COVID-19 Document Library

This flowchart applies to DUH and shows the procedure for supporting family presence and participation/visitation during end-of-life of patients with suspected or confirmed COVID-19 infection. Uploaded 04.08.20

Southern Regional AHEC, Durham County Public Health, Alliance Health, and Duke AHEC are partnering to offer a livestream Opioid Use Training Disorder Training series for MDs, LCSWs, RNs, CMs, Pharmacists and APPs.

This patient email was sent on the week of 3.8.21 and explains current vaccination eligibility information . Uploaded 03.12.21

These 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. Uploaded 04.29.20

The following scripts and talking points are designed to assist DUHS staff in communicating our visitation and reopening guidelines as we transition from Tier 3 (Restricted Access) to Tier 2 (Limited Access). We appreciate the support of all team members in our efforts to keep our campuses safe as we continue to navigate our COVID-19 response. (12.3.21)

In this document, we answered some common questions from team members – including the rationale for why certain decisions have been made. Where possible, we also included a link to the most current document that explains the specific recommendations and guidance. Updated 05.13.20

Duke Primary and Urgent Care employees can use this algorithm in coordination with their manager to determine whether they meet the criteria for practice-based point-of-care COVID-19 testing. UPLOADED 1-14-22

This document illustrates seal check instructions for the Halyard N95 respirator. While this guide was made for the Halyard brand of N95 respirators, the same principles of fit testing apply to other types of respirators. Uploaded 05.26.21.

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. Updated 05.26.20

This document answers frequently asked questions about how and when to clean Zebra/Cisco phones. It also includes best practices for infection prevention for when the phone rings while you are in an isolation room. Uploaded 02.03.22

This document contains FAQs that address the Revised COVID-19 Vaccination Requirements for Duke Health Health Care Workers. Uploaded 7.23.21

This document can be accessed through the Secure Policy Center. This document outlines care policies and FAQs for the care of forensic patients from Butner Federal Medical Complex (FMC). These policies address the care of an inmate patient who is under the legal custody of law enforcement or a correctional facility. Uploaded 06.05.20

This document is the standard work for converting existing office visits to telephone visits for non-COVID patients. Uploaded 03.23.20

This document is for call center staff to use when screening for COVID-19 symptoms and possible exposure. Uploaded 03.21.20

This document is titled "Inpatient Management of Multisystem Inflammatory Syndrome in Children (MIS-C)." This document provides early guidance to clinicians managing children with symptoms associated with the recently described Multisystem inflammatory syndrome in children (MIS-C) in the Inpatient setting. Uploaded 06.29.20

To reduce the confusion associated with caring for patients with suspected or confirmed communicable diseases, this document explains action steps for positive travel screenings and Maestro Care flags linked to COVID-19. Uploaded 03.30.20

This document (effective March 23, 2020) applies to all visitors to Duke Health facilities and outlines current visitor restrictions. Uploaded 03.23.20

This document includes guidelines for Duke Raleigh Hospital EVS team members on cleaning procedures for inpatient rooms during the COVID-19 response. Uploaded 7.22.20

This document contains the triage algorithm for determining medical necessity and urgency of Clinical Evoked Potential (EP, VEP, SEP, BAEP) studies on patients with a suspected or confirmed COVID-19 infection. Uploaded 04.01.20

This is a "Stop and Read Before Entering sign" for non-Duke Primary Care outpatient locations in Spanish. Uploaded 03.22.20

This sign informs patients and visitors that eating/drinking is prohibited in our waiting rooms. These should be displayed in waiting rooms. Uploaded 10.01.20

This document addresses perioperative management of patients who are KNOWN or SUSPECTED (i.e. rule-out) COVID-19 positive and need urgent surgery. Patients who do not fall into those categories will continue to be managed in the usual fashion. Uploaded 04.04.20

This email was sent to pediatric patients and their caregivers on 3.13.20 instructing them about what to know prior to coming to a Duke Hospital or Clinic during the COVID pandemic to help prevent the spread of infection. Uploaded 03.24.20

We understand that in past years, our colleagues and their families have enjoyed coming together to celebrate the holiday season. This year will feel different, but we want to prioritize the safety of our team members and their loved ones. Eating together is a high-risk activity, so this year we encourage you to consider virtual gatherings. This document includes some alternative ideas for your virtual holiday celebrations. These events everyone to relax and reconnect while celebrating safely. Uploaded 10.29.20

