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Employees_COVID 19

COVID-19 Information for Employees

(757) 668-7238

January 7, 2021


We are committed to protecting the health of our patients, families, visitors, physicians, providers, and staff during the COVID-19 pandemic. We are working with campus partners; Federal, State and Local Government; VDH; CDC; and unified community emergency operations to establish best practices for our care delivery.

Please monitor your e-mail and CHKD.org for updated information regarding screening, testing, and operational response to COVID-19.

NEW - COVID-19 Vaccine Information

COVID-19 Vaccine Open to All Employees

In our ongoing effort to make our work environment as safe as possible for our staff members, patients and families, CHKD is pleased to announce that beginning January 7, 2021, we will offer first and second doses of the COVID-19 vaccine to all CHKD Health System employees who wish to receive it. The vaccine will not be mandatory.

Please review the following fact sheets, and print and complete your consent form.

Bring your completed consent form and your badge with you when you come to get your vaccine. Please allow enough time for the required 15-minute observation period after your shot. There may also be waits for those without appointments.

General Information from the VDH:

Vaccine Locations, Times and Dosage Information

Please be aware and respectful of the fact that occupational health is busy administering the vaccine. Please use the VDH link above and/or your personal healthcare provider whenever possible for answers to general vaccine questions or questions related to any specific health condition you might have. Emails are being answered, but patience is appreciated.

If you still have questions after reading this, please send them to COVID19today@chkd.orgor talk to your Manager/Director.

In Brief: COVID-19 Vaccines

Authors: Sarah Parsons, Pharm. D., BCPPS and Laura Sass, MD

With US Approval of one coronavirus vaccine and recent approval of a second, many healthcare professionals have questions surrounding the overall safety and efficacy of the vaccines. The most common concerns include:

  • Speed: Reluctance secondary to "warp speed"
  • Components: The mRNA platform and lack of human data
  • Reported claims and rumors

The goal of this education is not to influence acceptance but to provide accurate facts and information to alleviate fears and address common questions that surround the new and upcoming COVID-19 vaccines. Read the entire article here.

Employee Screening

Staff Screening - Peer-to-Peer Screening Still Required

Clinical areas are still expected to perform and document peer-to-peer screening to prevent anyone with COVID-19 symptoms from working and potentially spreading the illness to patients and coworkers. Please document completion of the screening, but do not record any personal health information for your peers.

Non-clinical staff are expected to self-screen before leaving home.

While no one should ever come to work when they are sick, this is especially true now, during the pandemic.

For additional information, please see the documents listed below:

Screening Criteria

We are following CDC guidance on monitoring healthcare personnel (HCP), which states the following:

As part of routine practice, HCP should regularly monitor themselves for fever and symptoms of COVID-19.

Please self-monitor for COVID-19 symptoms prior to leaving home before the start of EVERY shift. Staff working on inpatient units and ED need to self-monitor for the following symptoms at their regular call-out time:

  • Temperature (greater than 100°F or 37.8°C).
  • Cough (new, worsening, or change in cough).
  • Shortness of breath.
  • Loss of smell or taste.
  • GI symptoms.
  • Sore throat.

Click HERE for instructions.

  • If HCP develop fever (T≥100 degrees F, 37.8 degrees C) or symptoms consistent with COVID-19* while at work, they should keep their mask on, inform their supervisor, and leave the workplace. Healthcare facilities should screen all HCP at the beginning of their shift for fever and symptoms consistent with COVID-19.*
  • Actively take their temperature and document absence of symptoms consistent with COVID-19*. If they are ill, have them keep their cloth face covering or facemask on and leave the workplace.

*Fever is either measured temperature >100.0 F or subjective fever. Note that fever may be intermittent or may not be present in some individuals, such as those who are elderly, immunosuppressed, or taking certain medications (e.g., NSAIDs). Clinical judgment should be used to guide testing of individuals in such situations. Respiratory symptoms consistent with COVID-19 are cough, shortness of breath, and sore throat. Medical evaluation may be warranted for lower temperatures ( <100.0 F) or other symptoms (e.g., muscle aches, nausea, vomiting, diarrhea, abdominal pain headache, runny nose, fatigue) based on assessment by occupational health.

Additional information about clinical presentation of patients with COVID-19 is available here.

PPE and Supplies

New Information Regarding N95s

Please note that Interim Guidelines for Use of N95 Respirators, which includes new information on the reprocessing of N95s, has been uploaded to the Infection Prevention and Control Manual in MCN. The guidelines are located within the COVID-19 folder. Managers are asked to promptly review these guidelines to ensure that their areas have the supplies needed for reprocessing.

    Please discard any earlier versions and replace with this version.

    Reusable Gowns Coming to Main Hospital

    We have started to supply reusable isolation gowns in place of disposable isolation gowns at the main hospital. These gowns will be included as part of your daily linen service from ESD. Departments that use gowns but do not have a daily linen service may request the gowns from ESD. These gowns are “one size fits most.” We will continue to carry disposable gowns in alternate sizes, and those gowns may be ordered from Supply Chain as you currently order them today.

