Temporary Guidance during COVID-19 Pandemic
May 12, 2021
The goal of this visitation guidance is to protect medical staff and beneficiaries from unnecessary exposure to COVID-19. The local HPCON level and medical necessity may dictate processes that are more restrictive than shown below.
Visitor – relative, partner, friend, or colleague that is a guest of an inpatient.
Caregiver – relative, partner, or friend of the patient (or parent/guardian) who chooses to provide assistance with transportation, rehabilitation, psychosocial support, and/or cognitive needs of the patient in both the inpatient and outpatient settings.
PUI – patient under investigation for COVID-19
No visitors are permitted at WRNMMC. This applies to both the inpatient and outpatient settings.
All Inpatient Caregivers:
All inpatient caregivers must take the following steps to obtain authorization for visitation on an inpatient ward:
- Proceed to the Command Duty Office (CDO) or Patient Administration Department (PAD) located in the Eagle Zone (Bldg 10, 1st Floor) and identify as a caregiver of an inpatient whose medical team has granted approval for visitation based on the stated criteria below.
- Review and sign consent memorandum confirming adherence to all public health and infection control procedures, to include:
- Wearing a mask at all times in accordance with current hospital policy
- Maintaining six feet of physical distancing within the patient room as much as feasibly possible
- Performing hand hygiene immediately upon entering and leaving the patient room
- Limiting movement to other areas of the hospital except as necessary for transit to and from the patient room
- Acknowledging potential risk of exposure to COVID-19 infection while in the hospital.
- Daily COVID/influenza-like symptom assessment by ward staff.
- Acknowledging that failure to adhere to these requirements may lead to revocation of caregiver privileges.
- Present the signed consent memorandum to the nursing station of the inpatient ward.
- No PUI or COVID-19 positive caregivers are permitted to visit a patient on the adult inpatient ward.
- One caregiver is permitted for accompanying patients for hospital discharge. Caregiver must report to PAD located in the Eagle Zone (Bldg. 10, 1st Floor) to inform them of patient pick-up. Caregiver must wait in the lobby while nursing staff brings the patient downstairs.
- One caregiver is permitted for patients undergoing emergency surgery or procedure. Caregiver transit is restricted to the surgical waiting area and the patient room.
- One caregiver may be present in the hospital at any one time for Wounded Warrior and Medevac Patients.
- Two caregivers are allowed for patients receiving End-of-life care (when care has been transitioned to Comfort-only directed care or patient death is imminent despite medical interventions as deemed by the medical team).
- One caregiver may be present for major life-altering medical conditions, treatment decisions, or anticipated extended hospitalizations.
- One caregiver may be present for patients deemed to have a very poor prognosis or in immense physical or emotional suffering where direct face-to-face support of a caregiver would benefit their care.
- One caregiver may be present for patients with severe neurocognitive deficits or psychiatric illnesses where a caregiver would assist in overall improvement and optimization of the patient’s medical care.
- Exceptions to the above may only be made on a case-by-case basis by directorate-level exception. However, no caregivers will be allowed for adult PUI or COVID-19 positive patients except for end-of-life/withdrawal of care.
- The family of each pediatric patient is allowed to name up to two primary caregivers for the duration of the hospital stay. Only one primary caregiver may be present in the hospital at any one time. Designated caregivers will not change during the patient's hospitalization.
- Caregivers should be parents or legal guardians and must be in good health.
- No PUI or COVID-19 positive caregivers are permitted to visit the pediatric ward.
- Pediatric patients hospitalized as a PUI or COVID-19 positive patient are allowed only one designated caregiver who should stay with the patient in their room during the patient’s stay.
- Exceptions to the above may only be made on a case-by-case basis by directorate-level exception.
Neonatal Intensive Care Unit (NICU) Patients:
- Families of NICU patients are permitted to name up to two primary caregivers for the duration of the hospital stay. Only one caregiver may be present in the hospital at any one time. Designated caregivers will not change during the patient's hospitalization.
- Caregivers should be parents or legal guardians and must be in good health.
- All caregivers must wear a hospital-issued procedure mask when in the NICU.
- No PUI or COVID-19 positive caregivers are permitted in the NICU.
- Previously identified PUI or COVID-19 positive caregivers may resume visitation in the NICU after the following criteria are met:
- Ten days have passed since symptoms first appeared or individual had COVID positive test
- If immunocompromised or recovered from COVID-19 requiring a hospital admission, after 20 days have passed since symptoms first appeared or individual had COVID positive test
- Fever has been gone without the use of fever-reducing substances (such as acetaminophen or ibruprofen) for at least 24 hours
- Improvement from COVID symptoms
- No caregivers are permitted for infants who are PUI or COVID-19 Positive. Exceptions made on a case-by-case basis may include critically ill infants or end of life care (at the discretion of the attending Neonatology and nursing staff).
- One designated caregiver for obstetric patients is permitted for labor, delivery, and duration of mother's hospital stay. The designated caregiver should remain in the patient's room as much as possible. Exception may include visitation of infant in NICU.
- In the event of precipitous/urgent delivery when COVID-19 status is not yet known, the designated caregiver can remain with the mother if the following criteria are met:
- Both caregiver and mother do not have any COVID-19 symptoms
- Both caregiver and mother have no history of a COVID-19 positive test within the preceding 10 days
- In the event that a mother is identified as a PUI or found to have a positive COVID-19 PCR test, Infectious Diseases (ID) and Infection Control (IC) Services must be contacted for guidance on a case-by-case basis.
- Exceptions to policy may be considered for the following: end-of-life/withdrawal of care, stillbirth, peri-viable delivery, expected life-limiting or life-threatening condition for the newborn or mother.
- One caregiver is permitted to accompany outpatients in order to facilitate care or treatment. An exception for Pediatric patients authorizes minor siblings to be permitted when accompanied by the caregiver.
- Visitors are not permitted in the Emergency Room. On a case-by-case basis, and at the discretion of the ED attending, one caretaker may be allowed into the ED exam room to provide additional history to optimize the patient's medical care and assist with disposition. If the patient requires admission, the caretaker will not be allowed to accompany the patient to an inpatient floor unless they meet the previously mentioned criteria above or at the discretion of the primary medical and nursing team.
- Caregivers are not permitted in the adult cancer infusion suites. One designated caregiver may be allowed with a pediatric patient undergoing an outpatient infusion if the caregiver screens negative for COVID-19 symptoms.
- Caregivers are not permitted in the Perinatal Assessment Center (Building 10, 6th floor) as the rooms are too small to allow for social distancing.