Resident Visits and Absences

By Uncategorized

August 31, 2020

 

Resident Visits – Retirement Home and Nursing Home Policy

 

We are so pleased to present new information about resident visits and what that looks like moving forward for our Home.

 

A visitor is defined by the Ministry of Heath as any family member, close friend or neighbour.

 

Prior to each visit, the visitor must:

  1. Pass an active screening questionnaire administered by home staff upon entry to the home (same questionnaire as previous)

http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/2019_screening_guidance.pdf

 

  1. b) Indoor visitors are required to verbally attest to Home staff that they have tested negative for COVID-19 within the previous two weeks and not subsequently tested positive. The home is not responsible for providing the testing. As a visitor is required to enter the home to be screened and to must pass through the home to access all outdoor visiting areas, the Home is asking for verbal attestation of testing for outdoor visits as well at this time.
  2. c) Comply with long-term care home infection prevention and control (IPAC) protocols, including proper use of face coverings or surgical/procedural masks (see below)

 

Visits = Monday – Friday.

 

Time = 09:30-noon and 2:00-4:00

 

After 30 days, the home will assess its readiness, the current situation with covid-19 in the community, staffing, and infection control processes to determine if alternate visiting hours can be adjusted to include evenings and weekends.

 

Each day of the week is set aside for each unit as follows (however may change week to week to accommodate holidays and the homes covid-19 in-house testing for staff):

 

Monday = Barclay Lane

 

Tuesday = Retirement Home

 

Wednesday = Victoria Way

 

Thursday = Fairbank Court

 

Friday = Ruby Hall

 

Please note that visits may be cancelled at any time in the event the home cannot meet the operational needs to facilitate and coordinate visits or if the home is in outbreak.

 

Managing Visitors. The aim of managing visitors is to balance the need to mitigate risks to residents, staff and visitors with the mental, physical and spiritual needs of residents for their quality of life.

 

Homes must have a visitor policy in place that is compliant with the updated Directive #3 and is guided by applicable policies that must address the following: (please note that the “Homes Response” section is considered to be new policy”

 

  1. Be informed by the ongoing COVID-19 situation in the community and the home and be flexible to be reassessed as circumstances change.

Homes Response: The home will continue to correspond with residents and families through direct contact, e-mail, social media and through the Homes website www.fiddicksnursinghome.com on a weekly or as needed basis based on current covid-19 situations in the community.

 

  1. Be based on principles such as safety, emotional well-being, and flexibility and address concepts such as compassion, equity, non-maleficence, proportionality (i.e., to the level of risk), transparency and reciprocity (i.e., providing resources to those who are disadvantaged by the policy).

Homes Response – all of the following aspects have been considered with regards to the development of this policy for residents, staff, essential visitors, and visitors:

Safety

Emotional Well Being

Flexibility

Compassion

Equity

Non-Maleficence

Proportionality

Transparency

Reciprocity

 

  1. Include education about physical distancing, respiratory etiquette, hand hygiene, infection prevention and control practices (IPAC) and proper use of PPE.

 

Homes Response:

Physical Distancing

For a reference: Social distancing, also called “Physical Distancing,” means keeping a safe space between yourself and other people who are not from your household. To practice social or physical distancing, stay at least 6 feet (about 2 arms’ length) from other people who are not from your household in both indoor and outdoor spaces.

 

Do not physically embrace with your loved one. Please ensure that you are following physical/social distancing guidelines and remaining within designated area. Failure to do so will result in your loved one being in isolation for 14 days and a COVID-19 test completed. Future visits may be discontinued.

 

Respiratory Etiquette

After blowing nose, touching eyes, mouth, coughing or sneezing and at the conclusion of the visit, clean hands with the hand sanitizer provided beside the visitor chair. Please see below for cough etiquette:

https://www.youtube.com/watch?v=J2jbEetZ8G4

 

Hand Hygiene

Clean hands using the hand sanitizer or handwashing station provided at entry to the Home. Sanitization stations are also located in each resident’s room and hallways. Please see below for instructions on hand hygiene:

https://www.youtube.com/watch?v=4E7UkDlnvZA

 

Infection Prevention and Control Practices

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevent-control-covid-19-long-term-care-homes.html

 

Proper use of PPE

A surgical/procedural mask will be provided for the visit and must be worn at all times. Please see below for proper application and removal of masks:

https://www.youtube.com/watch?v=PwYapjQUVmo

 

  1. Include allowances and limitations regarding indoor and outdoor visiting options.

Homes Response

Option #1 – ONE visitor will be allowed to visit the resident in their room (only). Physical distancing is required at all times. You must wear the surgical/procedure mask provided to you by the Home throughout the duration of the entire visit. The visiting schedule per unit remains in effect (see above in yellow). The visit can be the length of the visiting hours or less. Visits will not be occurring during the resident’s meal times. There will be access to public washrooms on the residents unit only for your use. If you do not know where they are located, please ask a staff member. These visits MUST be BOOKED in the same manner as previous.