    The reusable gowns are being supplied and laundered by Cintas. We are placing new hampers in each unit specifically and only for soiled gowns. Please do not mix used patient linens and soiled gowns in the same hamper. Putting each in their separate hampers will prevent staff from having to sort the items prior to sending out for laundering.

    Our initial go-live is for the main hospital only. Offsite locations will continue to order disposable gowns from Supply Chain utilizing their current processes. Once we ensure the service levels are stabilized at the main hospital, we will begin working with the offsite locations individually in order to transition over to the reusable gown service.

    Unit staff members should be on the lookout for HLC training regarding donning and doffing these new gowns.

    Product Notices from Supply Chain - Mask Supply and Usage Update

    We are happy to announce that Supply Chain and the many people working with them to source PPE have successfully secured an increased number of Level 2 facemasks. This will allow us to loosen our restrictions on use. We now have enough masks to go back to normal usage for those who are caring for any of our patients on Droplet and Enhanced Contact/Droplet precautions. The Level 2 masks should also stay in place more easily.

    While staff may use the same mask for the whole day (universal masking) if they choose to, this is not required. Please remember that masks should always be discarded if wet, soiled, or otherwise degraded.

    The masks will be stocked on par carts for those units that have par carts managed by Supply Chain. All other departments including offsite locations should order directly from the warehouse.

    Our supply chain has acquired several new products that may be ordered following normal procedures. Click on the links for more information.

    Eye Protection Required

    In an effort to further protect our staff from unanticipated exposure to COVID-19, CHKDHS has determined that eye protection, in addition to a medical-grade mask, will be required for anyone when:

    • Entering the room or treatment area of a patient in both the outpatient and inpatient settings.
    • During all direct contact with patients in which an engineering control such as a cough/sneeze guard is not available.

    Eye protection is not required to be worn when:

    • Entering a clinical department or in a clinical department but away from the immediate patient care room or treatment area.
    • Walking in a hallway.
    • Working in an office setting.

    Please review the updated guidance for preserving your eye protection.

    Please note: Eyeglasses are NOT PPE.

    Minimum Requirements for Eye PPE

    CHKDHS is committed to your health and safety and supplies several different types of eye protection. Due to COVID-19 supply chain challenges, our usual PPE for eyes is not available so we have a variety of different options for you to choose from, including glasses, goggles, and face shields.

    Many staff members have asked if they are allowed to wear eye protection that they purchase for themselves. While CHKDHS is not asking or requiring you to purchase your own eye protection, this will be allowed as long as your eye protection meets the standards below. To be worn in a CHKD Health System facility, eye protection must:

    • Be able to be cleaned and disinfected.
    • Be close fitting to the forehead.
    • Provide good coverage of the entire eye area.
    • If vented, the vents must sit back behind the eye area.
    • Fit closely to the head or have a strap to secure it.
    • Fit over corrective eyeglasses, if glasses are worn underneath.
    • Combination eyewear and eye shield should have same attributes, with the shield completely covering the chin and both sides of the face.

    For those interested, there are companies that will make prescription safety eye protection. The same safety attributes are required for prescription safety eye protection. Please contact Infection Prevention and Control if you have any questions.

    At CHKD, we have developed strict protocols to prevent the spread of COVID-19 in our hospital, health centers, and physician practices. Chief among them are physical distancing, hand hygiene, and universal masking.

    Mandatory Face Coverings for Patients, Visitors, and Staff

    Anyone entering a CHKD location is required to wear a face covering. Children who are under age 2 or who are not developmentally or medically able to wear a mask or face covering safely are exempt. There are very few conditions that prevent a child from wearing a mask safely.*

    All adults are required to wear masks inside CHKD facilities.

    Enhanced Visitor Mask Requirements

    With COVID-19 on the increase throughout the community, we must ask parents and other visitors to keep their face coverings on at all times, except when they are eating or sleeping, even while they are in a private room with their child, our other patients, and our staff members from COVID-19.

    Please distribute the following disclaimer with each fabric face covering:

    Employees are permitted to wear their own cloth face coverings in certain situations that do not involve patient contact. Please review the Use of Cloth Face Coverings SBAR for details, along with this safety guidance from the CDC on how to wear your mask and take care of it properly.

    Staff are required to wear their own cloth face covering when arriving and leaving work within CHKDHS facilities. Due to decreasing donations of cloth face coverings, we are unable to offer donated cloth face coverings to staff. Visit the CDC website for directions on making an easy, no-sew cloth face mask.

    Staff should continue to wear masks at all times while working and to perform appropriate hand hygiene. The COVID-19 pandemic is not over. It is still crucial to follow all infection control strategies.

    Medical-grade masks must be worn when in any clinical unit, when providing clinical care or patient/family services, and by all frontline staff. Cloth face coverings are not PPE.