This document contains the admissions workflow for pediatric patients requiring COVID-19 testing. Uploaded 04.10.20

Printable resource to provide child care resources for essential employees during COVID. It is provided by the North Carolina Department of Health and Human Services and the North Carolina Department of Public Instruction. This is the English Version. Uploaded 03.26.20

This is a flyer for the Duke-NUS AMC Joint Webinar Series: Adaptation and Innovation Across the Pacific in Response to the COVID-19 Pandemic. Uploaded 12.11.20

This document includes standard work instructions for managing patients’ routine laboratory appointments at Duke Primary and Urgent Care clinics while minimizing potential exposure to COVID-19. Uploaded 04.14.20

This is the consent form necessary for minors receiving the Pfizer-BioNTech COVID-19 Vaccine.  Updated 08.25.2021

This document provides guidance for masking and addresses questions regarding double masking. Below is the content of the document. Uploaded: 1.29.21 

Renewed discussions regarding the potential benefit of double masking on source control and prevention of COVID-19 transmission have prompted many questions about whether changes will be made to the current DUHS masking policy.  Eleven months of experience has demonstrated that the healthcare setting is a well-controlled environment with robust infection prevention protocols in place that help limit the transmission of COVID-19. The healthcare setting is distinctly different than a community setting without these strict controls in place and much of our workforce is now vaccinated.  Furthermore, masks used in healthcare settings are also assessed for filtration efficacy and meet regulatory standards before distribution.  

Unfortunately, no well-designed studies have been conducted to scientifically answer the question “are two masks better at preventing COVID-transmission than one?” One study demonstrates the impact of wearing a well-fitting mask to improve source control and how wearing an overlying mask may improve overall mask fit.¹ Logically, having additional layers of barrier protection over the nose and mouth would reduce particle dispersion. 

With the now broadly circulating B1.1.7 (UK) variant and concern over the B1.351 (S. African) variant in the U.S., many are looking for ways to augment the infection prevention strategies in place – double masking is one such strategy. As we strive to continuously update our COVID-19 guidance to keep in step with the scientific community, we updated masking guidance language as follows. We will continue to closely monitor COVID-19 infections among team members and, should we see any concerning trends or signals, will reevaluate our recommendations below:

Double masking is optional for patients, visitors, and Duke team members at this time. However, we do encourage team members to make simple mask modifications to improve fit, and thereby improve source control. More tips to make your mask fit better are available on the Infection Prevention webpage.

• For patients and visitors: Patients and visitors will be offered a Duke-issued medical mask when entering the healthcare space. If the patient or visitor is wearing their own mask, they may place the Duke-issued mask over the top of their mask if they choose. Patients and visitors may wear their own masks as long as they adequately cover the mouth and nose and have ties or earloops. Patients and visitors may not wear neck gaiters or bandanas. Patients and visitors may not wear any mask with an exhalation valve. Simple mask modifications can be made to help improve fit, if needed. Review a full list of our patient and visitor masking guidelines.
• For Duke team members: Duke team members are still required to wear a Duke-issued medical mask in the healthcare setting. Should team members choose to wear a second mask, they may place a Duke-issued mask over the top of their own mask. Simple mask modifications can be made to help improve fit, if needed. Wearing the Duke-issued medical mask as the outer layer provides a fluid-resistant barrier. We continue to recommend eye protection during patient care activities. Review a full list of our team member masking guidelines.

Mask modifications:

There are many options to make your mask fit better if it is too loose.

• This video demonstrates one way to make your mask tighter.
• A second option is to simply twist the straps of your Duke-issued mask before you put it on so that the elastic is in a crisscross.
• Another option is to use a plastic clip to pull the straps tighter behind your head.

References:

Mueller et al. Matter 2020 Sep 2;3(3):950-962.

