LRH during COVID times

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Advice
to the patient
  • All patients entering the hospital premises should wear a mask.
  • Reserve an appointment (date and time) before coming to the clinic.
  • Wash hands before entering the buildings.
  • Obtain a triage pass from the counter and provide correct information.
  • Only one bystander is allowed per patient.
  • Only one visitor pass is given per patient.

Since the beginning of the community spread of the COVID-19 LRH was identified as a hospital to treat suspected patients. LRH so far has managed over 140 suspected patients including 3 positive patients. Maintaining essential health care services while ensuring protection of the staff

  • Allocation of 1/3rd of the staff of a Unit to work at a given point to prevent team overlapping and to ensure continuity of the healthcare system even if there is a staff exposure.
  • Distribution of drugs to the patients through post – must make a note of appreciation to the Consultants and Medical Officers who gave their personal contact numbers willingly for the benefit of the patients which were published through media and social media. Pharmacists who worked day and night for this task. Clinic and ward staff and the administration for their untiring efforts to make this mission a success.
  • With much gratitude the administration commends the continuous supply of Personal Protective Equipment by numerous donors at various occasions.
  • Being mindful of the limited resources, administration decided to make arrangements for sewing linen masks with a filter which can be reused. Special thanks to the Consultant Microbiologist and the team of Matrons and the nursing and supportive staff including seamstress who went out of the way to make this a reality.
  • Arrangement of triage counters for the hospital with the facility of the sound system and patient examination booths. Special thanks to the Sri Lanka Navy and other donors contributed.
  • Renovation of Isolation ward which was funded by UNICEF and constructed by Sri Lanka Navy with labor cost free of charge.
  • Structural changes done by the Sri Lanka Navy in the MICU Isolation room designated to treat COVID-19 suspected critically ill patients.
  • Decontamination of the Respirator (N95/KN95) masks. With the guidance of the Director and Consultant Microbiologist the Sri Lanka Navy constructed the Respirator mask decontamination chamber. Through which these masks can be reused uptill 30 times. Thus saving money used on purchasing.
  • Formation of the COVID CELL.
  • Special thanks to our frontline Health care staff. Especially Medical Officer – Infection Control for taking samples for PCR test fearlessly from the suspected patients daily.
  • Patients visiting the hospital were given continuous education on safety measures and social distancing.
  • Separate Register has to be maintained for the surgeries and procedures & staff involved as well as the patients details during this period.
  • Several guidelines were issued by the Director from time to time according to the Health Ministry updates.

After 2 months of curtailing routine work, the administration decided to commence 25% of hospital routine work from 04.05.2020 considering the long waiting lists at LRH and many thousands of children attending clinics at LRH.

STAGE 1 – Over the phone – 6 Questions Contact history, symptoms, from high risk area? (COVID-19 Form 1) If concerns discuss with the relevant Consultant and Consultant may contact Isolation Incharge VP. Send the list of patients to OPD Nursing Incharge.

STAGE 2 – Entering hospital/ On Admission – Triage Nurse (Non Respiratory ‘B’ side) to ask 5Qs of COVID-19 Form 2 and commence filling of COVID-19 Form 3, checked by MO-OPD and attached to BHT. If concerns mention in the form and inform the relevant MO Admission at OPD.

STAGE 3 – Ward/Unit Triage – MO/Intern MO to continue filling the COVID-19 Form 3 – checklist for every patient

Form 1 – Guide for STAGE 1 ‘Over the phone’ triage

Form 2 – Guide for STAGE 2 Triage by Nursing Officer at triage counter

Form 3 – Checklist to be filled and attached to the BHT for all Requested Admissions

Form 4 – Checklist to be filled and attached to the BHT for all Casualty Admissions

Five Triage Centres were established proximate to the entrances at LRH where Nursing Officers will ask 6 questions, check temperature and issue colour coded Triage chit mentioning fever, presence of respiratory symptoms and COVID-19 suspicious history.

PINK – Respiratory ‘A’ side – for all patients with respiratory symptoms

GREEN – Non Respiratory ‘B’ Side and GREEN – Non Respiratory ‘C’ side – all patients coming for routine admissions and clinics/investigations/reviews in the ward/dressings/ suture removal/ therapies etc.)

WHITE – Accident Service

BLUE – Orthopedic clinic entrance – Patients coming for routine clinics/investigations/reviews in the ward/dressings/ suture removal/ therapies etc.)

Measures taken to minimize the crowd entering the premises. Currently, developing an e- solution for this purpose which includes teleconferencing and file sharing platform is at planning stage.

  • List of contact numbers from units were published for the patients to contact relevant unit
  • The medical officer would decide on the mode of treatment according to the clinical needs of the patient.
    • Direct the patient to the closest hospital where the required specialty care is available.
    • Give priority to the patients who definitely need tertiary care urgently.
    • An appointment (date and time) will be reserved for the patient who needs to attend the clinic.
  • Advantages – Cost effective for the government. Cost effective for the patient (eg. Transport, lodging etc.)