COVID-19 Information for Employees

Please visit the CDC website for information about COVID-19 vaccines.

Effective March 21, 2023, patients, visitors, and team members will no longer be required to wear a mask at all times within a CHKD facility.

• Patients who are seeking treatment for a viral illness such as COVID-19 or the flu should continue to mask to prevent spreading the virus to others.
• Team members must continue to follow all PPE guidelines when treating patients with suspected or confirmed COVID-19.

Please continue to be responsible if you are feeling sick. Team members should stay home when they’re ill and wear a mask if they are experiencing any cold or allergy-like symptoms. 

While our COVID-19 policies continue to evolve, our priority remains the safety of our team members, patients, and the community. Masks will still be available for anyone who wants to wear one. Please continue to follow hand hygiene guidelines and practice social distancing when possible.

We will continue to monitor respiratory illness activity across our community and may change masking guidance, as appropriate. 

The process for illness and triage is the same for now and has not changed.

SBAR: Reimplementation of COVID Testing Program

Due to decreased community transmission, we will be modifying asymptomatic testing in the pre-procedural patients. There will be no changes for all patients admitted to CHKD, as they will require testing prior to bed placement. Patients entering the Sleep Lab for CPAP will also continue to be tested 48-72 hours prior to the procedure, as is our current process.

For pre-procedural patients, including those undergoing surgery or sedations, testing is recommended for any patient who has had respiratory symptoms in the preceding 6 weeks to the scheduled event. If none, no testing is required unless the patient is being admitted post procedure/sedation.

RECOMMENDATIONS:

1. All patients admitted to CHKD will require SARS-CoV2 testing. The choice of test is determined by the treating team. Cepheid SARS-CoV2 PCR is recommended for asymptomatic patients. For those patients with respiratory symptoms, the choice is RP2 (22 respiratory targets) or Cepheid SARS-CoV2 PCR or Cepheid 4-plex when available.
2. Starting October 24, 2022, all patients undergoing procedures will require testing 48-72 hours PRIOR to the procedure IF they have a history of any respiratory symptoms in the preceding 6 weeks. Please order Cepheid SARS-CoV2 PCR.
3. If there is no history of respiratory symptoms in the prior 6 weeks prior to the scheduled procedure, NO testing is required unless they are being admitted post procedure/sedation.
4. We will continue to monitor and assess our percent positivity in combination with community transmission levels to determine any future changes.

New PPE Requirements/Chart for Respiratory Illness

CHKD has issued new PPE requirements. Please review these, print them out for reference, and discard any previous versions. 

Highlights of the changes include the following:

• Added a clarifying header to the aerosol generating procedures (AGPs). No other changes were made.

In addition, please note the following information that has not changed from earlier versions.

• Intubations on all patients require N95s.
• N95s or higher level respirator, eye protection, gowns, and gloves are still required for patients on Enhanced Contact/Droplet.
• Masks and eye protection are required for patients on Droplet Precautions for all suspected/known viral respiratory infections.
• Aerosol-generating procedures (other than intubations) performed for patients not on transmission-based precautions still require a mask and eye protection during these procedures (Standard Precautions).

COVID-19 Precautions for All Buildings Housing Clinical Areas

The following requirements are in place for all CHKD facilities that patients visit.

• Eye protection is no longer mandated for standard care or routine interactions for those in patient-facing roles. Eye protection shall still be worn according to the PPE requirements outlined in the PPE chart dated March 29, 2022. Anyone who wishes to use eyewear may continue to do so.

Pre-procedure and Admission Testing - August 30, 2022

Continual monitoring of positivity rates occurs and will be used in conjunction with public health recommendations to make decisions about testing, masking, and other infection prevention interventions. See testing section for current testing requirements. It is still expected that all symptomatic patients will have respiratory pathogen testing as indicated clinically on admission and during hospitalization. As a reminder, that regardless of COVID-19 status, N95 respirators or higher and eyewear are required for all intubations.

Changes to COVID-19 Isolation and Quarantine

The CDC updated its IPAC recommendations to reflect new guidance for isolation and quarantine, along with consideration for vaccination status. CHKDHS has updated its guidance to reflect these changes.

Currently, CHKDHS patients infected with COVID-19 and those under investigation are placed under "enhanced contact and droplet isolation," with adjustments as needed based on updated federal and state standards. Changes will not affect those PPE standards but will address the length of isolation based on patient immune system status and severity of illness. Removal of enhanced isolation will continue to require IPAC approval.

Updated recommendations are as follows:

1. Empiric use of enhanced contact/droplet precautions (quarantine) is recommended for patients who have had close contact with someone with SARS-CoV2 infection if they are not up to date with all recommended COVID-19 vaccine doses for 10 days following their last contact with an infected person. This includes persons under investigation (PUI) and parents.
2. Quarantine is NOT needed for patients/parents who have had close contact with SARS-CoV2 infection or who have had COVID-19 infection within the past 90 days IF they are up to date with all recommended doses of COVID-19 vaccine doses. This will require proof of vaccination either from the VIS database or a vaccine card. This will be verified by the medical or surgical team the patient is admitted to.
3. For the infected patient: the duration of the isolation is dependent on immune status. For those with a normal immune system, isolation is 10 days from the first day of symptoms/positive test along with no fever for 24 hours and improving symptoms in those with no, mild, or moderate symptoms. Those with severe symptoms require at least 20 days of isolation, and testing is considered to remove isolation.
4. For the immunocompromised, isolation is at least 20 days, with SARS-CoV2 testing performed on day 20 and day 21 to remove isolation precautions under the direction of IPAC for inpatients. If any test is positive (PCR or rapid antigen), the isolation continues. Testing may be repeated every seven days until negative. If the testing is negative, isolation may be discontinued with IPAC approval for inpatients.