This document is titled "Emergency Department Evaluation for Suspected Multisystem Inflammatory Syndrome in Children (MIS-C)." This document provides early guidance to clinicians managing children with symptoms associated with the recently described Multisystem inflammatory syndrome in children (MIS-C) in the Emergency Department. Uploaded 06.29.20

Guidance for healthcare workers caring for COVID patients on how to protect themselves and their families from possible spread of infection when they return home from work. If you are symptomatic, register with the Employee Health Tracking System and arrange care. Updated 04.26.20

The call center algorithm provide guidelines for triage staff to collect and route necessary information from patients with suspected COVID-19 in the DUHS system. Uploaded 03.21.20

This document provides a checklist for Duke Raleigh Hospital EVS team members on the cleaning procedures for inpatient rooms during the COVID-19 response. Uploaded 7.22.20

This document contains the triage algorithm for determining medical necessity and urgency of Electroencephalogram (EEG, long term monitoring [LTM], epilepsy monitoring) studies on patients with a suspected or confirmed COVID-19 infection. Uploaded 04.01.20

An 11x17 poster limiting one visitor per patient in the outpatient setting. This poster is in English and should be posted on a clinic's exterior. Uploaded 03.22.20

This poster provides updated guidance to healthcare workers on when to discontinue special airborne contact (SAC) isolation for patients with COVID-19 (Discontinuing isolation). This guidance applies to all areas of Duke Health including adult and children’s inpatient, outpatient, surgical, procedural and other care areas. The 11”x17” poster includes the tables and flowchart to outline this criteria. Uploaded 12.12.20

This document provides COVID-19 patient education resources available in Maestro Care. Uploaded 04.06.20

This patient email was sent on 3.16.20 and encourages them to keep appointments and to continue to take medications. Uploaded 03.24.20

Duke Health is enacting additional network security measures to help mitigate an ongoing and serious cyber threat and protect our patients, staff and infrastructure. Effective immediately, all devices connected to the Duke Health network will be prevented from accessing personal email and social media accounts. We understand that this necessary precaution will not be easy for many of our team members and patients. This letter may be used to explain this update to our patients and visitors. Uploaded 11.01.20

This pediatrics document lists emergent procedures related to the care of suspected or confirmed COVID-19 patients in the pediatric cardiac catheterization lab. Uploaded 04.10.20

Printable resource to provide child care resources for essential employees during COVID. It is provided by the North Carolina Department of Health and Human Services and the North Carolina Department of Public Instruction. This is the Spanish Version. Uploaded 03.26.20

After receiving the COVID-19 vaccine, you may develop some side effects in response to the vaccine in the next 24 to 48 hours. This information is a guide to help you decide if you should contact the employee COVID-19 Hotline for advice on getting a COVID-19 test. Uploaded 6.3.21

These after-visit summary instructions are for Spanish-speaking patients who have known COVID-19 infection and are being discharged from the hospital. They outline important information about home isolation and self-monitoring periods. They also provide guidance for those living in households with someone with COVID-19 symptoms. This document can be used as discharge instructions/after visit summary/AVS. Updated 09.30.20

This document outlines Duke Health's recommendation for managing children with respiratory symptoms prior to an operative procedure for Fall/Winter 2021. Uploaded 08.23.21. 

This documents key facts to know before working or volunteering at a Duke vaccination (vaccine) clinic. Updated: 6.9.21

This document includes standard work instructions for collecting N95 masks at the end of Duke Primary and Urgent Care team members’ shifts. Uploaded 04.22.20

This information is not intended to typecast a cultural group or perpetuate stereotypes. It is meant to encourage curiosity about different cultural beliefs and practices that may influence how our patients understand their care and respond to their care providers. It is important for all healthcare employees to understand how to provide linguistically and culturally appropriate services to our diverse patient population.

This tip sheet reviews the safety features of the syringes being used. Uploaded 3.24.21

The attached document contains frequently asked questions about life support certifications. Uploaded 05.04.20

COVID Visitor Restrictions Patient Letter in Spanish 1.14.22. Uploaded 1.16.2022

According to the Centers for Disease Control and Prevention (CDC), more than 6.8 million doses of the Johnson & Johnson (Janssen) vaccine have been administered in the U.S. as of April 12. The CDC and Food and Drug Administration (FDA) in a joint statement on Tuesday, April 13, recommended a pause in the use of Johnson & Johnson's (J&J's) single-dose COVID-19 vaccine out of an abundance of caution. This email was distributed to all Duke Health patients who received a J&J vaccine within three weeks of the update from the CDC and FDA. Uploaded 04.16.21

Isolations signs for special droplet and contact precautions have been updated to include when to use face shield to provide care in various situations. This handout familiarizes readers with the new signs. Uploaded 05.14.20

