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Ambulatory Resource Page 10.21.20

COVID-19 Ambulatory Resource Page

Page last updated 10/21/2020 at 11:54 AM

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Guiding Principles

The information on this page is general guidance and may be operationalized differently to fit the needs of each ambulatory service and facility. Guiding principles that should be followed in the ambulatory setting:

  • Universal Masking of patients, visitors, and associates is required
  • Physical distancing in all clinic/waiting areas (in addition to masking) must be prioritized
  • Hand hygiene and cleaning/disinfection procedures must be followed
  • Symptom screening of patients, visitors, and associates should occur upon arrival and prior to scheduled visits
  • Appropriate personal protective equipment (PPE) is expected to be worn

Before a Patient Visit

During scheduling, patients will be asked about a recent diagnosis of COVID-19 for themselves or household contacts and about COVID-19 symptoms. All resources related to scheduling and patients visits can be found on StarPort.

Testing

Visit the Pre-Operative Testing Page for all information and resources related to pre-op testing.

Onsite Clinic Operating Principles

Physical Distancing

Each facility should arrange waiting areas and clinic spaces to accommodate physical distancing. Please note that strategies to achieve physical distancing may vary between clinics and facilities.

Some examples to consider include: decreasing the number of waiting room chairs, adding floor tape boundaries, or having patients wait outside or in their cars once they have completed the check-in process to be notified when they are ready to be seen. 

Signage should be placed to remind patients/visitors of physical distancing requirements. MedStar Health Marketing has developed extensive signage, decals, and floor graphics to support physical distancing. Please contact Marketing for order forms and information.

Universal Masking

All staff are to wear a surgical or procedural masks at all times. Masking and physical distancing are additive.

All patients and visitors are required to wear a mask which should be brought from home. Clinic staff should ensure that this step is done prior to registration and before the patient moves within the clinic space.

If a patient does not have a mask from home, provide them with a mask from the MedStar supply. Additional information and resources can be found on StarPort.

For more information on the masking and visitor policy, see the Temporary Patient Visitor Restrictions During COVID-19.

Room Closure Guidance

To ensure the safety of subsequent patients by allowing airborne particles to clear the environment, extended room closure is required after AGPs are performed on COVID+ patients and PUIs. This principle is applicable to all settings including the operating room, inpatient rooms, and ambulatory exam/procedure rooms. For full protocol information, please reference StarPort.

Cleaning and Disinfection

Surfaces should be frequently cleaned/disinfected, in both the clinical and waiting/check-in areas. Staff should follow standard disinfection protocol and use EPA approved disinfectants for COVID-19.

  • Non-porous, high-touch areas, and horizontal surfaces in common spaces (e.g. waiting areas) should be cleaned/disinfected on a frequent and consistent basis (at least twice per day).
  • Clinical areas and equipment should be cleaned/disinfected after each patient encounter or use.
  • For room disinfection (including in-room equipment):
    • After use by a known COVID+ patient in the first 10 days after diagnosis:
      • If patient’s mask was removed during the visit: wear gown, gloves, surgical/procedural mask, and eye protection.
      • If patient’s mask was NOT removed during visit: wear surgical/procedural mask and gloves.
    • After use by all other patients: wear surgical/procedural mask and gloves.
  • Hand sanitizer should be made available to patients and associates throughout the clinic.
    • Associates should perform hand hygiene before and after each patient encounter, after removing PPE, before and after eating, after handling specimens, and after using the bathroom.
    • Patients should be reminded to perform frequent hand hygiene.

PPE

All information and guidance regarding appropriate PPE can be found on the PPE essentials page.

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Surgical Resource Page-10.21.20

COVID-19 Surgical Resource Page

Page last updated 10/21/2020 at 10:56 AM

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Per updated CDC guidance on July 22, 2020, repeat testing within 90 days of a positive COVID-19 test is not recommended.

