COVID-19 Bulletin: Thursday 29 October 2020

October 29, 2020

Welcome to your Thursday edition of the COVID-19 bulletin. Today we are updating you on a number of pandemic response matters, including important changes so please make sure you read the bulletin thoroughly.

But before this the Trust wanted to take this opportunity to thank you for your outstanding efforts which have seen us through this far. Please do not neglect your wellbeing, but take the time to explore all that we offer across our organisation to help you retain your equilibrium whilst we continue to respond to the challenges of COVID-19.

Your own wellbeing, and that of your teams, remains vital, particularly as we see steady increases in the numbers of patients who are positive for COVID-19. If there is any other support that you think we could provide to you or your colleagues please get in touch. We want to make sure that we do all we can to support each other throughout these challenging times.

Numbers not statistics: This week (Last week)

1. Farewell to Lilac and important changes ahead

In response to the changing environment and as we experience a significant upswing in numbers of COVID-19 positive patients needing our care, we have made the decision to close our Lilac stream and revert to Green, Amber and Red wards to ensure we can provide safe care for every patient, bringing us fully into line with general NHS classifications.

This reflects the fact that we are seeing a high number of asymptomatic COVID-19 positive patients in Amber areas and will help improve safety with improved flow from our busy ED and AMU departments. All Lilac wards will become Amber, with all Lilac COVID positive patients moving into Red streams. Every patient left in our Amber wards will be risk assessed and where there is a suspicion of COVID being present they will be nursed in an appropriate environment while rapid testing swab results are awaited.

What the closure of Lilac wards means for you is that it is essential you follow infection prevention and control policy and procedures strictly to the letter, ensuring at all times you adhere to the correct PPE for the area you are in. Enhanced PPE is available for any colleague whose risk assessment requires it. To remind you of your obligations see the guidance on Connect.

To ensure that all colleagues understand and are applying the policy correctly, we will be auditing compliance through the use of spot checks, as we are taking an extremely firm line on the appropriate use of PPE within our buildings, social distancing whilst at work and regular handwashing. We expect all colleagues to comply with our PPE policies, that includes wearing masks in all clinical buildings and being socially distant from one another. There is no such thing as a “work bubble”. Any repeated breach of our PPE guidelines will result in disciplinary action. We are sorry to have to take such a strong line on this but we owe it to each other and to our patients to do the right thing to protect each other and ourselves.

Please note: If you require new IPC classification posters for your area they can be collected from Medical Illustration at City or the Communications Office, Trinity House, Ground Floor, Corridor A at Sandwell.

2. Masks for all

Masks for patients

To provide added assurance around our Lilac/Amber ward changes, from today all inpatients (with exceptions including children under the age of 12, patients with dementia or anyone with a medical or psychological reason who is unable to) will be asked to wear a fluid resistant surgical face mask while they are out of bed for any reason, including sitting in a chair at their own bedside. Please promote patient hand hygiene as well. The reason for this is because of the rising number of asymptomatic patients that we are finding through our screening procedure. We simply must make every effort to provide as safe an environment as we can within our Trust. We will provide masks for patients which will be distributed to them along with an information leaflet on their admission to the ward.

You can see below the flow diagram for the escalation process, or alternatively click here.

Masks for colleagues

Due to the high and increasing rate of community infection, we must do all we can to reduce infection transmission and infection in staff. We are therefore looking at the processes needed for colleagues in non-clinical areas within our Trust – such as offices like those at Trust HQ and Trinity House, as well as other ‘separate’ areas off the main hospital blocks – to wear a mask at all times (where there is more than one person in a room). This is irrespective of and in addition to social distancing measures currently in place.

There will be more definitive information on this in the next day or two.

How to wear your mask

We have all seen people wear masks in an incorrect manner – sometimes even in truly bizarre ways. It is inevitable with the changes above that patients will need reminding of this, as well as colleagues. The instruction here is simple – your mask should cover your mouth and your nose. See our ‘dos and don’ts’ graphic below:

3. Lending your support to Critical Care – Join the ICU Reservists Team

Thank you to everyone who stepped forward and supported colleagues in Critical Care during the first surge in COVID-19 cases earlier in the year. We are now looking to welcome nursing and health care support colleagues from across the organisation in to our newly formed ICU Reservist Team.

With cases of COVID-19 beginning to once again increase, we may need to increase the size of our ICU service significantly at short notice to cope with the additional clinical needs. To cope with this, we need people like you to make sure we do it quickly and safely.

If you have previously worked in Intensive or High Dependency care, have other skills that you think you could offer or just a wish to be part of the Intensive Care response to COVID-19 then please register as an ICU Reservist.

Your contribution could vary from occasional Bank shifts to full redeployment for the duration of the pandemic and the team will work with you and your current managers to facilitate that. You will be offered training and support to help you become an essential part of our team.

Click here to complete a short form in regards to joining the ICU Reservists Team.

4. Swabbing guidance on issues and pathways

An increasing number of COVID-19 swabs are being rejected from the laboratory, due to a number of issues. This may include a specimen leaking, incorrect swab received, or duplication of samples.

Our Infection Prevention and Control team has put together a document which lists common issues and the relevant solutions. Click here to read the full document.

We have now increased the availability of urgent and rapid PCR sampling from 16 to 76 samples per day.

Routine samples: It has been agreed that COVID-19 samples will be collected by porters from all wards, ED and AMU every hour at City and Sandwell from 8am to 8pm.

Overnight samples (taken after 9pm) which are mainly taken in ED and AMU should be kept in these areas overnight to be collected by a porter during the early morning run at 5.30am.

Urgent samples: Please ensure that the ‘Urgent 2 Hour TAT’ sticker is attached to the outer blue transport bag and is hand delivered to pathology reception. DO NOT put urgent samples into the MediBins.

 Remember:

• Every patient MUST be swabbed on admission.
• Patients on Amber wards MUST be swabbed every five days.

Please refer to the following swabbing pathways for unplanned and planned admissions.