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6.3.2020 at 5:17 am: Monitoring Visitor Restrictions
With the state of North Carolina in Phase 2 of lifting restrictions in place to slow the spread of infection, Duke Health is evaluating our policies on visitor restrictions. While we review possible changes, our top priority is the health and safety of our patients, visitors and team members. At this time, current visitor restrictions remain in place. You can view all of our current visitor restrictions here. Yesterday, we shared this update with all managers and physicians to outline the considerations we’re making while reviewing possible revisions.
6.3.2020 at 5:10 am: Team Member Universal Masking Updates
As more of our team members return to our clinical environments, we want to share an updated handout and FAQs to outline our current policy in effect regarding masking. These resources now reflect the importance to continue wearing a face covering while you are walking to and from your car, waiting for the bus or riding on the bus.
6.1.2020 at 5:19 am: Monitoring Visitor Restrictions
We have received feedback from our patients and team members about the importance of reviewing the restrictions currently in place. Our team is considering revising this policy as we work to enhance patient access to care. While we review possible changes, our top priority is the health and safety of our patients, visitors and team members. Our current restrictions align with visitor policies at all Triangle-area health systems, and we are working with them while considering how to safely revise our policies.
6.1.2020 at 5:15 am: Re-introduction of Nursing & Allied Health Learners
Our pre-licensure and graduate students from selected programs/schools will be re-entering the clinical environment today, June 1. We are intentionally taking a slow approach in order for our patients, staff and learners to remain safe. Here are some FAQs to provide more information as they reenter our environment.
6.1.2020 at 5:11 am: COVID-19 Testing Refusal – Position Statement and Patient Letter
For the safety of our patients, visitors and team members, Duke Health providers will not schedule, or will cancel, elective procedures for patients who refuse pre-procedural COVID-19 testing. This is a position statement and patient letter for any Duke Health provider faced with this scenario.
6.1.2020 at 5:09 am: Communications Cadence Update
To better streamline our communication, we will modify our regular task force email updates to Mondays and Wednesdays. We will continue to hold bi-weekly virtual town halls, update the COVID-19 website, share stories from across the health system in the "Inside Duke Health" newsletter, answer your questions through email to firstname.lastname@example.org and provide critical updates as needed.
6.1.2020 at 5:05 am: Updated Guidance on Working From Home
Earlier this month, we communicated that our administrative and non-clinical team members who are able to work from home effectively should continue to do so, with the approval of their supervisor.
Readiness to return will vary by teams and areas, as every offsite location has a different set of circumstances. Therefore, decisions about returning to work will be made at the local level. However, we do not anticipate a general return before August 1, as physical distancing remains a critical part of keeping our team members and the broader community safe. In addition, supply chain constraints for items such as hand sanitizer, soap and sanitizing wipes mean we must prioritize the distribution of these items for our patient care areas.
Team members whose primary or redeployment assignment requires them to be onsite to support operations will still need to report for those roles as directed. Leaders and teams are encouraged to review resources on best practices for working remotely and contact their local HR leader with any questions.
5.29.2020 at 5:18 am: Maestro Care Update: Exposure to COVID-19 Status
Beginning Thursday May 28, a new infection status, “Exposure to COVID-19” will be visible within Maestro Care for patients who have a known exposure to a person infected with COVID-19. See this document for further information. Please contact your facility's Infection Preventionist with questions.
5.29.2020 at 5:03 am: Infection Prevention Highlights to Protect Team Members
This document highlights many of the measures we have implemented at Duke Health to keep our team members safe while continuing to provide high-quality care to our patients. This is intended to provide to team members with a key overview of many of the changes made to protect our patients, visitors and each other.
5.27.2020 at 5:17 am: Place N95 Masks in Reprocessing Bins
All healthcare workers who wear an N95 mask must place their used mask in the appropriate bin for reprocessing. Please do not keep or take home N95 masks at the end of your shift.
5.27.2020 at 5:11 am: Appropriate Use of Anticoagulation as DVT Prophylaxis During COVID-19 Hospitalization
COVID-19 has been associated with an increased risk of venous thrombosis and pulmonary embolism. A clinical guidance document has been created by the Division of Hematology in consultation with other clinical leaders that provides recommendations for the appropriate use of anticoagulation as DVT prophylaxis during a COVID-19 hospitalization.
- Guidelines for Antithrombotic Therapy in Hospitalized Patients with COVID-19
- COVID-19 Inpatient Anticoagulation Protocol – for ICU and non-ICU patients
5.27.2020 at 5:03 am: Antibody Testing Patient FAQs
This document provides answers to frequently asked questions about antibody testing. This is a good resource to educate patients about antibody testing and what these test results could mean.
5.22.2020 at 5:20 am: Reminder: Wear Your Mask While Entering and Leaving Facilities
As part of our mandatory universal masking policy, all team members should wear their Duke-issued mask while entering and exiting facilities. When you leave your shift for the day, wear your mask while you are walking to your car, waiting for the bus and/or riding on the bus. Review this handout with more information about how to appropriately wear and store your mask.
