What’s Included Here

*(subject to change with new developments)

PRE-VISIT SCREENING

STAFF must conduct a screening call before care is given to our patients for that day.

The following screening questions must be asked prior to providing care:

• 1– Exposure: In the past 14 days, have you or anyone in your home/facility had close contact with anyone diagnosed with or suspected to have COVID-19? 

• 2 – Symptoms: Do you or anyone in your home/facility have any signs or symptoms associated with Covid 19 including: raspy/itchy/sore throat, cough, fever, or shortness of breath? Fatigue? Muscle or body aches? Headaches? New loss of smell or taste? Congestion/Runny Nose? Nausea/Vomiting, Diarrhea? {yes/no}

Educate your patients on the following 3 visit protocols they must follow:

• 1 – Physical Distancing: Limit exposure in the home both for yourself, your patients and their families/caregivers. Attempt to maintain physical distancing, to the extent possible, by standing 6 feet apart.  When needing to teach caregivers, try to do so over the phone or via telehealth after your visit, or attempt to maintain distance of 6 feet while doing so. 

• 2 – Covering Face: INFORM your patient and their families/CGs of the NEED to cover their mouth and nose with a mask during your visit, WHETHER or not they have any Coronavirus symptoms or have been fully vaccinated. 

• 3 – Daily Temperature Checks/Symptom Assessment: Educate your patients and their caregivers to be alert and assess for symptoms associated with Covid 19 including monitoring of temperature for fever of 100.4 or higher, loss of taste or smell, etc. 

Once these questions have been answered, include the response in your visit note to document that you 

conducted the pre-visit screening. If the responses indicated a potential risk or exposure, immediately notify the management team and hold off on your visit until further orders are received by the patient’s doctor.

Please screen your patients on the morning of your visit, prior to driving out to see them. Please put in Forcura, if you are the first staff member out to see the patient for the day, that pre-screening was completed. DON’T forget to also ask the screening questions about anyone else who is living in the home with them or has visited them in the last couple of days. This is another vital, but forgotten, part of the screening process.

If you do not receive an answer on your pre-visit call, please ask patient/family/CG the screening questions at the door before entering the home.

Although we may not be able to know for sure if the patient or their CG/family we are visiting has contracted the virus or not, the least we can do is find out if they are exhibiting any signs and symptoms.

For all patient visits, please ask your patients and their caregivers/family members to use their own hand soap, alcohol hand sanitizer, masks, PPE, etc. for themselves and save your limited supply for your own use. If a patient (and/or a family member/CG) has been tested for Covid-19 or has tested positive, you MUST inform the admin team. Valeo Home Health and Hospice/Hearts for Hospice and Home Health Covid+ Patient Protocol will be initiated. 

HAND HYGIENE  

The number one way to combat the spread of this virus is through proper hand hygiene. Hand washing with soap and hot water is the best measure to prevent spread of COVID-19. 

All clinicians and their patients must wash their hands using soap and hot water for 20 seconds at the start of every visit. Clinicians must also perform hand hygiene at the end of every visit and throughout the visit as appropriate. 

When washing your hands, please thoroughly scrub the palms, the top, each individual finger including between fingers, under the nails and around the cuticles. 

If there is no soap and running water, or if it is difficult for you or your patient to get to a sink/basin to wash hands, you and your patient may use alcohol hand sanitizer of at least 60% ethyl alcohol or 70% isopropyl alcohol and rub all surfaces of your hands for 20 seconds. You will need to follow the same exact process of scrubbing your palms, the tops of your hands, each individual finger including between fingers, under the nails and around the cuticles when using hand sanitizer. 

Use a barrier such as tissues, paper towel or gloves to touch door handles and faucet handles in patient’s homes and avoid touching household surfaces with your bare hands.

PERSONAL PROTECTIVE EQUIPMENT

All staff, regardless of vaccination status of themselves or their patients, should wear a well fitting cloth or surgical mask when providing patient care and in a patient’s home/facility. For those patients who are either Covid 19 positive; have a Covid 19 positive family member or caregiver in the home; or who have been exposed to a Covid 19 positive individual within the last 10 days,  all clinicians providing care MUST wear a N95/KN95 mask, face shield or googles, and gloves. In addition, for those staff members providing personal care, wound care, etc where contact with bodily fluids may occur, a gown should be worn. 

You may reuse your mask from visit to visit by observing the following protocol:

• Wash/sanitize hands thoroughly as described above before removing your mask or at anytime you touch your mask. 

• After your visit once outside the home, remove your N95 mask/cloth/KN95 mask, being careful to not touch your eyes, nose or mouth or the INSIDE of the N95 mask/cloth mask. Place your N95 mask/cloth/KN95 mask in a breathable bag.

1. We have provided a UV light apparatus in both the SL and Orem locations for sanitizing of masks. We request you sanitize your N95/KN95 masks on a weekly basis. Cloth masks should be washed DAILY.

We have a ready supply of PPE to protect you and those you care for. If you have a need for additional equipment, please let the office staff know so that we can make it available for you to pick up.