Critical Safety and Infection Prevention Principles

  1. Standards are different for elective surgeries and urgent/emergent surgeries and procedures. Thoughtful classification of the procedure is important.
    • Pre-operative/pre-procedural testing is expected for elective cases to allow proper risk stratification (all operative cases and procedures involving an aerosol generating procedure or moderate sedation), and cases should generally be cancelled if testing is not complete. COVID positive patients will be
      rescheduled beyond 30 days.
    • Elective surgeries and procedures must be delayed if a patient is COVID positive or has symptoms suspicious for COVID19.
  2. MedStar Health system standards for PPE use should be followed at all times, to ensure safety to associates and patients and to conserve nationally constrained PPE items where possible. Guidance on proper PPE use is located on the PPE Essentials Page and StarPort.
  3. Surgical cases on PUI or COVID+ patients should be performed in negative pressure ORs whenever available, and system standards for room cleaning and disinfection should be followed.
  4. Further supporting resources are available on StarPort.

Elective and Non-Urgent Surgery

Criteria include, but are not limited to:

  • Screening patients: Entities should symptom screen patients 24 hours prior to surgery, working with local departments and physician offices.
  • Screening associates and physicians: Each entity should implement a screening solution for associates and providers, which may include screening at entrances, leveraging screening technology (currently being piloted at select hospitals), screening at the departmental level at the start of each shift, or integrating an “attestation” question in the time-clock system, requiring hourly and exempt associates to attest they are symptom-free upon arrival for shifts.
  • Physical distancing in waiting areas: Physical distancing must be strictly maintained in all settings where patients wait, to minimize direct contact between individuals. Ensure proper staff education, signage, etc., are in place. As practical, entities should implement non-traditional methods (e.g., call-ahead registration, waiting in car until called, etc.) For surgical waiting areas that cannot accommodate physical distancing requirements, consider modifications to MedStar Visitor Policy to allow patient drop off/pick-up or other alternatives. Entities should not begin elective procedures until a solution is implemented.
  • Maintaining supplies: All entities must ensure ample supplies, including PPE (one week’s supply), blood, equipment, medication, and COVID-19 testing equipment and reagents. Each entity is encouraged to designate a Supply Chain representative as an active member of local perioperative teams. All entities must maintain sufficient capacity and supplies to care for COVID-19 patients. 

Approach for Prioritization of Cases

Each entity president will appoint a perioperative leadership team, consisting of a surgeon, nurse and anesthesiologist. Reporting directly to the entity president, the team will have full authority for implementing the case prioritization protocol and determining the appropriate daily Operating Room volume. The team will collaborate with internal stakeholders (e.g., supplies, PPE, staff, bed availability, etc.). The methodology for the prioritization of cases includes acuity/urgency, service line priority, COVID-19 laboratory testing availability as per system prioritization (if constrained), and daily coordination with the MTO.

  • Emergent and urgent surgeries: procedures deemed time sensitive; delaying the surgery could negatively impact the health of the patient. 
  • Elective and non-urgent surgeries: procedures that can be rescheduled due to the nature of the procedure; delaying the surgery is unlikely to negatively impact the health of the patient. 

Surgical Planning Guidelines

Elective surgeries that can be delayed for 30 days:

  • Postpone surgery 30 days from onset of symptoms or positive COVID test.
  • After 30 days, continue with surgery without COVID isolation precautions.
  • Do not retest patients within 90 days of initial positive COVID test.

Urgent surgeries that cannot be delayed 30 days:

  • If surgery must be performed less than 20 days after initial COVID positive test or onset of symptoms, use COVID isolation precautions.
  • If surgery is performed greater than 20 days after initial COVID positive test or onset of symptoms, proceed without COIVD isolation precautions.
  • Do not retest patients within 90 days of initial positive COVID test.

COVID positive patients’ procedures should be postponed a minimum of 30 days whenever possible.

Pre-Operative Testing and Preparation

Visit the Pre-Operative Testing Page or StarPort for all information and resources related to pre-op testing.

Pre-Operative Patient Arrival

Inpatient

  • All consents and pre-procedure paperwork/ lab work should be completed prior to patient’s departure from inpatient unit.
  • Patients should be transported directly to the OR from their inpatient room following standard precautions.

Outpatient

Patient Arrival:

  • Ensure current visitor policies are being followed.
  • Screen all patients and visitors for COVID symptoms at entrance
  • Ensure all visitors and patients are wearing the appropriate mask.