5.22.2020 at 5:09 am: Standard Pay Practices Resume June 1
Effective June 1, we will restore our usual management practice of applying PTO and vacation time in instances where work is not being performed. Our availability for work policy will also apply. Those instructed by EOHW to stay home due to personal COVID-19 exposure or illness and are unable to work will continue to be paid their base rate of pay without using PTO.
5.22.2020 at 5:05 am: Tracheostomy Protocol During COVID-19
This document provides multidisciplinary guidance for safely performing tracheostomies and for post-tracheostomy care in patients who were diagnosed with COVID-19. Please note, there is a new recommendation to place previously COVID-infected, post-tracheostomy patients on special droplet and contact isolation during their incident hospital stay when they were treated for COVID. If they are readmitted less than 28 days after their initial test, the usual standard and transmission-based precautions apply.
5.20.2020 at 5:21 am: Additional Updates on Learners in our Environment
The anticipated return of students to the clinical training environment will include SubIs (MS4s) on May 18, PA students on May 26, NP students on June 1 and MS 2 MD students on June 15.
- Students may participate in the care of any patient, except those with COVID-19 or any other patient whose care requires use of N95 masks.
- Students may participate in the care of patients in contact isolation.
- Students may contribute to care in the operating rooms.
- Students will utilize the existing health system practices for screening of symptoms and use of face masks.
- Duke Health (SOM, DUHS and PDC) has jointly approved student participation (NP, PA, MD) in telehealth as long as students are acting in the same roles as prior to telehealth (i.e., the student may gather history, assist with the patient encounter and document the encounter as long as there is appropriate supervision). Appropriate supervision includes verification of any history obtained prior to the encounter, appropriate review of and use of appropriate attestations for documentation by preceptors. Here are tips for student participation in telehealth and secure chat.
5.20.2020 at 5:16 am: Clinical Trials Update
Duke University Health System is participating in a national study investigating the use of the antiviral drug Remdesivir to treat COVID-19. The FDA recently allowed Remdesivir to be used under an Emergency Use Authorization (EUA). The Duke Remdesivir allocation plan aligns with federal and state guidelines, making a small supply of the drug available for all three system hospitals. Prescribers and pharmacists should expect to receive more detailed information about this update soon.
5.20.2020 at 5:09 am: DUH Campus Parking Update
In April, temporary adjustments were made to parking access for some staff to park in alternative locations on the Duke University Hospital campus. Starting next week, these team members will be notified that they are to return to their assigned parking location.
5.20.2020 at 5:05 am: Disinfection Guidance for Inpatient Tablet & Accessories (New)
This document provides disinfection guidance for electronic equipment used across Duke Health for patients on isolation. The equipment includes tablets mounted on an IV pole, Bluetooth speakers, charging cords, etc.
5.20.2020 at 5:03 am: Guidance for Appropriate Repeat COVID-19 Testing (New)
This document provides guidance for appropriate repeat testing. Please note that all test orders available have gone through a rigorous validation process and that all results may be used as part of these repeat testing strategies.
5.18.2020 at 5:10 pm: Update on Learners at Duke Health
We are committed to safely bringing back our learners, and we’ve started a slow reintroduction of some learners in our environment. Fourth-year medical students are phasing into clinical rotations this week as a part of their next scheduled rotation. Physician leaders should coordinate with teams regarding the positive transition of bringing these learners back into our care teams. All learners are trained in new processes and protocols to support our COVID-19 response and following safe treatment practices.
Graduating PA students will restart on May 25 in order to finish on time, and second-year medical students who were removed from clinics in March will be returning on June 15, 2020, to complete their required clerkships.
5.18.2020 at 5:19 am: Wear Your Mask While Entering and Leaving Facilities
As a part of our mandatory universal masking policy, all team members should wear their Duke-issued mask while entering and exiting facilities. Please wear your mask while you are walking to your car, waiting for the bus and/or riding on the bus. Safely store your mask, and keep your mask with you to wear it again until you can return to screening and receive a new mask for the day.
5.18.2020 at 5:07 am: Vital Talk Communication Training Opportunity
Cambia Palliative Care Center of Excellence and the Institute for Human Caring are offering healthcare professionals free virtual training sessions for COVID-19 communication. These sessions will focus on four content areas (outpatient, ED, acute care and ICU) and will integrate a communication framework with concrete skills to navigate advance care planning and goals of care conversations in the COVID-19 era. Information on registration can be found on this document or you may register directly through the Institute for Human Caring website.
5.15.2020 at 5:11 am: Continue Practicing Physical Distancing
Duke Health would like all team members to maintain an awareness of proper physical distance and to continue using virtual means of connecting with others when possible. We still need to limit large gatherings and maintain distance, even while wearing masks. Please also continue to be mindful when in shared spaces like workrooms, breakrooms and other common spaces to practice physical distancing, frequently clean high-touch surfaces and be mindful when sharing food, as not taking proper precautions can lead an increased risk of exposure.
