Practices for Healthcare Providers and Patients

In an interview, Clinical Advisor asked Amy Fuller, DNP, the director of the Master’s Nurse Program at Endicott College in Beverly, Massachusetts, what steps nurse practitioners (NPs) and physician assistants (PAs) were taking to ensure the best prevention and treatment techniques.

Because the 2019 coronavirus outbreak has overlapped with the current influenza season, Dr Fuller noted that “it’s hard to differentiate because they both have the same kind of symptoms. But the incidence and prevalence for the flu is so much greater than for the coronavirus.” For nurses, NPs, and PAs, she noted that it should be “common sense” that if a patient is “coughing or sneezing, put a mask on.”

She continued by noting that both healthcare providers and patients should be “realistic” and that the SARS-CoV-2 virus will “be here with more of a presence than it is currently.” Healthcare providers should inform their patients to “avoid crowded places” and “avoid close contact with people that are sick,” in addition to avoiding cruise travel and nonessential air travel and staying at home as much as possible to further reduce the risk of exposure.4


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Another recommendation was for healthcare providers to be mindful of the patients who present to their practices and make sure to triage them immediately. It is important to be mindful of their symptomology, their contact with others, and their travel history.

Both clinicians and patients should avoid touching their face, nose, and eyes; be sure to wash their hands often with soap and water (for at least 20 seconds) or with at least 60% alcohol-containing hand sanitizer if soap and water is not available; and to clean and disinfect common surface areas in the home.4

When asked whether a patient should be self-quarantined or seen in a medical practice, Dr Fuller noted that it depends on the case. “I would certainly recommend self-quarantine if they have the risk factors…if [patient] symptoms are mild, and most cases are mild, [the patients] don’t require any kind of hospitalization.”

If a patient presents with symptoms, “the caveat could be that the nurse, NP, or PA can check on the patient in 12 hours and see how they are doing or instruct them to call back if their symptoms get worse. But if they just have cold-like symptoms with no fever, I’m not entirely invested in sending them to the hospital.”

There is currently no vaccine or antiviral to treat this infection. Current treatments may include fever-reducing medications but “the last thing we want to do is have a big rush of people to the hospital who only have mild, cold-like symptoms.”

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Risks and Symptoms to Look Out For

According to the CDC, it is important for healthcare providers to pay attention to symptoms such as fever, cough, and shortness of breath.4 While human coronaviruses can cause disease similar to a common cold, more severe cases can cause pneumonia, severe acute respiratory syndrome, and even death.5 Individuals with a higher risk for COVID-19 include older adults and those with chronic medical conditions such as heart disease, diabetes, and lung disease. Emergency warning signs that require immediate medical attention include difficulty breathing or shortness of breath, persistent pain or pressure in the chest, new confusion or inability to arouse, and/or bluish lips or face. Although these are not all inclusive, the CDC urges adults with these symptoms to contact their medical providers. 

Conclusion

Healthcare providers are at the forefront, caring for infected patients and increasing their own risk of exposure to the virus. The information surrounding COVID-19 is constantly being updated as we learn more about the virus, the illnesses it causes, and who is at risk.

It is imperative that clinicians continue to read new information and stay updated, practice recommended hygiene, wear the appropriate PPE, and make sure that their patients are educated. Following the appropriate steps will help to reduce the spread and the virus and hopefully prevent further exposure in uninfected individuals.

Reference

  1. What healthcare personnel should know about caring for patients with confirmed or possible COVID-19 infection. Centers for Disease Control and Prevention.  Updated February 29, 2020.
  2. Bonsall L, Todd B. COVID-19: what nurses need to know about personal protective equipment (PPE). Lippincott Nurs Cent. March 6, 2020. Accessed March 10, 2020.
  3. Shortage of personal protective equipment endangering health workers worldwide. World Health Organization. March 3, 2020. Accessed March 11, 2020.
  4. People at risk for serious illness from COVID-19. Centers for Disease Control and Prevention. Updated March 9, 2020. Accessed March 11, 2020.
  5. Coronavirus disease (COVID-19) outbreak: rights, roles and responsibilities of health workers, including key considerations for occupational safety and health. World Health Organization. Accessed March 11, 2020.

This article originally appeared on Clinical Advisor