Flyer: Support our front-line unit team members!  Donate to the Healthcare Worker Unit Support Fund. Uploaded 01.14.2021

Historically, estimated glomerular filtration rate (eGFR) was calculated using a formula that included a person's body habitus, age, sex, serum creatinine, and race. Recently, the validity and appropriateness of a race-based correction to eGFR has been questioned; in response, the American Society of Nephrology and the National Kidney Foundation have reviewed the data underlying the race-based correction and determined that race can be removed from eGFR calculations as work continues for a new national standard. Beginning June 15, 2021, Duke Health is eliminating the race-based correction coefficient from eGFR. More information about this update is available in this document. This is a first step in preparation for national guidelines that will standardize measurements of kidney function and will help ensure that our patients receive care that is fair, just, and free of bias. Uploaded 6.4.21

This sign instructs Spanish-speaking patients and visitors to wear a mask at all times and shows how to put on the mask. Uploaded 05.27.20

This document includes information and directions to the new DUH Employee Vaccination Clinic starting July 23, 2021. Please note that the DUH clinic will provide vaccinations by appointment, however, we will also accept walk-ins but appointments will have priority. Uploaded 7.22.21

Second-year medical students will return to their clerkships on June 15, 2020. We encourage embracing these students as active members of our team and in the care of patients. This is a document addressing frequently asked questions (FAQs) for the anticipated return of MS2 students to clinical experiences/clerkships. Uploaded 06.11.20

This document outlines the roles of each staff member at drive-up collection sites (i.e., swabber, spotter, runner and doc of the day). Uploaded 03.30.20

This NC DHHS form is for any person under investigation being tested for COVID-19. Uploaded 03.21.20

This 5"x7" card (handout) is available for patients and community members to encourage them to join the waitlist for COVID-19 vaccination (vaccine). Uploaded 4.22.21

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. Uploaded 04.22.20

Patient education document detaling monoclonal antibody treatment information, eligibility requirements, and FAQs. Updated 9.17.21.

This tool provides the questions that should be asked of each person receiving vaccination, which patients need longer observation times, and which patients cannot receive vaccine.  There are also guidelines as to how to handle patients who might have had reactions after the first dose.  Uploaded 3.24.21

This flyer/handout contains information to help team members know what to do next if they don’t pass a symptom check at screening locations. Uploaded 05.01.20

In consultation with DUHS infectious disease experts and state and federal agencies, Duke Employee Occupational Health and Wellness has updated its tiered system to help provide a framework for team members returning to work following a known exposure or positive COVID-19 test. (Updated 03.09.22)

Southern Regional AHEC, Durham County Public Health, Alliance Health, and Duke AHEC are partnering to offer a livestream Opioid Use Training Disorder Training series for MDs, LCSWs, RNs, CMs, Pharmacists and APPs. Sessions will be held May 12, 19 and 26, 2021, from 12 p.m. – 12:30 p.m. The series is free to attend, and the first 100 registrants will receive CE credit. This document includes more information about the series and a registration link to join. Uploaded: 04.16.21

Isolations signs for special droplet precautions have been updated to include when to use face shield to provide care in various situations. This handout familiarizes readers with the new signs. Uploaded 05.14.20

The Duke Antimicrobial Stewardship and Evaluation Team, Duke Pharmacy, and Duke Division of Infectious Diseases have provided updates on COVID-19 therapeutics. DUHS supply of COVID-19 therapeutics is now adequate to consider ambulatory therapies for all tiers of high-risk patient groups with mild/moderate disease. Please refer to this document and Duke CustomID for further information. Updated 03-25-22.