5.13.2020 at 5:06 am: Updated Isolation Signs Overview (new)
Isolation signs have been updated for special droplet precautions and special droplet and contact precautions. Please see the documents linked below for more information about these each of updated signs.
• Special Droplet Precautions
• Special Droplet and Contact Precautions
5.13.2020 at 5:03 am: Place N95 Masks in Reprocessing Bins
All healthcare workers who wear an N95 mask must place their used mask in the appropriate bin for reprocessing. Please refer to the instructions for extended use and reuse for more detailed instruction.
5.13.2020 at 5:16 am: PPE FAQs
Please read this document for answers to some common questions regarding PPE – including the rationale for why certain decisions have been made. Thank you to all of our team members for staying up to date on the latest recommendations.
5.13.2020 at 5:06 am: Infection Prevention 101
This document outlines the basic principles behind standard and transmission-based precautions and explains the “why” behind PPE recommendations for caring for COVID-suspected or confirmed patients.
5.13.2020 at 5:03 am: Criteria for Discontinuation of Special Airborne Contact Isolation
This updated document includes steps to follow when discontinuing Special Airborne Contact isolation in the inpatient setting and re-isolation of patients who return to the ED or inpatient care after a prior diagnosis of COVID-19.
5.13.2020 at 5:01 am: Sharing Your Experience with the Hero Registry
The Duke Clinical Research Institute (DCRI) is enrolling healthcare workers in the Healthcare Worker Exposure Response and Outcomes (HERO) Registry, and they need your help. The HERO Registry is asking anyone who works in a setting where people receive healthcare to participate. There is no cost to join. Participants will receive surveys, opportunities to participate in future studies and learnings from the research community. The registry will follow a protocol developed by the DCRI and data guidelines to keep healthcare worker information secure. To sign up for the HERO Registry, visit their website.
5.11.2020 at 5:24 am: Recommended PPE for Outpatient Management of Asymptomatic Patients (New)
This document provides recommendations for the required PPE for a variety of visits in outpatient settings with differential risk. Providers should follow Standard and Transmission-Based Precautions in addition to the precautions recommended in the Ambulatory Infection Prevention Policy.
5.11.2020 at 5:23 am: Management of Patients with Suspected or Confirmed COVID-19 in the Outpatient Setting (New)
This document provides recommendations for outpatient management of patients with suspected or confirmed after receiving a COVID-19 diagnosis.
5.11.2020 at 5:18 am: Position Statement and FAQs for Antibody Testing for COVID-19 (New)
This document provides guidance to physicians to facilitate conversations with patients regarding requests for antibody testing for COVID-19 (SARS-2-CoV).
5.11.2020 at 5:09 am: Clinical Location Screening Update – Temperature Screenings
Beginning May 11, Duke Health will enhance screenings at all clinical locations for patients, visitors and team members to include temperature checks with touchless infrared thermometers. As always, if a team member screens positive, he or she will be directed to call the Duke COVID-19 hotline at 919-385-0429 for next steps. Team members must have their Duke ID badge with them in order to enter the facility and begin their shift.
5.11.2020 at 5:03 am: Updated Telehealth Resources Available
The documents below provide guidance and tips for using telehealth during the COVID-19 pandemic.
- Smart List for Adding Consent Attestation for Video Visits During COVID-19 Pandemic (.TELEVIDEOVISITCONSENTPRIVACYIDTIMECODING)
- Guidance for Providing Telehealth Services During the COVID-19 Pandemic
- Duke Primary Care Quick Reference Guide for Scheduled, Chargeable Telephone Visits
5.8.2020 at 5:39 am: EOHW Health Profile Error Message
Employees may have received a request from Employee Occupational Health & Wellness (EOHW) to complete a health profile this week. The email to these employees was a technical issue and a follow-up clarification email has been provided to every employee who was affected. If you have any questions about this, please call the COVID Hotline 919-385-0429 option 1 which is open 8 a.m. to 8 p.m., seven days a week.
5.8.2020 at 5:37 am: Phase 1 of North Carolina’s Reopen Plan Starts Today
The first phase of the three-phase plan to reopen North Carolina goes into effect today at 5 p.m. Non-essential businesses such as salons and gyms will remain closed, and the stay-at-home order will remain in effect yet modified for necessary tasks. Durham County requires people who leave their home to wear masks and we encourage our team members to be leaders in this area.
5.8.2020 at 5:34 am: Clinical Trials Update
Duke University Hospital participated in a national study investigating the use of the antiviral drug Remdesivir to treat COVID-19. Positive results from this study show the drug could shorten the recovery time of more than 1,000 hospitalized patients from 15 days to 11 days. To learn more about this trial, check out the recording of our last Duke Health town hall from our infectious disease team.
5.8.2020 at 5:23 am: Supply Chain Update
Recently, we received a large shipment of more than 2 million shoe covers, and we expect 75,000 more reusable isolation gowns delivered by the end of the month. Large orders with 3M for N95s are still in place, and it is critical that all of our areas, including ambulatory, continue to use our safe process for decontaminating masks for reuse.