Physical Distancing:

  • Asymptomatic, recovered COVID positive patients:
    • Consider dedicated waiting room area for COVID positive patients.
    • Maintain 6 feet of spacing between patients in waiting, pre-operative, and recovery settings. Physical barriers (such as curtains) should be used when available.
  • Symptomatic COVID positive/PUI patients:
    • Patients should bypass registration and be brought straight to an isolated area for processing.

Preparation for Surgery

  • Place COVID-19/ PUI sign on all exterior entrances to OR.
  • While setting up the room, room staff will wear surgical mask, and shoe covers. Remove unnecessary equipment from the OR.
  • Anesthesia
    • Confirm the presence of a CMAC/Glidescope
    • New HEPA filters on anesthesia circuit should be placed distal to the EtCO2 connector and on the expiratory limb of the circuit. (EtCO2 connector should be placed between the HEPA filter and circuit).
    • Pyxis machines stay in the ORs and ideally should be 6 feet away from the head of the bed during intubation. If the Pyxis machine cannot be moved (against wall or other restriction,) the bed may be moved away from the Pyxis prior to intubation and then returned.
    • If for any reason drawers of a Pyxis machine needs to be accessed, immediate hand hygiene must occur immediately before and after drawer access.
    • Prepare medications needed for induction in standard fashion. Acquire all anticipated narcotics from Pyxis machine prior to patient entering room.
  • Nursing (RN and Tech)
    • Standard OR preparation.
    • Have only necessary supplies and PPE in the room to avoid waste.
    • Repeated exit and entry into the room during the case to retrieve supplies should be avoided.
    • A runner will be assigned to obtain necessary supplies to minimize door openings. The OR door should only be opened to exchange supplies.
  • After patient is transferred to OR table, follow the same steps to clean the bed as for patients under Contact Precautions.

Physical Distancing Guidelines

Prior to Patient Arrival: Consider options for pre-registration and/or touch free registration options to limit contact with admitting personnel on day of surgery.

Patient Arrival

  • Consideration of any person accompanying patient must be made in accordance with the current visitor policy at the care location.
  • Screen all patients and visitors for COVID symptoms.
  • Ensure all associates, visitors and patients are wearing the appropriate mask.

Registration

  • Install proper indicators on floor in waiting areas (6 feet apart) to prohibit congregating or violating physical distancing requirements.
  • Explore possibilities to achieve contactless registration.

Surgical/Procedural Waiting Area

  • Ensure proper physical distancing. Install proper indicators on floor (6 feet apart) to prohibit congregating or violating physical distancing requirements.
  • If waiting room exceeds limits of physical distancing, consider leveraging technology (phone/text/app) to notify visitor of patient’s status so that they may wait in a more open area (e.g. wait in car, outside etc.).

Preoperative/ Preprocedural Holding Area

  • For preoperative/procedural areas without solid walls between patients, ensure physical barrier (such as curtain) is drawn.
  • Install proper indicators on floor to prohibit congregating or violating physical distancing requirements.
  • Follow entity visitor policy.

Recovery Area

  • Ensure physical distancing requirements can be maintained between patients (6 feet apart or separated with a physical barrier).
  • No visitors allowed unless patient has a specific need (e.g. Disability).

Discharge: Recommend alternate solutions to discharge process to achieve physical distancing requirements and limiting contact.

Intraoperative Procedures

One negative pressure room, if available, will be dedicated to COVID and PUI patients.  All efforts, whenever possible, should be made to utilize the dedicated negative pressure OR for COVID patients if available. Efforts should be made with environmental safety and facilities to develop alterations to additional rooms whenever possible. Staff transitions and handoffs should be minimized. Minimum staff to conduct the procedure should be utilized.

Follow standard MedStar Health guidelines for use of PPE, donning, doffing, and disinfection of PPE.

