Hospital Corner

By Taylor Lambert, R.N.

DAYTON–COVID-19 has undoubtedly interrupted daily living all around the world, however those residing in nursing home facilities have arguably faced the most restrictive and impactful adjustments over the past several weeks.

Booker Rest Home (BRH) quickly implemented the necessary restrictions as the knowledge of COVID-19 evolved and continues to make any changes required to keep the residents safe and healthy.

While the majority of the population is following social-distancing guidelines, BRH has been following even more dramatic measures as the residents are considered to be one of the most vulnerable groups in light of COVID-19. Some of the specific steps that this nursing facility has taken to maintain the safety of their residents include restricting all visitors with the exception of compassionate-care situations. This guideline means that the residents have been isolated from their loved ones for an extended period of time, aside from a few exceptional instances in which it was crucial for the emotional or physical health of a resident and their family to see each other. If this scenario did occur, loved ones were expected to wear a mask and to maintain six-feet distancing as much as possible.

The restriction of visitors includes the loved ones of the residents as well as any volunteers, vendors, and non-essential healthcare personnel. This means that typical visits from entities such as hairdressers, churches, etc. have been postponed at this time in order to decrease the chance of introducing COVID-19 into the facility.

Any personnel that is considered necessary to enter BRH undergoes an extensive screening prior to entering the facility. The screening includes monitoring for fever and filling out a questionnaire addressing any possible symptoms or risk factors such as cough or shortness of breath, or possibility of COVID-19 exposure. If the person is ill, exhibiting any symptoms, or fails the questionnaire, they will not be granted access. If the person does pass the screening, they then can enter the facility and are required to sanitize their hands and don a mask prior to entry. All staff are expected to wear a mask when in health care areas.

Any non-essential outside appointments have also been postponed in order to decrease the chance of COVID-19 exposure. Any appointments that are essential and necessary for the well-being of the resident will be continued, for example going to an outside medical appointment, however the resident will be encourage to practice social distancing, practice adequate hand hygiene, and wear a mask during that time. Routine doctor's rounds inside the facility have also been resumed using technology such as tele-visits when possible. The BRH providers have been assessing their patients via telemedicine whenever appropriate to further decrease the risk of exposure within the facility.

While the above-mentioned circumstances address the ways in which BRH is attempting to prevent COVID-19 from entering the facility, further steps have been taken to identify infections early in the case that an infection were to occur. All residents are screened daily for fever and symptoms of COVID-19. Their vitals are monitored as well as any signs or symptoms that could suggest infection including, but not limited to respiratory symptoms, malaise, GI symptoms, etc. A more detailed plan has also been put into place, should a staff member or resident be suspected for or test positive for COVID-19.

Actions are also being taken to prevent the spread of COVID-19 in addition to these restrictions that serve to prevent the occurrence of COVID-19 from entering the facility as well as identifying the illness early if it does occur. Booker Rest Home has initiated several modifications to the daily lifestyle of the residents in order to keep them safe including cancelling any events that necessitate large gatherings. More specifically, communal dining has essentially been prohibited, aside from the few residents that need assistance with eating in which case they can continue to eat in the dining room seated 6 feet away from other residents. Group activities have also been limited and improvised to maintain social distancing.

Booker Rest Home is also constantly assessing their supply of personal protective equipment to ensure they have the necessary items such as masks as for preventive measures, in addition to more extensive PPE in the case that COVID-19 is acquired within the facility.

While many of these changes are restrictive and have the ability of negatively impacting the residents, the staff has really used their creativity and optimism to find ways to keep the attitude up-beat and positive! The activities department has created fun ways to continue group activities, following social distancing guidelines, such as hall-way BINGO or hall-way bowling. The staff has also participated in "Spirit Week" and dressed up according to a varying theme each day, such as "Tu-Tu Tuesday" or "Whacky Wednesday".

The staff is continually monitoring the residents' mental and emotional health and has found ways for the residents to communicate with their loved ones while also prioritizing their health. Some examples include access to a tablet or computer monitor in which they can video chat with their friends and families, in addition to regular phone calls. Some residents have even been able to visit with their loved ones outside of their windows utilizing social distancing guidelines.

COVID-19 has certainly interfered with the daily life and routines of residents and staff of nursing home settings; however, BRH has truly found a balance of prioritizing the health of the residents while also implementing safe and creative ways to preserve their overall well-being. Although life may not return to "normal" any time soon, BRH will continue to adapt to the continuously evolving knowledge surrounding COVID-19 in order to keep residents both safe, and happy!