5.8.2020 at 5:18 am: Human Resources on Returning to the Workplace
As North Carolina enters Phase I of lifting shelter-in-place orders today, those team members who can continue to effectively perform their work from home should continue to do so with the agreement from their supervisor. We do not anticipate any changes to current work arrangements before June 1. The safety and well-being of our team members are our top priority, and we commit to communicating what to expect throughout this important process.
5.8.2020 at 5:09 am: Appropriate PPE During COVID-19 Response (Update)
See this updated infographic for concise and simplified recommendations for what PPE healthcare workers should wear during the COVID-19 response.
5.8.2020 at 5:04 am: Respiratory Therapy Practices During the COVID-19 Pandemic (New)
View this document as a guide for the safe delivery of respiratory therapeutics during the COVID-19 pandemic.
5.6.2020 at 5:14 am: Life Support FAQs
Based on recommendations from American Heart Association, Duke Health has extended the expiration of life support certification. Team members have at least until the end of the calendar year to recertify. The health system life support team will be publishing a plan within the next few weeks to allow people who have expired certifications or whose certifications will expire through December 2020 to catch up. You can view an FAQ about this process here.
5.6.2020 at 5:07 am: Social Media Posts
Each staff member has the responsibility to protect patient privacy. This is a reminder that discussing Protected Health Information on social media or posting photos of a patient or a patient’s body part, wound, etc. to any non-Duke site, including your personal social media site, is prohibited. You may not do so even when the patient agrees or even when the patient cannot be identified.
5.4.2020 at 5:32 am: Redefining Our “Normal” Video
As we plan for what’s next, we’re grateful for your commitment to caring for our patients, their loved ones and each other. We’re all adjusting to a lot of new and redefining our “normal.” Check out this video to learn more about how our team is prioritizing keeping our patients and team members safe as we enhance access to care.
5.4.2020 at 5:13 am: Updated CDC Guidance on Discontinuing Isolation
CDC guidance for discontinuing transmission-based precautions for patients with COVID-19 infection has been updated to extend the duration of isolation from seven days to 10 days since symptoms first appeared. This update was made based on evidence that suggests a longer duration of viral shedding and captures a greater proportion of contagious patients.
The following documents have been updated on the COVID-19 site to reflect this change in CDC guidance. After-visit summary (AVS) updates will be revised in Epic as soon as possible:
• AVS for known COVID-19 inpatients being discharged from hospital: .COVIDAVSDISCHARGEINSTRUCTIONS and .COVIDAVSDISCHARGEINSTRUCTIONSSPANISH.
• AVS for patients with no symptoms or mild symptoms who do not need hospital treatment: .COVIDAVSINSTRUCTIONS and .COVIDAVSINSTRUCTIONSSPANISH.
• Ability to Work/Return to Work for Healthcare Providers
• CDC Guidance: Employee Risk Assessment for COVID-19 Exposure
• Criteria for Discontinuation of Special Airborne Contact Isolation
5.4.2020 at 5:09 am: COVID-19 Room Entry Logs No Longer Required
In coordination with changes in reporting requirements from the CDC and the North Carolina Department of Health and Human Services, DUHS is no longer requiring room entry logs to be completed for staff or visitors entering the rooms of patients with suspected or confirmed COVID-19 infection. Any breaches in PPE or suspected exposure within these rooms should be reported through the Employee Health Blood and Body Fluid Hotline at 919-684-8115. Please ensure that existing room entry logs for healthcare personnel and visitor monitoring are disposed of securely (i.e., in the shred bin).
5.1.2020 at 5:18 am: Communication Cadence Update
To better streamline our communication, we will modify our regular task force email updates to Mondays, Wednesdays and Fridays. We will continue to hold weekly virtual town halls, update the COVID-19 website, share stories from across the health system in our newsletter "Inside COVID-19," answer your questions through email to email@example.com and provide any critical updates through email as needed.
5.1.2020 at 5:09 am: Supply Chain Update
Right now, we are confident in the supplies we have available to continue providing exceptional care for our patients. We now expect another 2 million earloop masks to be delivered in multiple shipments by the end of the month, 14,000 isolation gowns are expected this week, and another 50,000 will be delivered this month. Lastly, we expect 2 million more shoe covers to arrive next week.
4.30.2020 at 5:04 am: Enhancing Access to Patient Care – Key Messages
Here are approved key messages to share with our patients about how our team is committed to safety while we prepare for this next phase of our response.
4.29.2020 at 5:06 am: Preparing Our Environment
While we work to prepare our facilities to re-engage our patients, below are just a few of the changes being made at some locations to reduce the spread of infection.
- Increased use of telehealth to connect with our patients, including phone and video visits
- Encouraging physical distancing and allowing extra time between appointments
- Enhanced visitor restrictions to limit the number of people in our facilities
- Expanded hours and appointments available on the weekend when appropriate
- Patient, visitor and staff screening for symptoms prior to entering our facilities
- Increased signage at all clinics to encourage physical distancing and hand hygiene
- Mandatory masking and hand hygiene for all patients, visitors and team members
- Installing additional hand sanitizing stations at our facilities
4.28.2020 at 5:08 am: Ambulatory Surgery Update
On May 4, we plan to start opening more outpatient environments for ambulatory surgeries. We are making numerous changes to expand upon our existing safety procedures for team members and patients to keep them safe and protect them from possible exposure to COVID-19. More information about this gradual process to reschedule surgeries will be provided in the coming days and weeks.