PATIENT SIGNATURES 

If you are comfortable obtaining a patient signature on your device, please sanitize your device by cleaning with a 70% isopropyl wipe before and after signing. If you or your patient are not comfortable sharing your device, pull up the red house while at the patient’s home to get the gps location and tap “patient unable to sign”. The GPS address stamp will serve as your locator. Please remember that in order to obtain a correct location, you must close Wellsky/Kinnser out at the end of your visit prior to traveling to your next patient. An incorrect address may be noted if not i.e. your last location may pull up on the gps locator. 

EQUIPMENT/SUPPLY/NURSING BAG USE

For routine visits: ask your patient if they have a thermometer, BP machine and/or pulse-ox machine you can use for them so you don’t have to use yours. By using their BP cuffs, oximeters, and thermometers, the chances of cross contamination are reduced. In an effort to reduce cross contamination, if a patient is seen by multiple disciplines in a day and are not exhibiting any S&S related to vital sign issues or demonstrates need for VS check due to health issues such as orthostatic hypotension, HTN not controlled, Valeo Home Health and Hospice/Hearts for Hospice and Home Health will implement a once a day vital sign check. Vital signs are to be reported on the patient’s Forcura thread by the first staff member seeing that patient for the day so that other clinicians may record VS based upon these measures, as well as verification of screening questions. 

USE a barrier in each and every home, throw the barrier away after each use. Make sure that your barrier is large enough to place your bag on, as well as ALL equipment/supplies you may need for your visit. Get supplies out 1 time and zip bag back up until needing to place them back inside when visit is completed. MAKE sure that you clean all needed/used equipment (BP cuff, thermometer, oximeter, etc) BEFORE and AFTER each use/patient contact with an antibacterial cleaning solution and paper towel or with antibacterial wipes.  Spray/wipe YOUR bag down with Lysol or Clorax wipe/Disinfectant  or alcohol spray upon leaving the home, prior to placing on a barrier or in a container in the trunk of your car. 

• Supplies in a Disposable Bag: Carry wound care and foley catheter supplies into the patient’s home in a Ziploc or disposable trash bag that you can leave in their home. 

In ALL homes, take in ONLY the necessary items needed for your visit. In potential or suspected homes, use double bag technique. Place all necessary/needed items in Ziploc bags inside of a disposable trash bag. Open the trash bag up and use it as a barrier for your other items in the Ziploc bags. Once you have completed your visit, place your patient care items in their Ziploc bag, wipe the Ziploc bag down, and place on a barrier/in a container in the trunk of you car. Throw the trash bag away. Clean patient care items thoroughly prior to the next use with antibacterial solution and paper towel or antibacterial wipes.

PROTECT YOURSELF AND YOUR PATIENTS. Keep in mind, it is better to overdo washing/hand sanitizing/wiping than underdo. 

CHARTING IN THE HOME

We highly recommend that you limit the amount of time you are in a patient’s home to only hands-on care and head-to-toe assessment. Instead, complete documentation in your car both prior to and after providing care.  

STAFF MONITORING FOR SYMPTOMS

For those staff members who are NOT fully vaccinated (meaning that you are not at least 2 weeks from your last vaccination), daily symptom monitoring including temperature checks are required. If you are experiencing any S&S associated with Covid 19 or have a known exposure with an individual diagnosed with Covid 19, please inform your supervisor immediately. Covid 19 protocol will be initiated including testing and quarantine procedures

CARE OF THOSE WITH A COVID-19 DIAGNOSIS

ALL staff asked to see a potentially exposed, recently tested or confirmed + Covid 19 patient will be mandated to follow strict FULL PPE guidelines including: Face Shields, N95 mask, gown, gloves at all times while in the home. In addition, we will provide you the necessary protective equipment to have the patient/essential caregiver don prior to entry into their home to protect you including a mask. We will maintain strict PPE guidelines for a period of 20 days from onset of symptoms and 24 hours symptom free without the use of medications for all patients/caregivers.  

Telehealth visits, although not reimbursable (but payable to staff performing the telehealth visit), are allowable per Medicare and other payers in situations where they might be warranted. We ask that you utilize this resource to provide care as appropriate to your patients who either have been diagnosed with Covid 19; have been exposed to a positive Covid 19 individual; live with a positive Covid 19 individual or cannot be seen due to facility restrictions. The use of telehealth affords us the opportunity to supplement the care we provide and enhance the patient/caregiver learning experience.  For documentation purposes, please request a TELEHEALTH visit be added in Kinnser/Wellsky and document your virtual/telehealth “visit.” For payment purposes, please submit telehealth calls on a route sheet including whom you called and the length of time for the call. Telehealth visits/phone calls must reflect SKILLED NEED for reimbursement, to clarify a telehealth visit is not a check in call. 

PREVENTION 

The CDC has reinforced the use of everyday preventive actions to help prevent the spread of respiratory diseases and seasonal influenza. As always, please use universal standard precautions in each and every patient care situation. In addition, the use of a cloth or surgical mask for patient visits will continue to limit exposure between Home Health/Hospice staff and the patient’s/families we serve. Remember, hand hygiene is the number 1 way to prevent transmission of all diseases/infections.

THANK YOU for ALL YOU DO in protecting yourselves, our patients, their families and their caregivers.