Airway Management for Induction (Intubation)

  • Minimize/avoid positive pressure masking.  Ensure deep paralysis prior to intubation.
  • Video laryngoscope recommended for all intubations to position provider farther away from airway and to maximize 1st attempt success.  Intubation should be performed by the most experienced member of the anesthesia team assigned to case.
  • ETT cuff should be inflated immediately after intubation. 
  • Supraglottic Airway Device is the preferred method of rescue ventilation. 
  • Use inline suction systems if suctioning is necessary. 
  • Surgical team will be using N95 respirators and may remain in the room during intubation, minimizing door openings.  Follow CDC guidelines for donning/doffing PPE when exiting/entering room.

Specimen/ Trash Handling

  • Positive COVID status should be indicated on the pathology form.
  • Send specimen direct to pathology in cooler or Oxford Box.  If no box is available, specimen may be placed in a biohazard bag.
  • Trash and waste will be collected in standard trash bags for disposal.
  • All exposed/unused supplies will be discarded.
  • Medications that are removed from the PUI/COVID room Pyxis should be discarded if unused and should not be placed in the return bins. 

SPD/ Case Carts

Airway Management for Emergence (Extubation)

  • Consider strategies to minimize coughing on emergence. 
  • Use of a towel or plastic sheet placed over the airway during extubation (to minimize aerosolized secretions during cough) is encouraged.  Place well-sealed face mask as soon as possible. 

Recovery

  • ICU patients will return to ICU.  For patients remaining intubated, the HEPA filter from the anesthesia circuit will be applied to the bag/mask ventilator for transport. 
  • Non-ICU patients will be recovered in the operating room initially by anesthesia provider and PACU nurse.  Surgical team member will provide handoff report to PACU nurse. 
    • Once patient is stable, an additional PACU nurse is immediately available, and the primary PACU nurse is comfortable with handoff, the anesthesia provider may depart. 
    • Once PACU criteria are met, patient may be transported to the floor wearing a procedural mask.
    • Persons performing transport will wear a surgical or procedural mask.

Room Disinfection

EVS or any personnel disinfecting rooms should refrain from entering the vacated room until sufficient time has elapsed for enough air changes to remove potentially infectious particles. After this time has elapsed, EVS personnel may enter the room and should wear a gown and gloves,
face mask and eye protection when performing terminal cleaning. Please refer to the table below for room closure and turnover times.

Where to Stand During Intubation and Extubation Table

PPE and Disinfection for Surgical Procedures

For comprehensive PPE guidelines, visit the PPE Essentials Page.

Disinfection Guidelines

Use approved disinfecting products. For updated list of approved disinfecting products for various applications and environments, please reference the EPA Approved Disinfectants List.

  • Registration: After each patient, wipe all non-porous surfaces (including table tops, chairs, pens, clipboards, pin pads, etc.) with an approved disinfectant effective against COVID-19. Follow manufacturer’s instructions for contact time.
    • Alternatively, supplies such as pens and clipboards should be sequestered after use by a patient and periodically disinfected in bulk.
  • Waiting Area: Frequently (including at start and end of day shift), wipe non-porous horizontal and high touch surfaces with an approved disinfectant effective against COVID-19 (at least twice per day).
  • Preoperative and preprocedural areas/PACU: After each patient, wipe all non-porous surfaces (including table tops, chairs, pens, clipboards, pin pads, etc.).
    • Alternatively, supplies such as pens and clipboards can be sequestered after use by a patient and periodically disinfected in bulk.
  • Operating Room: Clean OR utilizing standard OR turnover protocols for non-PUI, non-COVID-19 patients.
    • For asymptomatic, COVID negative patients undergoing an aerosol-generating operative procedure, standard OR procedures should be followed.

Plasma Study

We are seeking plasma donors who tested positive for COVID-19 and are now fully recovered. Patient flyers are provided in English and Spanish.

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Ambulatory Resource Page

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PPE Essentials Page 10.19.20

PPE Essentials

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Page last updated 10/20/20 at 11:19 AM

PPE Guidance Grids

PPE for Ambulatory Locations
N-95 COVID-19 Negative and Non-PUI
PPE for Inpatient Locations

For videos on general principles, conservation and reuse, and donning and doffing, visit the PPE Instructional Videos page.

N95 Respirator Guidance

Specific guidelines and additional resources can be found on Starport.