4.27.2020 at 5:16 am: Financial Aid for Dependent Care
Applications are now being accepted for the Duke Health COVID-19 Dependent Care Financial Assistance Fund, established to offset the costs of dependent care during our COVID-19 response efforts. All Duke Health employees in good standing are eligible to apply, and applications are being accepted through May 29. Team members can learn more and access the application here.
4.27.2020 at 5:13 am: Meal and Medicine Resources for Patients in Home Isolation
This document is designed for patients who must stay home in isolation due to suspected or confirmed COVID-19 infection. It provides basic food safety tips for handling, cooking and storing food as well as resources for food and medication delivery services.
4.27.2020 at 5:04 am: Tips for Safely Transitioning Between Work and Home
This resource provides more specific infection prevention best practices, including what to do with your work clothing and work shoes and how best to clean and disinfect your home. It is designed to help healthcare workers returning home from work keep themselves and their loved ones safe from potential COVID-19 exposure. (This document replaces the former “Guidelines for Healthcare Workers upon Returning Home from Work.”)
4.24.2020 at 5:23 am: PPE Product Substitutions
Supplies, including PPE, may look different and come from different manufacturers but are just as safe and reliable as the items regularly stocked. The substituted products have gone through a rigorous testing and approval process by our infection prevention and occupational and environmental safety office.
4.24.2020 at 5:22 am: Contact/Reference List for COVID-19 Topics
Please view this one-pager for contact information and document references regarding common questions related to COVID-19, including testing, PPE, interpreter services and employee health.
4.23.2020 at 5:28 am: Face Shield Tip Sheet
This resource can be used to help healthcare workers determine the best process for reuse and extended use of their face shield. Specifics about the disposable face shields as compared to the extended use face shields are included in this resource.
4.23.2020 at 5:13 am: Head Covering PPE Recommendations
Head coverings, including bouffant caps, headbands with buttons and surgical caps, are not CDC recommended or required PPE for the care of suspected or confirmed COVID-19 patients (outside of performing sterile procedures). This document provides more information about Duke Health recommendations on head coverings for our team members.
4.23.2020 at 5:07 am: Interim Recommendations for Care of Inpatients from Congregate Living Facilities
We continue to see COVID-19 outbreaks in our community from skilled nursing facilities and prisons. This document provides additional clarification for the management of inpatients being admitted to the hospital from congregate living settings.
4.22.2020 at 5:19 am: FAQs for Decontaminating N95 Respirators
Duke Health is using a safe, proven process to decontaminate used N95 respirators using vaporized hydrogen peroxide. This decontamination technology and method has been used for years, and several leading health systems across the nation are now using it to reuse N95 respirators. Read these frequently asked questions about how this process kills germs, including viruses, while maintaining the integrity of the fit and seal without degrading the material.
4.22.2020 at 5:03 am: PPE Documents Guide
To help team members navigate the PPE-related resources in the COVID-19 document library, this PPE documents guide has been created to show the information in helpful categories, with dates to indicate when it was created or last updated.
4.21.2020 at 5:08 am: Updated Instructions for Extended Use and Reuse
This document provides clarification on the re-use and extended use of face masks (including surgical masks, tie masks and earloop/procedural masks) and face shields. It specifically addresses situations in which patients are on transmission-based precautions (i.e., droplet, contact and/or contact special enteric).
4.20.2020 at 5:15 am: PPE Reminder – No Head Coverings on Shoes
This document provides clarification on the re-use and extended use of face masks (including surgical masks, tie masks and earloop/procedural masks) and face shields. It specifically addresses situations in which patients are on transmission-based precautions (i.e., droplet, contact and/or contact special enteric).
4.20.2020 at 5:02 am: Masking Flyers – In Every Space, Cover Your Face
The flyers below can be printed out and displayed in staff common areas around hospitals and clinics to help Duke Health team members remember to wear their Duke-issued face masks throughout the day.
4.20.2020 at 5:01 am: Pediatric After-Visit Summary Now Includes Tip Sheets
The after-visit summary for children up to age 18 will now automatically include the language preference-appropriate tip sheets that illustrate best practices to prevent the spread of COVID-19. For those providing care to pediatric patients, this change will save the step of manually adding this information to patient instructions. As a reminder, the tip sheets are also available as system-level dot phrases in English, Spanish and Arabic as: .COVIDEASYTIPSPEDS, .COVIDEASYTIPSPEDSSPANISH and .COVIDEASYTIPSPEDSARABIC.
4.17.2020 at 5:09 am: Clarification for Donning and Doffing PAPRs
- All PAPRs are to be donned prior to donning the isolation gown so that the PAPR belt is underneath the gown while the PAPR pack motor is exposed on the back and has adequate circulation and ventilation.