    No Valves, Please

    A recent study of various types of face coverings reconfirmed that masks of any kind with valves do not protect others from the spread of COVID-19. Valves are openings in the mask that allow exhalations – which could contain SARS-CoV-2 droplets – to escape and infect others. Valved masks are not allowed in CHKD facilities. 


    Preserving Procedure Masks

    As we all know by now, masks are a limited and valuable resource. To ensure that we have an adequate supply of masks to last through the coming weeks and months of this pandemic, we must all take every precaution possible to conserve these masks.

    Employees who do not have direct patient contact should wear their CHKD-issued masks for five shifts, then discard them. Staff members who have direct patient contact should wear their CHKD-issued masks for two shifts then discard them. Staff members who are issued N95 respirators will receive separate guidance on how many times to wear each respirator. Please follow the instructions in the sheet linked below for removing your mask and folding it properly for storage in the paper bag provided.

    PPE Tips

    Infection Control and Prevention is sharing the following how-tos and tips regarding PPE:

    Additional Resources

    Download this Limited Contact Precautions sign for patients with a history of MRSA, ESBL, or VRE. Active infection with these organisms requires Contact Precautions.

    Hand Hygiene

    If you do not have access to portable Purell when needed, please use soap and water. Supply chain is working with all known vendors to purchase every possible solution to this challenge, including the installation of additional wall-mounted dispensers. Please do not use hand sanitizer from home.

    Oxivir Wipes

    Like other organizations, CHKD has a limited supply of Oxivir wipes. To make best use of the wipes, while facilitating Oxivir cleaning throughout the organization, CHKD will adhere to the following plan.

    • Hospital Oxivir wipes will be delivered to inpatient nursing units only. All other departments in the hospital should request a spray bottle of Oxivir and cleaning cloths by calling (757) 668-7152. When additional spray bottles of Oxivir are needed, staff may contact EVS at (757) 668-7152 to pick up a filled spray bottle of Oxivir along with cleaning cloths. Dirty cleaning cloths should be put in soiled linen bags. Given the limited quantity of Oxivir wipes, inpatient nursing units should be mindful of its use.
    • Off-sites Oxivir wipes will no longer be delivered to off-site locations. Starting March 31, initial requests for a spray bottle of Oxivir and cleaning cloths will be made by emailing Shawna Turner and Kristina Patterson. Empty Oxivir spray bottles can be exchanged for filled bottles by leaving empty spray bottles in your designated breakroom at the end of the day. EVS will fill the spray bottles and leave filled bottles as well as cleaning cloths in the breakroom. Dirty cleaning cloths should be put in soiled linen bags.

    Guidelines for Use

    • Be sure to use until the bottle is completely empty. Do NOT “top off” or add more disinfectant to a bottle that has not been completely emptied, rinsed out, and allowed to dry completely.
    • Do not directly spray disinfectant onto liquids or physical soil as it can spatter and expose the person cleaning. Remove physical soil as much as possible before spraying disinfectant.
    • As much as possible, spray disinfectant into a cloth until wet enough to disinfect the area and maintain the contact time of 3 minutes.

    Medical Mask Exemptions for Children

    The pediatricians of CHKD Medical Group and the pediatric subspecialists of Children’s Specialty Group have developed a unified statement for local school systems regarding medical mask exemptions for children and supporting materials to help children wear masks comfortably. Please make use of the following documents:

    Infection Prevention and Control

    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 whenever you take your mask off.
    • 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.


      What does this mean for employees?

      • Use paper towels and water to remove any food or dirt from surfaces as needed.
      • Then use a PDI Sani-Cloth AF3 wipe and thoroughly wet the surface area.
      • Allow surface to remain wet for 3 minutes to make sure germs are killed.
      • Surfaces need to air dry only.

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

      Overflow Eating Areas 

      Beginning Wednesday, November 11, the GI conference room (4th floor) and the 5CSSG conference room (5th floor) will be used as overflow eating areas. The 6th floor conference will no longer be used as an overflow eating area. 

      Please continue to be mindful of maximum occupancies and social distancing within these areas. 

      For those with meeting in the GI and 5CSSG conference rooms on or after November 11, please consider using Webex or an alternate conference room.

      Protecting Yourself from Infection

      Every staff member who has patient contact is required to wear a hospital-issued mask -- during every patient encounter AND when interacting with co-workers in a clinical setting. We understand that PPE can be uncomfortable, but we cannot let our guard down and risk COVID-19 exposure events because staff members were not wearing masks or other required PPE during patient encounters or when interacting with co-workers.

      One of the biggest challenges with this virus is that people can be infected, and transmit it to others, even when they do not feel or seem sick. For this reason, we must remain vigilant. We must follow masking requirements during every patient and co-worker encounter.

      Everyone is also now required to wear a personal mask or cloth face covering on their way in and out of any CHKD facility. This requirement extends from the front door until you reach your unit, office, or workstation. Medical-grade masks must be worn when in any clinical unit, when providing clinical care or patient/family services, and by all frontline staff. Employees are permitted to wear their own cloth face coverings during the work day in non-clinical areas in situations that do not involve patient contact. Cloth face coverings are not PPE.

