Combating COVID-19: Best Practices That Clinicians Need to Know
As the number of global cases of coronavirus disease 2019 (COVID-19) rises, it is imperative that health care providers stay abreast and prepared with the best clinical practices to combat the SARS-CoV-2 virus. Following appropriate guidelines, and practicing proper technique will benefit some patients and clinicians and better prevent the further spread of the virus.
It has been established that the virus mostly spreads from person to person via close contact or metabolism drops. The Centers for Disease Control and Prevention (CDC) defines close contact with a patient with COVID-19 as being inside 6 feet for an extended period of time or having direct contact with the patient’s bodily fluids (ie, phlegm, blood, metabolism drops). When treating patients in so much close proximity, it is especially important to use personal protective equipment (PPE), which can help to reduce the risk of getting the virus.
PPE and Isolation Precautions
In a podcast interview, Betsey Todd, MPH, RN, a nurse medical scientist and clinical editor of the American Journal of Nursing, noted the importance of proper PPE and how it varies depending on the 4 categories of isolation precautions: standard, contact, drop, and mobile precautions.
Unlike standard precautions, contact, drop, and mobile precautions are all types of transmission precautions that Ms. Todd notes may be used in combination. piece contact precautions include the use of gloves and gowns to treat conditions so much as methicillin-resistant staphylococci aureus, other conditions so much as flu infections or TB may require more PPE, so much as a face mask or shield (drop precautions) or an N95 respirator and negative pressure suite (mobile precautions), respectively.
When discussing the treatment of patients with unsuspected or confirmed COVID-19, Ms. Todd noted that there is relative certainty that the virus spreads by drops, which mightiness suggest the need for a mask and face cover. nevertheless, she notes that because the virus is still so new, “the CDC recommends for patients that are unsuspected of having or have confirmed COVID-19, that [health care providers] go ahead and use, not drop, but mobile precautions, and place the patient in a negative pressure room if available.”
Ms. Todd went on to note that “regular surgical-type masks are made for containing drops from [a clinician’s] own mouth…whereas N95 respirators or other kinds of particulate respirators are made to protect what [clinicians are] breathing in.” Therefore, she suggests the use of a mobile precaution technique.
Proper PPE would not be as effective if not worn right. When wearing a mask, make sure to fit-test by taking a moment to make sure that the mask fits suitably. Take a few deep breaths to ensure there is no leakage around or near the mask.
When asked who should be wearing the N95 masks, Ms. Todd replied, “the CDC and World Health Organization are really trying to strongly push back against the idea that everybody should go around wearing any kind of mask…. People think that it will protect them out in public, but the fact is that N95s are not appropriate for wearing long periods of time.”
The World Health Organization noted earlier this month in a news release that the “shortages [in PPE] are departure doctors, nurses, and other frontline workers perilously unequipped to care for COVID-19 patients, due to limited access to supplies so much as gloves, medical masks, respirators, spectacles, face shields, gowns, and aprons.”
Practices for health care providers and Patients
Amy Fuller, DNP, director of the Master’s Nurse Program at Endecott College in Beverly, Massachusetts, delineated steps nurse practitioners (NPs) and doctor assistants (PAs) can take to ensure the best bar and treatment techniques.
Because the 2019 coronavirus eruption has overlapped with the current flu season, Dr. Fuller noted that “it’s hard to differentiate because they some have the same kind of symptoms. But the incidence and prevalence for the flu are so much lesser than for the coronavirus.” For nurses, NPs, and PAs, she noted that it should be “common sense” that if a patient is “coughing or sneeze, put a mask on.”
She continuing by noting that some health care providers and patients should be “realistic” and that the SARS-CoV-2 virus will “be here with more of a presence than it is currently.” health care providers should inform their patients to “avoid huddled places” and “avoid close contact with people who are sick,” in addition to avoiding cruise travel and nonessential air travel and staying at home as much as possible to further reduce the risk of exposure.
Another recommendation was for health care providers to be aware of the patients who present to their practices and make sure to sort them instantly. It is important to be aware of their symptomology, their contact with others, and their travel history.
Both clinicians and patients should avoid touching their face, nose, and eyes; be sure to wash their hands often with soap and water (for at least 20 seconds) or with at least 60% alcohol-containing hand sanitizer if soap and water are not available, and to clean and clean common surface areas in the home.
When asked whether a patient should be self-quarantined or seen in medical practice, DrFuller noted that it depends on the case. “I would surely recommend self-quarantine if they have the risk factors…if [patient] symptoms are mild, and most cases are mild, [the patients] don’t require any kind of hospitalization.”
If a patient presents with symptoms, “the caveat could be that the nurse, NP, or PA can check on the patient in 12 hours and see how they are doing or instruct them to call back if their symptoms get worse. But if they just have cold-like symptoms with no fever, I’m not entirely invested within causing them to the hospital.”
There is currently no vaccinum or antiviral to treat this infection. Current treatments may include fever-reducing medications but “the last thing we want to do is have a big rush of people to the hospital who only have mild, cold-like symptoms.”
Risks and Symptoms to Look Out For
According to the CDC, it is important for health care providers to pay attention to symptoms so much as fever, cough, and shortness of breath. Novel human coronaviruses can cause unwellness similar to a common cold, more severe cases can cause respiratory disease, severe acute metabolism syndrome, and even death. Individuals with a higher risk for COVID-19 include older adults and those with degenerative medical conditions so much as heart unwellness, polygenic disorder, and respiratory organ unwellness. Emergency warning signs that require immediate medical attention include difficulty breathing or shortness of breath, persistent pain or pressure in the chest, new confusion or inability to arouse, and/or blue lips or face. Although these are not all comprehensive, the CDC urges adults with these symptoms to contact their medical providers.
health care providers are at the forefront, caring for infected patients, and increasing their own risk of exposure to the virus. The information encompassing COVID-19 is perpetually being updated as we learn more about the virus, the unwellness it causes, and who is at risk.
It is imperative that clinicians continue to read new information and stay updated, practice suggested hygiene, wear the appropriate PPE and make sure that their patients are educated. Following the appropriate steps will help to reduce the spread of the virus and hopelessly prevent further exposure in clean individuals.