- If your PAPR hood has a shroud; the shroud should be worn outside of the gown.
- If there is a double shroud, the inner layer will be on the inside of your gown with the outer layer on the outside.
- Initial disinfection of the PAPR hood is done prior to doffing isolation gown. Then, follow established step-by-step doffing procedures and instructions for extended use, reuse and disinfection.
4.17.2020 at 5:06 am: Masking Reminders
As an important reminder for the safety of all Duke Health team members, all staff members are required to wear face masks in common areas at all times. It is especially important to limit the number of unmasked individuals who are in close proximity with one another while eating and drinking in breakrooms, workrooms, workstations, the cafeteria, courtyards or any other settings where people can gather.
4.16.2020 at 5:26 am: Guidance for De-escalating Isolation After a Negative Test for COVID-19
See below for a summary of the available discharge instructions/after-visit summaries (AVS) for patients with known or suspected COVID-19:
- AVS for known COVID-19 inpatients being discharged from hospital (new). This document was created for patients with known COVID-19 infection who are being discharged from the hospital. It is available in English and Spanish, with the following Epic dot phrases: .COVIDAVSDISCHARGEINSTRUCTIONS and .COVIDAVSDISCHARGEINSTRUCTIONSSPANISH (coming soon in Epic).
- AVS for patients with no symptoms or mild symptoms who do not need hospital treatment (update). This document has been updated to include instructions for asymptomatic patients. It is available in English and Spanish, with the following Epic dot phrases: .COVIDAVSINSTRUCTIONS and .COVIDAVSINSTRUCTIONSSPANISH (coming soon in Epic).
- AVS for pediatric patients (no change). This two-page document illustrates best practices for preventing the spread of COVID-19. It is available in English, Spanish and Arabic, with the following Epic dot phrases: .COVIDEASYTIPSPEDS, .COVIDEASYTIPSPEDSSPANISH and .COVIDEASYTIPSPEDSARABIC.
- AVS for low health literacy patients (no change). This two-page document illustrates in icons best practices for preventing the spread of COVID-19. This document is the same as the AVS for pediatric patients, with the following Epic dot phrases: .COVIDLOWLITERACY, .COVIDLOWLITERACYSPANISH and .COVIDLOWLITERACYARABIC.
- AVS addendum for additional instructions (new). This Word document can be edited by staff working to discharge patients. It was created in response to the request to provide written instructions to patients in addition to the AVS instructions available in PDF format.
4.16.2020 at 5:14 am: Guidance for De-escalating Isolation After a Negative Test for COVID-19
This flow diagram has been updated to reflect changes in local epidemiology with regard to newly identified outbreaks of COVID-19 in congregate living facilities.
4.16.2020 at 5:07 am: Tip Sheet on PPE Extended Use and Reuse
This tip sheet aims to help healthcare workers better understand protocols for the reuse and extended use of face masks, face shields, N95 respirators and PAPR hoods.
4.16.2020 at 5:01 am: PAPR Hood Donning, Doffing and Disinfection Instructions
The following documents are intended to educate team members on the proper donning, doffing and disinfection procedures for powered air-purifying respirators (PAPRs).
- This step-by-step guide provides instructions for using the 3M Versaflo PAPR.
- These PAPR hood instructions explain the differences in donning the short headcover, hood with single shroud and hood with double shroud.
- This one-pager illustrates the proper PAPR disinfection process for special airborne/contact isolation, regardless of which type of PAPR hood is used.
- This document on PAPR hood reuse, extended use and disinfection has been updated to reflect this information.
4.15.2020 at 5:11 am: What to do with N95 Masks after Certain Procedures
This table describes what healthcare workers should do with their N95 masks following procedures and patient care. This document is a supplement to the document titled "N95 Respirators and Face Shields: Instructions for Extended Use and Reuse."
4.15.2020 at 5:04 am: Homemade Masks Allowed for Patients and Visitors
Patients, visitors and caregivers who choose to wear personal homemade masks are permitted to wear them in Duke hospitals and clinics. This document illustrates the masking protocol for patients, visitors and caregivers and can be displayed in common spaces. As a reminder, Duke Health team members are not permitted to wear personal homemade masks while at work.
4.14.20: Video about Duke Health Surge Planning
For months, Duke Health has been preparing for a rise of COVID-19 patients in our area. We have developed comprehensive plans to respond to the evolving needs of our community. As the surge projections continue to adjust, we feel we are well prepared no matter what need may arise. This short, animated video explains more about surge planning and how we're prepared to test, triage and care for patients with COVID-19 over the coming weeks.
4.14.2020 at 5:19 am: COVID-19 Patient Caregiver Accommodations
To support our team, Duke Health will offer hotel accommodations for direct caregivers of patients with COVID-19 in hospitals. Deeply discounted rates will also be available to all Duke Health team members. Each hospital will provide more specific information soon regarding the availability of this temporary housing and how to apply.