      Please remember that if you need to be quarantined because you are exposed on the job, and it is determined that you were not wearing proper PPE when the exposure occurred, your absence from work will come from your PTO bank. Any quarantine hours that you cannot cover with PTO will be unpaid.

      Infection Control Updates and Reminders

      CHKD's lab saw a marked increase in positive test results during the first week of July so please continue to use all prescribed infection control measures. Below are some things to be particularly aware of, as well as handouts and signs (found below) to post to help everyone remember.

      • Please choose an alternate space for breaks and meetings if you cannot maintain social distance.
      • Please put used N95s in the bins provided for reprocessing.
      • Wear your mask correctly, keeping the nose and the mouth covered at all times.
      • Masks/respirators with valves are not allowed.
      • Wear goggles or a face shield with every patient, even if you wear glasses. Eyeglasses do not protect you.
      • Please remember hand hygiene. It is still the basis of infection control, even with increased use of other PPE such as masks and gloves.

      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

    Patient Care and Testing

    COVID-19 Testing Process for Direct Admissions

    All direct admissions to the hospital will be tested for COVID-19 to ensure appropriate bed placement and minimize potential exposures. Please follow the process below.

    1. If coming from a clinic with testing capabilities, a rapid test should be completed while the patient is in the clinic.
    2. Follow the same procedure for securing an inpatient bed by calling the KidCom/Transfer Center, who will loop in the nursing supervisor.
    3. If a rapid test was not obtained in the clinic or the patient is coming directly from home, the nursing supervisor will identify a private room on the appropriate unit based on admitting diagnosis.
    4. Upon occupying the assigned room, the admitting MD/team should order the rapid COVID test (RP2) in Cerner for asymptomatic testing.
    5. Unit nursing staff will obtain the NP specimen and send to lab for processing—results take approximately an hour.

    In the event the test comes back positive, the patient will be moved to the special isolation unit located within PICU (back-up locations on 8C and 7C).

    Pre-Procedure COVID Testing

    An updated notice for families who are being sent for asymptomatic pre-procedure COVD-19 testing can be found here for the English version and here for the Spanish version. Additional collection sites have been added for the convenience for our patient families and to decrease their wait times.

    Infrared Thermometer Instructions and Checklist

    Please download these instructions for infrared thermometer (IR) use. Managers can download this employee competency checklist to ensure your unit is properly trained on IR use and protocol.

    Update for SARS-CoV2 PCR testing  

    CHKD will begin to offer IgG testing for SARS-CoV-2 through Powerchart on May 13. The Powerchart order will be “SARS-CoV2 IgG.” Please review the SBAR for guidance on this test.

    While the test will indicate whether a patient was infected with the virus in the past, we do not yet know if a positive test will indicate future immunity to SARS-CoV-2 infection. It should therefore not be used to decide who should return to work.

    In addition, because it takes several days for an infected person to produce antibodies, it should not replace the Abbott M2000 diagnostic test. As a reminder, for all pre-operative asymptomatic patients and symptomatic outpatients, please order the SARS-CoV-2PCR. This test is run daily, Monday through Saturday. 

    Please review this update for SARS-CoV2 testing for the CHKDHS. We will continue to have 3 different testing options available, but in this time of increased community spread, please be mindful of the test that you are ordering. Our allocation of the rapid testing platforms (Cepheid and BioFire) are limited, and use of these for all testing, especially in some settings, will affect our ability to provide rapid results in the future.

    Please be mindful that the molecular diagnostic lab is working at full capacity. We have expanded testing to 7 days per week, and have multiple M2000 runs per day. Please be patient and kind to the staff as you await your patient's results.

    Confirmed or Suspected Cases of COVID-19

    If you have a confirmed or suspected case of COVID-19, please review the most up-to-date recommendations for self-isolation and caring for yourself and your family.

    New Respiratory Specimen Process - Main Hospital

    All viral respiratory specimens collected in the main hospital must now be hand delivered to the laboratory. The lab is located on the second floor, near the Raleigh Garage entrance.

    Examples of respiratory specimens include:

    • Nasopharyngeal (NP) swabs.
    • Oropharyngeal (OP) swabs.
    • Nasal mid-turbinate (NMT) swabs.
    • Anterior nares swabs.
    • Nasopharyngeal wash/aspirate or nasal aspirate.
    • Pleural fluids.
    • Tracheal and lower respiratory tract aspirates.
    • Bronchoalveolar lavage (BAL) specimens.
    • Sputum.

    Click here for a handout you can post as a reminder.