N95 respirators should be used in the following scenarios:  

  • Providing care within the patient’s room to a hospitalized PUI or COVID-19 patient, such as those in the inpatient, observation, Emergency Department, and Labor and Delivery settings.  
  • Performing a category 1 or category 2 procedure (AGP or high risk procedure with cough induction with unmasked patient or prolonged close contact with unmasked patient) on any patient, including endoscopy, transesophageal echocardiograms, flexible laryngoscopy, and bronchoscopy.

Safe Extended Use, Reuse, and Decontamination of N95 Respirators and Eye Protection

Specific guidelines and additional resources can be found on Starport.

MedStar Health continues to review and assess Personal Protective Equipment (PPE) conservation practices, which include safe PPE extended use, reuse and decontamination strategies endorsed by national experts. 

In accordance with the Centers for Disease Control and Prevention (CDC), our PPE conservation strategy includes extended use of N95 respirators and eye protection.

Associates and physicians caring for PUIs or COVID-19 positive patients will receive one N95 respirator at the start of each shift. If it becomes visibly soiled or no longer keeps a strong seal, another N95 respirator will be issued.

Eye Protection Flier. Click to view.
PPE Extended Use Job Aids
PPE Extended Reuse Job Aid
PPE Extended Use, Reuse, Cleaning & Storage

Universal Face Mask Guidance

Specific guidance and resources for associates, patients, and visitors related to masking can be found on Starport.

Associates are required to wear procedural face masks in all clinical facilities, including administrative offices in hospitals or ambulatory locations. Cloth masks can only be used by associates working in non-clinical facilities such as White Oak or the MedStar Health Corporate Office.

Face masks are also required in all non clinical areas (offices, lobbies, cafeterias, hallways, restrooms etc.).

Patients are expected to wear face masks, when clinically feasible and appropriate, throughout the duration of their ambulatory or ED visit, and throughout hospitalization while outside of patient rooms.

All approved visitors are expected to bring their own face mask. If they do not have one, a blue cloth face mask developed by Under Armour will be provided. Visitors who wear masks with valves must have them replaced.

Universal Masking in Healthcare Facilities Job Aid

Isolation Gown and Personal Scrub Guidance  

Isolation gowns available in all MedStar Health entities have been reviewed and are appropriate for isolation precautions during the care of COVID-19 patients. Proper use of PPE and Universal Precautions will protect your clothing from contamination, therefore, it is safe to wear your personal scrubs when properly wearing recommended PPE.  

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Pre-Operative Testing

Pre-Operative Testing

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Page last updated 8/24/2020 at 12:30 PM

General Information

MedStar Health established a new Pre-operative COVID-19 Testing Call Center to serve as the single point of contact for scheduling and fielding general questions related to pre-procedural testing. The call center helps patients, providers and providers’ offices navigate the complex landscape of pre-operative COVID-19 testing—directing patients to the appropriate location based on their date of surgery, and ensuring that testing is completed in the appropriate timeframe. When referring a patient for testing, providers should continue to enter a referral order in MedConnect. The list of testing locations will now include instructions to contact the call center for scheduling. The MedConnect referral workflow can be found here; testing locations can be found here.

Pre-Operative COVID-19 Testing Call Center

Pre-Operative COVID Testing FAQ

Pre-procedural testing should be completed 72 – 96 hours prior to the procedure. Calculate 72 – 96 hours from the time of the courier pickup to the surgery time. When counting days, count Day 1 as the day of the test, and Day 5 as the day of the surgical procedure.

Refer to the MMG Labcorp COVID Testing Algorithm for detailed guidance on when and where to order pre-procedural testing.

For urgent testing, calculate 48 – 72 hours from the time of the courier pickup to the surgery time. Refer to the MMG Point of Care COVID Testing Algorithm for guidance on when and where to order rapid point of care (POC) testing.

Pre-operative testing timeline

Refer to the Pre-Operative Testing Timeline or click the image below for full details on when to order testing depending on the day of surgery:

Pre-Operative Testing Timeline. Click the image for more information.
Pre operative testing resources

Common Pre-Op Testing Questions

How close to surgery must patients get tested?