4.14.2020 at 5:04 am: Tips for Wearing your Mask
We understand that wearing a mask may present some challenges, and we want to provide some helpful guidance for properly removing and storing your mask while eating, drinking and going to the restroom. Please view this handout with more tips for getting through the day with your mask.
4.13.2020 at 5:33 am: Place Used N95 Masks in Reprocessing Bins
All healthcare workers who wear an N95 mask must place their used mask in the appropriate bin for reprocessing at the following times: end of shift, after performing an aerosol-generating procedure and if contamination occurs during patient care. Please do not keep or take home N95 masks at the end of your shift, as your mask could be contaminated, and that puts you and others at risk for potential COVID-19 infection. Please refer to the instructions for extended use and reuse for more detailed instruction.
4.13.2020 at 5:17 am: Sample Collection Updates
NP swab collection and transport instructions include important updates. Samples that will be sent through the pneumatic tube system within hospitals should be double-bagged before tube transport. Kits will now contain a second bag to facilitate this change in practice. NP swabs should be inserted and rotated for five seconds rather than 15 seconds.
4.13.2020 at 5:09 am: Guidance for Healthcare Worker PPE During COVID-19 Response
This document outlines recommended PPE for healthcare workers to wear during the COVID-19 response. Specific clinical guidance is provided for inpatient, ED, procedural areas, outpatient clinics and outpatient/inpatient radiology departments. This infographic provides concise and simplified recommendations for what PPE healthcare workers should wear during the COVID-19 response. The infographic is meant to supplement but not replace the “Guidance for Healthcare Worker PPE During COVID-19 Response” document.
4.13.2020 at 5:06 am: Recommendations for Negative Room Pressure and/or HEPA Filtration
This one-pager highlights the importance of wearing appropriate PPE during aerosol-generating procedures. It also explains the role of negative room pressurization or HEPA filtration and provides recommendations for what to do if a HEPA filter is not available.
4.13.2020 at 5:02 am: Criteria for Discontinuation of Special Airborne/Contact Isolation
This document provides updated guidance to healthcare workers on when to discontinue special airborne contact isolation for (1) lab-confirmed COVID-19 patients and (2) when COVID-19 diagnosis is presumed based on clinical presentation but COVID-19 PCR testing is negative.
4.10.2020 at 5:28 am: Guidance for De-escalating Isolation After a Negative COVID-19 Test
This flow diagram outlines a recommended decision algorithm for symptomatic patients with a negative COVID-19 nasopharyngeal swab whose clinical presentation remains highly suspicious for active COVID-19 infection. We ask that you review this carefully and use it in your clinical decision-making.
4.10.2020 at 5:19 am: Guidance for Procedural Areas Caring for Suspected or Confirmed COVID-19 Patients
This guidance is for healthcare workers in procedural areas and explains best practices, including when to use HEPA filters in procedural rooms for patients with suspected or confirmed COVID-19 infection.
4.10.2020 at 5:14 am: Isolation Procedures and COVID-19 Testing for Asymptomatic Immunocompromised Patients in the Inpatient Setting
This document provides guidance on testing and isolation procedures for the hematopoietic stem cell transplants (HSCT), solid organ transplants (SOT) and acute leukemic patients who are admitted to the hospital.
4.10.2020 at 5:12 am: Universal Masking Update
Until further notice, all visitors will wear masks in addition to our team members and patients. All patients will wear masks in common spaces, such as waiting rooms, cafeterias and hallways. Hospitalized patients do not need to wear masks in their rooms.
4.9.2020 at 5:23 am: Reminder: No Makeup while Wearing N95s and PAPR hoods
We have started collecting N95 respirators and PAPR hoods for reuse, and it is important to understand how wearing any makeup – including any facial oils, moisturizers, shaving balm, aftershave, beard oil, lipstick, foundation/concealer and blush – can make the masks appear soiled, even after the decontamination process. For this reason, we ask that healthcare workers who will wear N95s and PAPR hoods during their shift refrain from wearing makeup.
4.9.2020 at 5:18 am: Tips for Healthcare Workers Returning Home from Work
If you are a healthcare worker caring for patients with suspected or known COVID-19, follow the guidelines outlined in this document to protect your family upon returning from work.
4.9.2020 at 5:06 am: Priority Testing for Special Populations
We request that clinicians with clinical use cases that require a COVID-19 test result in less than 24 hours complete this short survey to allow aggregation of the requests and optimize the use of our internal testing capabilities. The survey will close at 5 p.m. on Sunday, April 12, and representatives from infection prevention, laboratory medicine, and the Chief Medical Officers will review and prioritize the requests.
4.8.2020 at 5:32 am: Returning N95 Masks
After wearing your N95 mask, you must return it to the appropriate bin unless it is visibly soiled so it can be processed for reuse. Our chosen method for decontaminating and reusing N95 masks is proven and safe. You’re welcome to view this video for more information about how the decontamination process works.
4.7.2020 at 5:06 am: Documentation and Coding
As a reminder for providers, please continue to accurately capture the conditions of our patients as it affects public health reporting, resource allocation and quality of care. For helpful tips, reference this document.