Click here for the full SBAR.

Why the Change to N95 Use for COVID-19

As many of you are aware, a change to N95 respirator use was recently made. Read why this was necessary here.

Safety Regulations for Common Areas

The Virginia Occupational Safety and Health Program (VOSH) and Virginia Department of Labor and Industry (DOLI) have recently released new Emergency Temporary Standards to slow the spread of COVID-19. While CHKD policies already meet or exceed most of the standards, we will be adopting new practices for common areas like conference rooms and break rooms to be in compliance with this new guidance.

All employees are required to:

• Adhere to maximum occupancy requirements in common areas, e.g., break and conference rooms. Facilities personnel will be visiting all sites to measure and determine maximum occupancy. Signs will be installed listing maximum occupancy.
• Complete proper hand hygiene before and after eating and drinking.
• Maintain at least six feet of distance between you and others.
• Clean and disinfect the immediate areas you use in common areas, e.g., break and conference rooms, prior to leaving the area. Please use CHKD-supplied cleaners and disinfectants, which meet requirements to kill SARS CO-V2 and other pathogens. These can be ordered by managers/directors who will receive ordering instructions via email. Each product has a "Contact Time" or total time it takes to kill the germs.

  Thank you in advance for keeping our shared workplaces as safe as possible.

  Protecting Yourself from Infection

  Please access the updated PPE requirements here. And please don’t hesitate to contact Infection Prevention and Control for any clarification or questions.

  Department Handouts and Signs

  • Enhanced Contact/Droplet Precautions Sign
  • Social Distancing Reminder Sign
    

• COVID-19
• MIS-C
• Remdesivir
• Baricitinib
• SARS-CoV-2 Oral Antiviral Therapies

COVID-19 Visitor Guidelines as of October 18, 2022   

With a greatly reduced level of COVID-19 in our community, CHKD has established the following visitor guidelines.

Doctor’s Appointments, Outpatient Surgeries, and Urgent Care: Two adults may accompany a patient.

Hospitalized Patients: Children may have four designated adult visitors for the duration of their stay. Medical assistants who help with activities of daily living are always allowed. Siblings, 12 years of age and older, who are not showing signs of illness are welcome in their brother's or sister's room between the hours of 8 a.m. and 8 p.m. while a parent is present.

A maximum number of four people may be in a patient's room at one time, which may be further limited depending on the size of the room and the severity of the patient's illness. 

Hospitalized patients with a positive COVID-19 test, and patients under investigation for COVID-19 may have two adult visitors (parents or guardians) for the duration of the inpatient stay. Visitors are required to remain at the patient's bedside while at the hospital, but are allowed to leave/return (walking between the front door of the hospital and the patient’s room) once per 12-hour nursing shift. Siblings are not allowed.  

COVID-19 Employee Symptom Triage Form

COVID-19 Triage Form

COVID-19 and Pregnancy

The CDC’s list of underlying medical conditions that put individuals at increased risk for severe illness has been updated and now includes pregnancy. The CDC advises that COVID-19 infections may also increase the risk of adverse pregnancy outcomes, such as preterm birth. Read more here. In addition, the CDC reminds women who are pumping breast milk at work to take extra cleaning precautions.

Any employee who would like to request accommodations based on their level of risk should contact occupational health at (757) 668-7852.

Criteria for Employees Exposed to COVID-19

Employees who have been exposed to the COVID-19 virus will be assessed according to the CDC risk exposure factors, available at this link: CDC Exposure Risk Categories in Healthcare Personnel.

Concerned About Exposure?

If you are worried that you have been in contact with a community or family member under suspicion for COVID-19, please contact the Occupational Health Clinic Monday – Friday 7 a.m. to 4 p.m. at (757) 668 7661. Please keep your manager up-to-date.

HAVE COVID SYMPTOMS?

Please do not come to work if you have symptoms that could be related to COVID-19. 

COVID TESTING

If you have symptoms of COVID-19, please do not come to work. Call Occupational Health to determine if you need to be tested. Home antigen test kits are accepted if the result is positive. Due to their high rate of false negative results, if you have a negative antigen result you may still need a COVID-19 PCR test.

Employees can receive free COVID-19 testing at CHKDHS outpatient labs by calling Occupational Health at (757) 668-7661.

Free testing is also available by searching COVID-19 Testing Locator website,

Return to Work Guidance

Occupational Health will give you guidance on quarantine, isolation, and when you can return to work. Infection prevention and control will continue to triage contract and temporary staff and residents.