    Isolation Precautions for Patients with Drug Resistant Organisms

    Due to the current pandemic and concern for PPE shortages, we have made the following changes to our contact isolation policies:

    • For patients with history of MRSA, VRE, or ESBL infection without a current ACTIVE infection: Use gloves only. No need for gown.
    • For patients with an active MRSA, VRE, or ESBL infection: Use gown and gloves as prior contact isolation practice.
    • For patients with history or active infection with CRE: Continue contact isolation with gowns and gloves.
    • For patients with C. difficult: Continue contact isolation with gowns and gloves.

    Isolation Precautions and PPE Recommendations for Confirmed or Suspected COVID-19 Patients

    There have been many changes to the guidelines on COVID-19 (suspected or confirmed) PPE requirements over the last several weeks. We are hopeful that the guidance below will offer some clarification. In the inpatient setting, N95 respirators are only needed in a very limited number of circumstances. These include while intubating and during procedures that are aerosol-generating. In all other circumstances, gown, gloves, surgical mask, and eye protection are required. Note: N95 Industrial respirators provided by Supply Chain meet PPE requirements and are approved for use in a clinical setting.

    Inpatient Setting

    • Enhance Contact/Droplet Precautions for suspected/known COVID-19 patients who do not require aerosol-producing procedures.
    • Enhance Contact/Airborne Precautions for suspected/known COVID-19 patients who do require aerosol-producing procedures.

    Outpatient Setting

    • In the outpatient clinics, contact and droplet isolation with eye protection should be used when evaluating patients with suspected or proven COVID-19.
    • N95 respirators are only needed in a very limited number of circumstances. These include while intubating and during procedures that are aerosol-generating.
    • Swabbing is not an aerosolizing procedure.

    Please see the PPE Guidelines Chart Here.

    Precautions When Caring for Persons Under Investigation

    • Have all patients follow cough etiquette and hand hygiene.
    • Isolate any person under investigation for COVID-19. Place a mask on the patient and put in a private room or area, even if only curtained areas are available. A negative pressure room is not required.
    • Notify clinical staff, and institute droplet and contact precautions: regular mask, gown, gloves, and eyewear.
    • Clinical staff should use the Criteria to Guide Evaluation of Persons Under Investigation for COVID-19 to determine if further action is required.
    • Keep a log of all persons who care for the patient or enter the room.
    • If a patient is tested for suspected COVID-19, you must maintain the confidentiality of that patient and our process. Under no circumstances should members of our team share that knowledge with family, friends, colleagues, or on social media.
    • Do not comment on patients’ protected health information verbally or in writing, including commenting on social media. Doing so would be a violation of HIPAA and our social media policy.

    CHKD Treatment Guidance for COVID-19 in Children

    Click HERE for new treatment guidance and algorithm for patients with suspected or confirmed COVID-19 infection who are admitted to an inpatient floor or the intensive care unit.


    Screening Process to Determine Whether a Patient Should be Tested for COVID-19:

    We follow Virginia Department of Health guidelines summarized below for evaluation of potential cases using both symptoms and epidemiology details. EMTALA requires us to screen any patient presenting. It does not require us to test. Testing guidelines apply to all.

    • Fever and/or signs of acute lower respiratory tract infections, such as cough, shortness of breath, and
    • Close contact (more than 10 minutes, less than 6 ft with no PPE) with a laboratory-confirmed COVID-19 case.
    • When symptoms begin within 14 days of the travel or exposure to a known case.

    We are also testing all surgical patients prior to surgery.

    Patient Care Resources

    Resources to Share with Patient Families

    Isolation vs. Quarantine Resources for Families

    Isolation and quarantine are important facets of community infection control, but understanding the difference between them can be confusing, especially for families. To help them understand, the CDC shares this basic resource in English and Spanish.

    Additional Resources to Share with Patients and Families

    COVID-19 FACT SHEETS

    English

    Spanish

    Treatment Guidelines

    Visitor Limits and Screening

    Visitation Limits

    At this time, we are maintaining our current limits on visitation. Only one parent/caregiver is allowed for outpatient appointments and surgery. Home health aides who help parents get patients to appointments are also allowed. COVID-19 positive, exposures and PUIs admitted to the hospital may only have one parent, caregiver or legal guardian for the duration of their hospitalization. Other inpatients may have two. Everyone is asked to apply these rules consistently and not to make exceptions for anything other than compassionate or end-of-life circumstances. While necessary for safety, these limits are hard on families; seeing them applied inconsistently would only increase that hardship.


    Visitor Screening Process Update 

    To keep our facilities as safe as possible, we will begin screening all visitors to any CHKD facility. Centralized screening will resume at the following locations: Oakbrooke, Oyster Point, Tech Center, Medical Tower, and Concert Drive. Because temporary staff are being hired to support this effort, the timeline to begin this screening is still to be determined. When a date has been set, that information will be sent to the email groups of the individual locations.

    Security will continue to assist with screening visitors at the main hospital. A thermal scanning device has been installed in the main lobby so visitors won’t have to be stopped to have their temperatures taken individually. For all other health center and clinic locations, registration staff will continue to perform visitor screening. After-hours services, such as the sleep lab, will continue to screen their own visitors.