4.7.2020 at 5:00 am: Dashboard
If you would like to stay informed about the current status of testing and COVID-19 cases at Duke, view the dashboard developed by Performance Services. To access it, you must be on the Duke Health network or connected to the VPN.
4.6.2020: Video about the decontamination process for N95 masks
4.6.2020 at 5:32 am: Conclusion of Flu Season
In light of the current COVID-19 pandemic, the mitigation strategies implemented and after consultation with the Duke Program for Infection Prevention, we are defining Monday, April 6 as the official end of the flu season. For the purposes of the Duke Health HCW Flu Vaccination Policy, new hires/providers/volunteers who are joining Duke Health on or after Monday, April 6 will not be required to be vaccinated against the flu or have an approved exemption, however they will be required to comply with the policy during the Fall 2020 flu vaccination period.
4.6.2020 at 5:18 am: Recommendations for Safely Discharging a COVID-19 Positive Inpatient who Continues to Require Isolation Precautions
This document provides guidance to staff on minimizing the possibility of exposure during COVID-19 positive inpatient discharge while navigating out of the building.
4.6.2020 at 5:02 am: Pre-procedural Guidelines for COVID-19 Testing and PPE Use
This document outlines the Duke Health recommendations for the use of testing and related PPE for procedures performed in the non-operating room environment.
4.3.2020 at 5:44 am: Tips to Prevent the Spread of COVID-19: Pediatrics After-Visit Summary
This document is for patients with low health literacy skills, including children, and illustrates several tips for preventing the spread of COVID-19. Versions in English and Spanish are available.
4.3.2020 at 5:19 am: Pre-operative and Pre-procedural Screening Test for Asymptomatic Patients
A pre-operative inpatient and outpatient COVID-19 screening test for asymptomatic surgery patients is now available. Please refer to the testing guidelines and the Maestro Care tips sheet before placing the order.
4.3.2020 at 5:04 am: Staffing Hub
We are preparing for additional staffing needs in critical areas, both clinical and non-clinical. To support these efforts, we have created the Duke Health Staffing Hub.
4.2.2020 at 6:07 am: COVID-19 Testing Decision Trees
The COVID-19 testing decision trees have been updated and simplified for the following settings: adult ambulatory, pediatric ambulatory, ED/inpatient hospital day less than or equal to 3, and inpatient hospital day greater than 3.
4.2.2020 at 5:33 am: Inpatient & Outpatient Donning and Doffing Procedures
These step-by-step donning and doffing procedures for inpatient and outpatient settings have been updated in an effort to safely conserve PPE for staff.
4.2.2020 at 5:05 am: Face Mask and Face Shield: Extended Use and Reuse
This document has been updated to reflect the new universal masking protocols and to address droplet precautions for patient care interactions.
4.1.2020 at 6:17 am: Masking Protocols and Frequently Asked Questions
To help you answer questions from colleagues and patients, we developed this one-sheet with instructions and frequently asked questions.
3.31.2020 at 4:00 pm:
Starting today, all team members will be required to wear a face mask while working at one of our clinical sites.
Watch the video for an overview of the new process, including how to wear and care for your mask.
3.26.2020 at 6:00 am: Employee Screenings
Starting today, we are implementing team member COVID-19 screenings. If a team member screens positive, he or she will be directed to call the Duke COVID-19 hotline at 919-385-0429 for next steps. Look for communication from your local entity regarding specifics for your work area.
3.25.2020: Personal Protective Equipment Leadership Update
We want to make sure you feel confident in our approach and secure in your protective equipment. Check out this video from our COVID-19 task force leadership for answers to your questions regarding our current and potential policies for using PPE.
3.25.2020 at 6:43 am: Indications and Procedures to Re-use Surgical and Earloop Masks
Please review this document which outlines instructions for re-using surgical and earloop masks for many healthcare worker groups.
3.25.2020 at 6:43 am: Childcare Coverage
If you have childcare needs, please fill out this survey by Monday, March 30 so that we can understand the likely use of these services. Someone from our team will be in direct contact about potential options. This is a new work stream, so although there are limited spots available right now, we expect more to come online soon.
3.25.2020 at 6:14 am: Novel Decontamination of Masks
In an effort to conserve our N95 face masks to reduce infection, our research and clinical teams have confirmed a way to use existing vaporized hydrogen peroxide methods to decontaminate the masks so they can be reused. We've been using this proven technology and decontamination method for years in our bio containment laboratory, and we will transition to using it as a method for cleaning masks for reuse at all three of our hospitals. Our infection prevention team will lead coordination of this effort.
3.24.2020 at 8:00 am: Health Care Worker Ability to Work Management Plan
This new resource from EOHW provides new protocols, testing guidelines and returning to work criteria for all Duke Health team members.
If you are feeling ill or have a question, please call the Duke COVID-19 Hotline at 919-385-0429, option 1, from 8 a.m. to 5 p.m. Beginning March 25, hours will be expanded to 8 a.m. to 8 p.m.