Safe and effective with a one-shot dose, the Johnson and Johnson (Janssen) vaccine offers 100% protection against hospitalization and death. This handout includes fast facts about the J&J COVID-19 vaccine. (Spanish) Uploaded 06.08.21

This document shares best practices for conducting professional, engaging, and clear virtual visits with patients. Uploaded 05.27.20

This document provides background for DUHS team members on the prevalence and spread of the COVID-19 Delta variant and what to do in case of a potential exposure. Uploaded 07.23.21

This document provides important reminders and guidance for all healthcare workers when using break rooms or shared spaces to help reduce the spread of infection. Uploaded 06.12.20

This flowchart depicts the process for drive-up test collection at DPC/DUC clinics. Uploaded 03.30.20

This document is for EVS team members and provides guidance on how to treat medical waste, PPE and linen in rooms of patients with suspected or confirmed COVID-19. Uploaded 03.16.20

This document contains information about the Duke Regional Hospital testing protocol for patients directly admitted to DRH or who have been transferred to DRH from another facility. Updated 06.19.20

This document contains clinical guidelines for Duke Orthopaedics providers to use when determining how and when to schedule follow up visits. Uploaded 03.31.20

This table is for healthcare workers to use in assessing COVID-19 risk exposure, per CDC guidance. It includes additional information from Employee Health on recommended monitoring periods and work restrictions for asymptomatic healthcare workers. Updated 05.01.20

The Hope4Healers Helpline is for health care professionals (and their families) who are experiencing stress from being on the front lines of the state’s COVID-19 response. It offers mental health and resilience support, 24 hours a day, seven days a week. This flyer has the basics. Learn more about Hope4Healers here. Uploaded 08.03.2020

This document contains three 11x17 posters for inpatient/ED healthcare workers showing steps for donning and doffing PPE, including with and without an anteroom. Updated 08.27.21

This document is for OR staff and addresses perioperative management of patients who are known or suspected COVID-19 positive and need urgent surgery. Patients who do not fall into those categories will continue to be managed in the usual fashion. Uploaded 08.13.20

This document provides more information about an update from the Centers for Medicare and Medicaid Services (CMS) that now allows for payment when physicians and healthcare providers counsel patients during self-isolation period after patients have been tested and prior to the onset of symptoms if the results are positive. The providers will use an Evaluation and Management code to bill for the service by documenting the counseling based on time. Uploaded 09.16.20

Tip sheet / printable resource for healthcare workers and highlights best practices for keeping safe at work. Uploaded 04.07.20

This document contains tips for and the smart phrase for documenting discharge instructions in Maestro in place of a signature. Uploaded 03.25.20

This flowchart depicts the process to confirm the COVID-19 status for patients accepted from an outside facility as a transfer to an inpatient bed. At the time of acceptance, the COVID-19 status should be documented in the patient’s chart. If this is not documented, the patient should be directed to the DUH Swab Team. Uploaded 11.18.20

This document has been updated to align with the current science on COVID-19 transmission in negative pressure rooms and/or rooms using HEPA filtration. It also includes FAQs that address recent questions from team members about how to safely use a HEPA filter. Updated 01.19.22

This document provides important clarifications on the extended use, re-use, and disinfection of PAPR hoods for all healthcare workers providing care to patients with known or suspected COVID-19 infection. Updated 04.14.20

The North Carolina Department of Health and Human Services recently updated their guidance on vaccine distribution. Duke Health is following all federal, state and local guidelines on the distribution of the vaccine to ensure that it is equitably administered within each group. This infographic is now available for sharing internally and externally. Uploaded 01.14.21

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. Please refer to the full instructions for extended use and reuse of N95s and face shields, PAPR hoods, and face masks and face shields for additional information. Uploaded 04.15.20

This poster outlines guidelines for all visitors in our inpatient locations to follow while in our facilities. This version of the poster is in English. Uploaded 08.25.21

This patient visit checklist is for healthcare workers in the ambulatory setting for planning, testing, and discharging patients with suspected COVID-19. Uploaded 03.21.20

This document outlines the proper configuration for the Versaflo PAPR unit and the yellow isolation gown. Uploaded 06.30.20

This how-to guide / job aide for staffing leaders for how to create and award COVID shifts in DukeShift. Uploaded 03.31.20

The document is for staff and includes detailed information and technology tools for working remotely. It includes instructions on accessing the VPN, WebEx, Zoom, Microsoft Teams, Jabber, and more. Uploaded 03.24.20

In these times where face masks and physical distancing are necessary to reduce the spread of infection, patients with hearing loss (and even some with normal hearing) are experiencing increased difficulties understanding spoken language. Check out these tips that may help improve communication when the patient or caregiver is experiencing communication difficulty. Uploaded 08.04.20

This document contains three 11x17 posters for outpatient healthcare workers showing steps for donning and doffing PPE, including with and without an anteroom. Uploaded 04.01.20