    Individuals who do not pass screening may not be admitted to the facility. Exceptions may be made for patients who show signs of illness related to the reason for their visit. For instance, a child with a fever who is coming to a sick appointment in a CMG practice may be allowed in, while a child arriving for a physical therapy appointment with a fever would not. These situations will be determined in advance and communicated to the screeners.

    Beginning December 1, we will also require screening for all visitors to non-clinical CHKD buildings, such as the Chesapeake Support Center, Redgate Office Building, the Hague, 905 Redgate, 841 Redgate, Health Center - South Campus (NDC) administrative floors two and four, and the Warehouse. This screening will consist of a temperature scan and verbal confirmation that the visitor is free of COVID symptoms. Staff will use infrared thermometers and the visitor screening algorithm when performing these screenings, and signs displaying the screening questions will be displayed to reinforce and expedite the process. We will use stickers to indicate that a visitor has been screened.

    A train-the-trainer approach will be used to prepare office and warehouse staff to perform visitor screening. Office and warehouse locations are asked to identify two staff members to attend train-the-trainer sessions. Those individuals can then train others in the building, as needed. Please send these staff names to Elizabeth Joslin to schedule training.

    Departments that need infrared thermometers to conduct their screenings may order them from Purchasing using item #28885. To order screening stickers, go to KDnet - Employee Resources - Office Supplies Ordering - Order Office Supplies from Office Depot. An individual in your department authorized to order supplies will need to sign into their Office Depot account and place an order for Avery 5664 labels.

    Be on the lookout for additional information on facility screening for staff and visitors in the coming weeks.

    Medical Records Pick-up

    Medical records will now be prepared for pick-up outside the front entrance of the main hospital.

    CHKD COVID-19 Dashboard

    Statistics for CHKD Covid-19 testing will be provided weekly for employees interested in seeing the data trends. A few key points when reviewing these visualizations:

    • Test data represents the PCR and RP2 tests we perform at CHKD on CHKD patients starting on 03/01/2020.
    • Antibody testing data is not included

    Every Friday we will update these slides with the most current data.

    Occupational Health

    Travel Updates

    With COVID-19 hotspots flaring in different areas, please continue to make wise decisions regarding travel plans. The CDC website is regularly updated to reflect the latest statistics on disease prevalence. We also share our own updated travel advisory here.

    International Travel

    Domestic travel screening forms are no longer required. If you have plans to travel internationally, please complete the travel notice form available here and send it to occupational health. Occupational health will notify your manager upon your return if your trip requires a period of quarantine (minimum 14 days). Human resources and occupational health realize and want to remind everyone that COVID hot spots and government travel advisories are subject to change at any time; it is not possible to guarantee that quarantine will not be required upon return. Employees are not paid for quarantine days resulting from personal travel if their PTO banks are empty.

    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 at work will be assessed according to the CDC risk exposure factors, available at this link: CDC Exposure Risk Categories in Healthcare Personnel. If the employee is quarantined, a leave of absence will be provided.
      • Employees who have been exposed to COVID-19 outside of the workplace through personal contact or travel will be assessed according to CDC guidelines. If they are quarantined, these employees will be eligible to use their paid leave banks.
      • The list of countries designated as a Level 3 Travel Health Advisory region is changing rapidly. For the most up-to-date information, visit the CDC’s COVID-19 website.

      Concerned About Exposure?

      If you are worried that you have been in contact with a community or family member under suspicion for COVID-19 (NOT CONFIRMED), please contact your PCP, urgent care, telehealth provider, or connect to MDLIVE, by signing in to your secure member portal or the Optima Health mobile app for advice. Please keep your manager up-to-date with results, and then please advise occupational health of the situation and recommendation.

      Return to Work Guidance

      CHKD is using the CDC Return to Work Criteria, which states the following, for staff members with confirmed or suspected COVID-19.

      Non-test-based strategy - Exclude from work until:

      • For known or suspected to be infected with the SARS-CoV-2 virus employees the symptom-based strategy excludes an employee from returning to work until at least 24 hours have passed since recovery, defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and, at least 10 days have passed since symptoms first appeared or since positive COVID-19 test if asymptomatic.

      Human Resources

      Maximum PTO Balance Extended

      In April of this year, the maximum PTO balance was increased from 320 hours to 400 hours due to COVID-19. The increased maximum balance was to remain in effect until the end of the year. However, due to the current surge in COVID-19, the impending flu season, and the upcoming holidays, the decision has been made to extend the increased PTO maximum until June 30, 2021. This gives employees with excess PTO hours additional time to use the hours before the maximum balance returns to 320 hours.

      Important: The 400 hour maximum will end with the last pay period in June of 2021. This means that, as of the first pay period in July of 2021, if employees have PTO hours in excess of 320, they will not accrue any additional PTO hours until their balance falls below 320 hours. Additional accrued hours will roll into EIB until their PTO balance falls below 320 hours. If you have questions regarding this change, please email  Kimberly.Moutvic@CHKD.org.

