COVID-19 Physician Information Update
May 5, 2020
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Updated Clinical Documents
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Order Sets, Procedures, Clinical Pathways, Guidelines and Policies
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LTC Principles for Decision Making
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The LTC working group believed it was important to support the difficult decisions facilities and staff are facing and that such guidelines can support consistency in how those decisions get made across the province. It is intended to be a tool against which facility administrators and staff can consider the decisions they make.
During the pandemic NSHEN is available to provide support with particular ethical challenges as they arise for long-term care facilities. Their contact information is included in the document.
The best place to access this document and other resources, ensuring the most recent versions are being used, is on the
NSHA COVID-Hub, which includes a section for COVID-19 Long Term Care.
We appreciate your ongoing thoughtful and considered decision making during this challenging time
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New COVID Hub Submission Form
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Since the launch of the
COVID-19 Hub, the Hub team has been working diligently to ensure health care providers and employees across the organization are able to access COVID-19 documents and content as quickly as possible.
Due to the rapid pace of COVID-19 content development and revision, there is a need to manage document submissions more efficiently. As a result, the Hub team has created an easy-to-use electronic
submission form in the About the Hub section for content creators to complete and attach to their documents for posting. Effective immediately, those wishing to submit content to the COVID-19 Hub for posting are asked to use this form instead of emailing policy directly. Documents that are sent directly to the Policy Content email address will be returned and authors redirected to the submission form.
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COVID-19 Guidelines for Home Visits of Primary Care Providers in Family Practice and Chronic Disease Management and Wellness
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Objective: These guidelines provide guidance for home visits to ensure the safety of patients, protection of providers, and reducing community spread of COVID-19.
HOME VISITS
When planning for a home visit, the health care provider must complete their previously established risk assessment to identify and eliminate hazards and risks within the patient’s home environment. In addition, the provider must complete the following IPAC home safety risk assessment in light of COVID-19, to verify that the home environment is suitable for providing care. This assessment should verify that:
- The client and household members are capable of adhering to the recommended precautions such as hand hygiene, respiratory hygiene, environmental cleaning and limitations on movement within the home.
- Household members maintain a physical distance of 2 metres from staff during the visit.
- The client has a means by which to communicate with their primary HCW should their condition worsen.
- Safety concerns are addressed such as fire hazards and risk for accidental ingestion associated with alcohol-based hand rubs.
On the day of the home visit and before entering the home, the primary health care provider must review the steps as outlined in
COVID-19 Quick Reference for Primary Care Providers in Family Practice “When the Patient is with you for an Appointment”. The primary health care provider should follow these same steps for all persons in the same household as the patient. In addition, the provider must complete the
Point of Care Risk Assessment (PCRA) to determine the necessary personal protective equipment. A home visit should not occur if the PCRA identifies a risk of exposure that requires droplet precautions. As well, the visit should only proceed if the patient and household members do not have any screening risk factors or identified symptom criteria. If the provider is unable to complete the above prior to the visit, these steps should be completed at the doorway at a 2 meter distance.
Notes:
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CSPL COVID 19 Bulletin #8
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Emergency Preparedness Week (EP Week) is an annual event that takes place during the first full week of May. EP Week is promoted as a time to encourage Canadians to take action to be better prepared to protect themselves and their families during emergencies. Together with community leaders, first responders, all levels of government and non-government organizations, we can build a more resilient and safer Canada.
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FAQs for Medical Device Reprocessing Staff about N95 Collection and Reprocessing
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NSHA has developed a strategy to balance supply and demand of our PPE. We have discussed the needs to manage our supply between shipments and NSHA has N95 supply to meet current needs.
As we move forward with our planning, we are preparing for all scenarios, including the potential of reprocessing. This is a back-up measure to prepare for any possible N95 shortage in the future.
We are collecting N95s for possible reprocessing and will be launching further N95 conservation measures. We will begin rolling out our collection strategy in targeted, high-use areas, such as ICUs, emergency departments, perioperative, and COVID units.
We are doing this to make sure that those staff and physicians who need an N95 to provide care safely could continue to access them even if we reached a point in the future where there was a shortage of supply. We are NOT asking staff to wear reprocessed N95 respirators at this time.
We have developed
frequently asked questions specifically for MDR staff about N95 collection and reprocessing and we recognize others may be interested in this information as well.