  • Testing should be completed >72 hours and <5 days before surgery. Count 72 hours starting from the hour the testing sample is collected. When counting days, count Day 1 as the day of the test, and Day 5 as the day of the surgical procedure. This adherence to protocol is necessary to protect our associates and to conserve PPE.  The only exception to this requirement is a life-threatening emergency procedure.

What if a patient refuses testing?

  • Patients who refuse testing will have their procedure cancelled and will be counselled on the importance of testing for both them and their provider.
  • This patient testing requirement cannot be overridden by the patient’s physician.

What if there are exceptional circumstances for my patient that do not fit the pre-op testing protocol ?

  • Complex patient circumstances that do not fit the standardized protocol will be discussed by the patient’s surgeon and anesthesiologist to determine the optimal testing protocol given the patient’s circumstances.
  • Only the VPMA of the entity can approve proceeding with an urgent/emergent or scheduled case without testing.  Each VPMA will provide a report to us at the end of each week listing the number of testing exceptions and the rationale.

Do patients need to be retested between same day procedures? 

  • No, patients with repetitive procedures in the hospital also do not need to be retested, if they have a negative test within 5 days.

When should I order a rapid test pre-op?

  • Emergency cases do not require testing prior to surgery. Patient care in emergent situations should not be delayed due to testing. Please see the “What PPE should I wear to surgery” section for guidance on appropriate PPE during these cases.
  • All patients are educated about self-quarantining at the time of testing (see Pre-Operative Testing and Self Quarantine Instructions). Patients are responsible for self-quarantining between the time of the test and when they arrive for surgery. However, findings indicate that MedStar Health has had no conversions to COVID-19 positive status for patients who could not or did not quarantine. Therefore, effective July 10, 2020 the updated pre-operative COVID-19 testing protocol no longer includes the second test requirement or the need to cancel elective surgeries for patients who could not or did not quarantine. Reference this Updated! Pre-Operative COVID-19 Testing Protocol memo for more information.

What if rapid turnaround testing with LabCorp is not available?

  • While the standard protocol is to use LabCorp for pre-operative testing, each entity may prioritize some rapid turnaround testing capacity for pre-operative testing, recognizing the inherent trade-offs for patient flow if this strategy is chosen.

When should I retest a COVID positive patient?

  • Patients should not be retested within 90 days of a COVID positive test. Patients can be retested after the 90 day window has passed.

Nasal Swab Collection and Competency

MMG and Urgent Care: Nasal Self Swab Specimen Guidance

Nasal Swab Competency Quiz

Nasal Swab Competency Signoff

Antibody testing

Antibody tests should not influence clinical management of patients (e.g.: antibody test results should not be incorporated into decision making for surgical planning, testing, PPE use, etc.). Currently, the main benefits of antibody testing are epidemiological. This may change over time as we learn more about prevalence of the disease and the best way of interpreting test results. For more information, refer to the Antibody Testing Provider Guide and the Antibody Testing FAQ page.

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Sports Medicine Policies and Resources

Sports Medicine Policies and Resources

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COVID-19 has created an unprecedented effect in the lives of all youth athletes in Maryland, Washington DC, and Virginia. The following resources have been assembled as a clearinghouse for health professionals, coaches, parents, players, and administrators to aid in return to safe sport play and decrease the likelihood of COVID-19 transmission in youth sporting events. Included in these resources are sport-specific recommendations from national youth sports organizations as well as links to return to play directives from federal, state, and local governments. County webpages have been included, showing future reopenings and closures of local parks & sports facilities. Included in these resources are recommendations for safe living practices, emergency action planning directives, as well as recommendations for sport-specific practices that support social distancing and potentially mitigate chances of COVID-19 transmission. We offer these resources as a supplement to the direction of local health officials and community leaders.

Please call with any inquires to 1-888-44-SPORT

MedStar Health

Federal Guidance

State Guidance

Recommendations for Sport Play

Resources for Medical Professionals

American Academy of Pediatrics
American Psychological Association

Risk Resources

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Updated Temporary Patient Visitor Restrictions During COVID-19 (v2)

Updated! Temporary Patient Visitor Restrictions During COVID-19

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PPE Essentials Page

May 28, 2020

To protect the safety of our patients and associates, the following guidelines are now part of our MedStar Health temporary patient visitor restrictions for hospital (inpatient) locations.