      Employees will not lose the excess hours – they will be able to use them until they are gone. Note: the maximum PTO hours that would be paid out if an employee separates is 320 hours.

      Optima EAP COVID-19 Recovery Plan for Staff

      Organizations that have experienced changes in their operations due to COVID-19 are busy making recovery plans, including CHKD. However, your own personal recovery plan is just as important as the organization's. A personal plan can help you re-engage in the most productive way possible as we continue to develop new protocols throughout the health system. Consider these tips from Optima EAP as part of your own recovery plan.

      Optima EAP COVID-19 Resource Center

      Optima EAP’s COVID-19 Resource Center is loaded with information to help you stay safe and thrive during this challenging time.

      Optima EAP Resource Center Link

      Remote Access Information

        COVID-19 CHKDHS Employee Benefit Related Information

        The following information has been provided by our benefit vendors. Please feel free to download and share this information as needed.

        NOTE: The MDLive related links below provide information related to a NEW BENEFIT that was added to our CHKDHS Health Plans effective March 23rd. Telehealth visits through MDLive are now covered at NO COST until February 28, 2021. Please review the documents below for more information.

        IMPORTANT: When accessing MDLive you will need to have your Caremark Prescription information available in case you are prescribed medication.

        Child Care

        We understand that many employees are struggling with child care issues. In addition to the offer from Childtime Learning Centers listed below, we are working with the EVMS Minus 9 to 5 program and the YMCA to identify additional options in our region.

        The Y Announces E-Learning Academy Full-Day Childcare

        The Y is now offering a flexible, full-day childcare option that will allow you to pick the days you need childcare, and will be designed to ensure that your child can complete their virtual learning as laid out by their school in a safe and nurturing environment at the Y. Registration is going on now and spots are limited. Get more details and register. Please complete our anonymous childcare survey to help CHKD assess the effect of remote learning in our schools.

        Childtime Learning Centers Offering Discounted Enrollment

        Childtime Learning Centers is now offering open enrollment for children of healthcare staff. The registration fee is waived along with a 10% discount to CHKDHS staff. Childtime has eight convenient locations with full and part time openings

        For more information, call Amber Vere at (757) 421-2718 or visit Childtime.com.

        Enhanced Family Support from Sittercity/Bright Horizons

        As part of CHKDHS’ commitment to provide support to employees and families during this challenging time, we are excited to announce that ALL CHKDHS employees (full & part-time & PRN) will have access to Bright Horizons Enhanced Family Supports™. Learn more at the links below:

        Staff Absenteeism Policy

        Click here to read the COVID-19 staff absenteeism policy.

        Staff Support

        Mental Health and Coping During COVID-19 Webinar

        For those who missed the free Optima Health webinar "Mental Health and Coping During COVID-19", it is now available on demand for you to view on the Optimaeap.com website. Login instructions are as follows:

        Support U is Here to Help

        When stressful events take place, recognizing that you need a little support is the most important first step to processing difficult emotions. Support U is here to help.

        The Support U team is made up of CHKD peers who are available to offer reassurance and support to providers who may need help. These volunteers can include physicians, nurses, pharmacists, pharmacy technicians, respirator therapists, social workers, and chaplains.

        Each member is dedicated and trained to support peers who need help or advice.

        To contact a Support U team member, email SupportU@CHKD.org.

        Tips for Coping with Stress

        Signs of stress are normal and may be more common in people with loved ones directly affected by the outbreak. In the wake of this pandemic, monitor your own physical and emotional health. Know the signs of stress in yourself and your loved ones. Knowing how to cope with stress, and when to get help, will make you and your community stronger.

        For more tips on easing stress during this difficult time, click HERE.

        Care for Caregivers

        To support our caregivers who are tirelessly supporting our patients and families, we have compiled the following list of resources intended to help you cope with stress and anxiety:

        Tips for Social Distancing, Quarantine, and Isolation During an Infectious Disease Outbreak, Substance Abuse and Mental Health Administration

        Taking Care of Your Emotional Health, Centers for Disease Control and Prevention

        Mindfulness and Relaxation

        Free Guided Meditations (resource only, not endorsed or promoted by CHKD)

        Virtual Counseling

        Optima EAP Virtual Counseling

        Finance

        GL Code for COVID-related Expenses

        The organization has established a GL code for any purchases related to our COVID-19 response. Please contact Walt Soto or Karen Mitchell for more information.

        Finance has prepared the following instructions to help with timecards and tracking expenses related to CHKD’s COVID-19 response.

        New Expense Coding Guidelines

        To ensure COVID-19 expenses are accurately coded and proper supporting documentation exists, please use these updated COVID-19 Expense Coding Guidelines. This will support any eligible expenses to be submitted for public assistance reimbursement.

        New Employee Pay Codes

        Click the following link for COVID-19 Related Specific Work Hours and Employee Leave pay codes.