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Every year, May 5 is celebrated as World Hand Hygiene Day. In Canada, the 2020 national message is ‘Clean Hands Have Never Mattered More.’
As part of the campaign, we invite you to take the
Clean Hands Self-Assessment to see if you are following all the proper steps to clean your hands with soap and water or alcohol-based hand rub. These are unprecedented times and more than ever, we all KNOW that cleaning our hands is helping to FLATTEN THE CURVE and SAVE LIVES.
This year, we also wish to extend our gratitude and appreciation to NSHA healthcare workers, physicians, patients, residents and our essential visitors for your admirable adherence and commitment to hand hygiene practices.
There is no doubt; clean hands have never mattered more.
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Choosing Wisely Webinar Tomorrow!
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Income Stabilization Program
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Physician Reassignment Opportunities
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In response to the unique demands of providing care during COVID-19, NSHA is organizing opportunities for physician redeployment or reassignment. These opportunities are shared to physicians by your local leadership (ZMED, Department/Division Heads, Chiefs, Network Leads, and Site Leads).
The intent in all reassignment is to match physicians to the areas and needs that best match their skills, interests, and abilities. Physicians will be matched as needs arise across the province.
To date, the following areas have provided opportunity for physician reassignment:
- Long term care
- Inpatient care
- Secondary assessment centers
- Access Clinics – Primary Care
- Emergency Medicine
- ICU/Critical Care
- Primary Assessment Center
- Virtual Care
Current needs are met but we expect these needs to fluctuate in the future. It is important to build a robust roster of available resources in the event that care needs change quickly. However, in some cases, physicians who volunteer for redeployment may not be matched as there is no current need identified.
The following guiding principles are to be considered:
- All programs will endeavour to continue current service delivery (reduced/unchanged/increased) and assist with COVID-19 care.
- Each physician has the ability to contribute to our combined effort to support pandemic response.
- Clinical work for COVID-19 patients will be performed by physicians who best meet the required skillsets and who would typically provide this level of care.
- Physicians reassignment is a voluntary program.
- Department Head (s), Site Lead(s), Zone Medical Executive Director will make every effort to fairly and equitably reassign work between departments when required.
- Reassignment request (s) may exist to provide support in another zone and will only occur if there is a critical need. Participation in these opportunities is voluntary.
- Physicians who are quarantined or ill, they may be requested to support virtual care assignments or COVID-19 planning if they are well enough to contribute.
- Please see Occupational Health guidelines for staff with chronic conditions as well as pregnant staff. These will be considered in reassignment opportunities.
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Healthy Pictou County found an innovative way to celebrate Doctor's Day this year.
"With the help with Chapel Cove Chocolates, we provide each of our doctors with some tasty treats, along with some other goodies as well.
Something really special was we enlisted the help of local young artists to colour, draw and create cards and pictures of thanks, which were then placed in the lounge at the Aberdeen Hospital. We also added some extra treats in the lounge, and also some items to make it more cozy and inviting, thanks to McKean's Flowers and Forge Home and Garden."
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Provincial COVID-19 Status Update
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Today, May 5, Nova Scotia is reporting three additional deaths related to COVID-19, bringing the total to 41. The deaths occurred at the Northwood long-term care home in Halifax Regional Municipality.
"Today, sadly, we have to report three more deaths from COVID-19 at Northwood. I offer my condolences to the families and loved ones," said Premier Stephen McNeil. "We are working hard with the Northwood team and our partners have rallied around the home and its residents and staff. We will keep supporting them until this horrible disease is defeated."
As of today, Nova Scotia has 991 confirmed cases of COVID-19. Six new cases were identified Monday, May 4.
The QEII Health Sciences Centre's microbiology lab completed 454 Nova Scotia tests on May 4 and is operating 24-hours.
As of May 4, there were 11 licensed long-term care homes and unlicensed seniors' facilities in Nova Scotia with cases of COVID-19, involving 245 residents and 113 staff.
If you have two or more of the following symptoms, visit
https://811.novascotia.ca to determine if you should call 811 for further assessment:
- fever
- new or worsening cough
- sore throat
- runny nose
- headache
To date, Nova Scotia has 30,984 negative test results, 991 positive COVID-19 test results and 41 deaths. Confirmed cases range in age from under 10 to over 90. Six individuals are currently in hospital, two of those in ICU. Six-hundred and fifty-two individuals have now recovered and their cases of COVID-19 are considered resolved. Cases have been identified in all parts of the province. A map and graphic presentation of the case data is available at
https://novascotia.ca/coronavirus/data .