Updated! Hospital (Inpatient) Locations

  • No visitors are permitted at any hospital location. Exceptions to these restrictions may be approved by hospital Vice President of Medical Affairs (VPMA) and/or Chief Nursing Officer (CNO) in specific circumstances, including two visitors per patient at end-of-life; two parents/caregivers of pediatric patients; one personal visitor or one professional support person in Labor & Delivery (a professional support person is allowed in post-partum units); one visitor per patient undergoing urgent/emergency surgery; one visitor to accompany patient for hospital discharge; one visitor if indicated by patient’s provider to support patient rehabilitation needs.
    • Any visitor who lives in the same household as a COVID-19 positive person is not permitted. Approved visitors will be asked whether they live in the same household as a COVID-19 positive person.
    • Patients with disabilities may designate one support person to accompany, visit and stay with them in the hospital. A support person is defined as someone who is legally authorized to make decisions for the individual with disabilities, a family member, a personal care assistant, or a disability service provider. In this situation, the support person will be permitted to visit even in the instance that the support person is a household contact of the patient. Other reasonable accommodations for individuals with disabilities may be approved by the VPMA and/or CNO, provided the accommodations comply with all infection prevention policies.
  • No visitors under the age of 18 are permitted, unless they are parents of pediatric patients.

As a reminder, all visitors are required to bring and wear their own face mask for the duration of their visit at any/all clinical care locations. If they do not have one, a blue cloth face mask developed by Under Armour will be provided.

Visit the Temporary Restrictions during COVID-19 page for MedStar’s complete updated visitor policies.

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N95 Decontamination Process Video

N95 Decontamination Process Video

N95 Decontamination Process

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PPE Essentials Page

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Instructions for Adding MSH Covid Screening Tool as a Link to your Smart Phone Home Screen

Instructions for Adding MSH Covid Screening Tool as a Link to your Smart Phone Home Screen

This associate screening tool is currently being piloted at specific MedStar locations, and has not yet been rolled out system-wide. These instructions will show you how to add the link as an icon on your smart phone home screen for easy access.

Click to navigate to:

For iPhone

1. Open the Safari browser on your iPhone. (Chrome will NOT work for iPhone).

2. Enter the associate screening URL address: mi2apps.medstar.net/covidrtw/

3. Select the share icon at the bottom of the screen.

4. Select “Add to Home Screen”

5. Type the desired name for the link that will appear as an icon on your home screen. Select “Add.”

6. The link will appear as an icon on your home screen.


This associate screening link is currently being piloted at specific MedStar locations, and has not yet been rolled out system-wide. These instructions will show you how to add the link as an icon on your smart phone home screen for easy access.

For Android

1. Open the Chrome browser on your Android device (Works for Android NOT iPhone).

2. Enter the associate screening tool URL address: mi2apps.medstar.net/covidrtw/

3. Select the menu icon at the top right of the screen.

4. Select “Add to Home Screen.”

5. Type the desired name for the link that will appear as an icon on your home screen. Select “Add.”

6. The link will appear as an icon on your home screen.

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PPE Instructional Videos

PPE Instructional Videos

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Page last updated 6/11/2020 at 1:48 PM

Visitor Mask Assembly

Under Armour Visitor Mask Assembly Video

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Azithromycin Discharge

Azithromycin Discharge/ Outpatient Prescriptions and Update for Hydroxychloroquine Prescriptions

April 19, 2020

Azithromycin

Washington, D.C., regulations now limit azithromycin prescriptions for ONLY approved ICD-10 diagnoses, including documented COVID-19 positive results, based on the D.C. Health Department letter here.

Place diagnosis in ‘special instructions’ box in MedConnect, as shown. Duration cannot exceed 10 days, and refills are prohibited.

Hydroxychloroquine and Chloroquine

MedStar continues to discourage outpatient use for COVID-19 related treatment or prophylaxis; our outpatient pharmacies will fill prescriptions ONLY for chronic rheumatologic conditions, see reference here.