          General Information

          Clergy Visit Process

          Regulatory bodies such as the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) have affirmed that, even during a pandemic, “facilities must ensure patients have adequate and lawful access to chaplains or clergy.” When staff learn of a patient’s/family’s request for a clergy visit, they should contact Chaplaincy Services by calling 8-5381 or paging 554-6776. The same process should be followed when clergy arrive in the hospital lobby.

          COVID 19 Basics for Non-Clinical Staff

          Droplets, PPE, reagents and swabs? We spend so much time communicating important medical information that we forget that many of our employees don’t have a medical background. Click HERE for the basic COVID-19 facts with a minimum of medical jargon.

          Research and Clinical Trials - Guidance for CHKD Investigators

          The following guidance has been issued regarding any research protocol approved by the EVMS IRB:

          • The IRB office remains open, but is physically closed. All submissions should be through IRB Manager. The requirement for delivery of signed hard copies of documents is being waived at this time. Please sign, scan and upload all signature pages.
          • Principal investigators should work closely with study sponsors regarding amendments to study procedures, as well as missed study visits/treatments a result of COVID-19 facility restrictions.
          • In an effort to contain the number of unnecessary visitors in facilities, any face-to-face study procedure or visit that is not essential to a subject’s health and safety must be paused. Some visits may be eligible to be conducted remotely via phone or telehealth. Please discuss with sponsors as needed.
          • There is a tiered system that EVMS has implemented for decisions on what studies/procedures are allowed to continue. This information can be found on the IRB’s web page at the following link: https://www.evms.edu/covid-19/research_guidance/.Investigators must contact the IRB office for approval to continue studies in the treatment tiers. Please do this ASAP.
          • Review of new studies will continue; however, the tiered system will apply until further notice. Therefore, enrollment in a non-treatment study will be on hold even if approval is received from the IRB. **This will not apply to survey or computer-based studies that do not require in-person visits.
          • If you have sponsored research that is supported by the CHKD Clinical Trials Unit:

            • The majority of these studies are reviewed and approved by IRBs outside of EVMS. The research office is closely monitoring communication from those IRBs and will provide updates as necessary.
            • The research coordinators are communicating with sponsors and CROs daily, to both provide and receive information to guide how these studies are moving forward.

            Please note that there will be NO interruption to studies where our patients are receiving investigational drugs as treatment.

            Many of our patients rely on the research pipeline to receive vital, cutting-edge treatments across all of our service areas. We expect that these studies will continue uninterrupted to the extent that it is safe and feasible to do so. The research office will continue to work closely with sponsors and IRBs and provide updated information to investigators as we have it. Please direct any questions to our main line at 668-9991. You can also reach the EVMS IRB at 446-8423.

            Adjustments in Parking Assignments

            • Lot-19 staff parking will have temporary access to PG#3 on Fairfax Ave.
            • Lot-19 NDC staff will have access to Lot 6 next to public health.
            • Contractors that are normally on Front Street will have access to Lot 19.

            For those with temporary parking adjustments, there is no action needed on your part to access these parking areas.

            Parking media and assignments can only be picked up at the security window at the ambulance entrance during badging hours (7 a.m. to 9 a.m, 11 a.m. to 1 p.m., 3 p.m. to 5 p.m., and 11 p.m. to 1 a.m.). All forms and maps are on KdNet for parking changes and needs.

          Café Restrictions and Food Deliveries

          NEW - Important Reminder: Shared Meals = Shared Risk

          Eating together remains one of the easiest ways to spread COVID-19 among colleagues. When teams or departments eat together, exposures can require quarantines that disrupt our ability to provide care. Please resist the temptation to eat together. It isn’t worth the risk.

          Staff Access to Café

          KD café will be re-opening to hospital staff on Friday morning, June 12. The temporary staff café on the 6th floor will return to conference room space at that time. Order/pick up will continue to be available by sending the online order form to foodandnutrition@chkd.org. The café is only able to prepare orders that are received with an attached order form. Please allow 20-25 minutes so we may freshly prepare your order. You may pick up your order at the pizza station. Due to social distancing, we will have limited seating in the café. Please reserve the dining room seating for patients and family members as a first priority. Additional seating will be added in the coming weeks.

          Outside Food Deliveries

          To minimize lobby traffic, only curbside delivery will be allowed at this time. Please give the delivery person a phone number to call to notify you once they have arrived, and inform them that they are to remain at the curb.

          Please clean any outside containers and always perform hand hygiene when leaving and entering the building.

          Need Information Services?

          Please help information services process your request quickly and efficiently by submitting it through their customer service portal.

          Just click on the link above or find it in the popular links section from KDnet's homepage (far left). Using their forms ensures that they have the information needed to process your request.

          Please note: This link can only be accessed from inside our network. Unless you remote into our network from home, this function is not available and can only be accessed from your work computer.

          If you are working from home without remote access, but need to speak with an IS service desk specialist, please call (757) 668-7075.

          Remote Access Information

          (757) 668-7238