Public health is working to identify and test people who may have come in close contact with the confirmed cases. Those individuals who have been confirmed are being directed to self-isolate at home, away from the public, for 14 days.
Anyone who has travelled outside Nova Scotia must self-isolate for 14 days. As always, any Nova Scotian who develops symptoms of acute respiratory illness should limit their contact with others until they feel better.
It is now more important than ever for Nova Scotians to strictly adhere to the public health orders and directives - practise good hygiene, maintain a physical distance of two metres or six feet from others, limit essential gatherings to no more than five people and stay at home as much as possible.
Quick Facts:
- testing numbers are updated daily at https://novascotia.ca/coronavirus
- a state of emergency was declared under the Emergency Management Act on March 22 and extended to May 17
Additional Resources:
Government of Canada toll-free information line 1-833-784-4397
The Mental Health Provincial Crisis Line is available 24/7 to anyone experiencing a mental health or addictions crisis, or someone concerned about them, by calling 1-888-429-8167 (toll free)
Kids Help Phone is available 24/7, by calling 1-800-668-6868 (toll-free)
For help or information about domestic violence 24/7, call 1-855-225-0220 (toll-free)
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This section of our update is a list of helpful resources updated daily for physicians.
Please reach out to
Shawn Jolemore with your suggestions for additional content.
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Leadership and Wellness Poster
Updated for Week of May 4 - May 10
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Individual Executive Coaching for Physician Leaders with Executive Coach Lorie Campbell
Are you struggling to lead yourself or your team(s) well during this pandemic?
Take advantage of 30 or 60-minute focused, one-to-one virtual executive coaching sessions for formal physician leaders only. Email
Lorie Campbell to book a time for this free service, provided by NSHA Medical Affairs Leadership Development.
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Special Webinar for Physician Leaders
May 6 from 7-8 p.m.
“COVID – What’s normal? Leading through crisis and change” with Dr. Jackie Kinley and Tony Case. Presented by Physician Leadership Development for formal physician leaders. For more information, contact
shawn.jolemore@nshealth.ca.
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Daily Physician Wellness Check In - COVID-19 What's Normal?
Join Drs. Jaqueline Kinley and John Chiasson for daily online meetings to chat about coping strategies and mental health concerns. Meetings are daily M-F at 12 NOON. and are open to all physicians. Click here for the
*updated* Zoom -
Join Zoom Meeting Link
New Local Website offering Support and Resources for NS Physicians
Please visit a new
website full of helpful resources and important contact information for NS physicians and their families, brought to you by volunteer members of the Dalhousie University Department of Psychiatry and Doctors Nova Scotia’s Professional Support Program.
Communication about Substance Use
With Dr. David Saunders, Wednesday, May 6, 4-5 p.m.
Mindfulness for Physicians: Incorporating Self-Compassion
With Dr. Nicole Herschenhous, Friday, May 8, 4-5 p.m.
Addressing Grief within our Healthcare Community: Mine, Yours & Ours
Weekly on Thursdays from 9:30 a.m. to 10:30 a.m.
Join Serena Lewis and Roy Ellis (NSHA Bereavement & Grief Coordinators) as we begin the conversation of grief in our current and future workplace. This discussion will provide information on recognizing and understanding how loss is intertwined in our lives, as well as the current landscape of our community of care providing. Roy and Serena want to hear what topics will benefit you in the upcoming weeks that will support you - as you care for yourselves, your own families and within patient care.
DNS Professional Support Program
Feeling overwhelmed or need to talk to someone?
As we try to wrap our heads around the weekend’s tragic events and the senseless loss of so many innocent lives, I want to remind you that help is available. Whether you were directly connected to it or not, the tragedy intensifies the stress of the pandemic and the pressure on our lives due to the measures we are all following.
Contact the Doctors Nova Scotia (DNS)
Professional Support Program at 902-468-8215 or 1-855-275-8215 (toll-free) mail or via
email. LifeWorks by Morneau Shepell is also available to members and their families affected by the events in Portapique and surrounding communities. The crisis support line is open 24-7. Call 1-844-751-2133.
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Physician Screening for COVID-19
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Call 1-833-750-0632 to speak to Occupational Health and Safety for your screening options.
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