Physician-in-Chief's Message
May 15, 2020
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Dear Colleagues,
This week has been busy as we have ramped up surgeries and outpatient visits.
Please see important updates below! Thank you to Tom Belhorn for his Q & A section!
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Pre-Operative/Pre-Procedure Testing Update
- We will now be able to test our pre-operative/pre-procedure patients in a shorter than the 5 day window time frame. It has been approved that we have a new process for COVID-19 pre-operative/pre-procedure testing for Children's OR patients for which the 5 day time frame would jeopardize patient safety. Remember, ideally, you would schedule your patient 5 days out for surgery/procedures and use the "in basket" message method, as outlined in the attachment I sent you-all in my most recent communication.
- For now as a pilot process, the following will occur for outpatients who must be scheduled in the less than 5 day time period, as determined clinically by the surgeon/proceduralist .
- The charge nurses from our COR, (as determined by Sara Lisinski) AND our Children's Specialty Care team,(sedation's, procedures and MRI, IR etc.) will obtain training on how to schedule COVID-19 testing. This is a 1 hour training done by the Chapel Hill RDC folks. This will take place Monday and Tuesday. Then, when you have to add a patient on the OR schedule that is an outpatient, for 2-4 days out, a member of our team as fore mentioned, will have access to the RDC schedule, will call your patient, and schedule their COVID-19 test to occur within 48 hours of the operation/procedure.
- This will go live Wed, May 20, 2020.
- This is just for the Chapel Hill RDC.
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Your COVID-19 Questions & Answers
Response from Tom Belhorn
Q:
I heard on the news that one of the rapid tests, an Abbott COVID test I think, was not as good and missed a lot of true positives. Is this true, and can we get a larger number of more accurate rapid tests to use?
A:
This week news outlets have reported about several less accurate COVID tests on the market. The UNC lab has two types of batched tests and the one rapid test for COVID-19 PCR in current use. All three of these tests have comparable (and excellent) sensitivity. As stated before, even though these tests are quite sensitive, results always depend on the quality of the sample and the stage of infection in the patient (a great NP swab in a person with early symptomatic COVID-19 will yield a positive result!). Our rapid test is accurate, but it is true the supply is low. We have an average of 48 tests per day available and this week we have used many more than that each day. New guidelines for use of the rapid test will be distributed early next week. We are always looking to access a larger number of more accurate rapid tests, but availability is low. The newer rapid antigen test is not nearly as sensitive as the PCR (as expected), and the newer saliva tests are also not as sensitive compared with assays using NP swabs. Stay tuned for further updates on advances in testing and availability of these assays at UNC.
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The UnMask Project
After 2 months of wearing face masks we can all agree that providing patient care while wearing masks is disorienting, impersonal and confusing for patients, families and for us as well. We have a solution: UnmaskUNC badges!
Dr. Yael Shiloh-Malawsky, Assistant Professor Child Neurology, and her daughter Gilly
developed these picture badges. Particularly helpful with children and patients with cognitive disabilities, these picture badges can help us connect with patients, and remind patients and families that we have faces and smiles!
Below is an example of an unmaskUNC badge from our very own, Dr. Katelyn Bricker.
- photo
- name
- role/position (resident, fellow, attending, nurse coordinator...)
- Infection prevention recommends that, similar to other wearable items, it should be wiped down daily, and should not be worn over isolation gown.
- We will get it ready and delivered, free of charge.
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Blessings for Donning and Doffing
Hadley Kifner, our pediatric chaplain wrote this attached blessing for the health workers.
PPE (personal protective equipment) protects your body from exposure to a virus while you care for vulnerable patients. Protecting your mind and spirit is important while you work, too. You are valued and special; your skills are needed and appreciated. As you serve to help others heal, your whole self is worthy of being healthy and strong, too. As you like, incorporate the below meditative words into your practice as you donn and doff PPE. These blessings are from no particular spiritual tradition and yet they are written on purpose with courageous clinicians – like you - in mind.
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Have a wonderful weekend!
Gratefully,
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