information contact:  Patti Carstens, Sara Olsen or cme@childrensomaha.org

To register for any of these events, go to ChildrensOmaha.org/ContinuingEd Select either Nurses or Providers Continuing Education. Then select Children’s Employees & External Audiences. Scroll to event and click register. For registration questions, please contact CNE@childrensomaha.org or CME@childrensomaha.org

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