 

Option #2 – Up to TWO visitor(s) may visit in one of our conversation stations located in the main lounges off of the residents unit or outdoors. *NOTE the Home has enhanced the stations to be more homelike and private.* Physical distancing is required at all times. You must wear the surgical/procedure mask provided to you by the Home throughout the duration of the entire visit. The visiting schedule per unit remains in effect (see above in yellow). The visit can be 1 hour or less. Visits will not be occurring during the resident’s meal times. There will be no access to public washrooms. These visits MUST be BOOKED in the same manner as previous.

 

Option #3 – Short stay absences. Residents may leave the Home’s property for a short stay absence for health care-related, social, or other reasons. A short stay absence does not include an overnight stay, with the exception of single-night emergency room visits (see below). Upon return to the home, residents must be actively screened but are not required to be tested or self-isolate.

Residents will be provided with a surgical/procedural mask to be worn at all times when outside of the home (if tolerated) and reminded about the importance of public health measures including physical distancing. It is encouraged that anyone visiting with a resident during a short stay, also wear a face mask, have areas the resident may touch sanitized prior to the absence and to keep physically distanced during the absence. These visits MUST be BOOKED in advance in the same manner as in Home visits. The Home will need to prepare medications, paperwork and other necessary items for the short stay absence. Although short stay absences are approved, it is preferential that any short stay absence occurs between the hours of 9:30am and 5:30pm in accordance with resident’s routines and plans of care. It is strongly encouraged that anyone who is transferring the resident or who is visiting with the resident during a short stay be tested for Covid-19 routinely.

 

Important notes:

Outpatient medical visits are considered a short stay absence and residents do not require testing or self-isolation upon their return.

 

Emergency room visits that take place over a single night (e.g., assessment and discharge from the emergency department spans one overnight period) are also considered equivalent to an outpatient medical visit that does not require testing or self-isolation upon return. If the resident is admitted to the hospital at any point, or the emergency room visit takes place over two or more nights, the Home is to follow the steps for Re-Admissions from Hospital.

 

  1. Include criteria for defining the number and types of visitors allowed per resident when the home is not in an outbreak, in accordance with MLTC and MSAA policies. When the home is in an outbreak, only essential visitors (as defined below) are permitted in the home.

Home Response – As above #4

 

  1. Include screening protocols

Homes Response – Visitors be actively screened on entry for symptoms and exposures for COVID-19, including temperature checks and will not be admitted if they do not pass the screening.

 

  1. Include visitor attestation to not be experiencing any of the typical and atypical symptoms.

Homes Response – Visitors be actively screened (and will not be admitted if they do not pass the screening) on entry for signs or symptoms that may include:

Fever (temperature of 37.8°C or greater), OR

Any new or worsening respiratory symptoms (cough, shortness of breath, runny nose or sneezing, nasal congestion, hoarse voice, sore throat or difficulty swallowing), OR

Any new onset atypical symptoms including but not limited to chills, muscle aches, diarrhea, malaise, or headache

  1. Comply with the home’s IPAC protocols, including donning and doffing of PPE.

Homes Response – Proper use of PPE – A surgical/procedural mask will be provided for the visit and must be worn at all times. Please see below for proper application and removal of masks:

https://www.youtube.com/watch?v=PwYapjQUVmo

 

  1. Clearly state that if the home is not able to provide surgical/procedure masks, no family visitors should be permitted inside the home. Essential visitors who are provided with appropriate PPE from their employer, may enter the home.

Homes Response – Should the Home experience a decline in our ability to purchase or procure surgical/procedural masks for visitors, no visitors will be allowed in the Home.

 

  1. Include a process for communicating with residents and families about policies and procedures including the gradual resumption of family visits and the associated procedures.

Homes Response – The home will continue to correspond with residents and families through direct contact, e-mail, social media and through the Homes website www.fiddicksnursinghome.com on a weekly or as needed basis based on current covid-19 situations in the community.

 

  1. State that non-compliance with the home’s policies could result in a discontinuation of visits for the non-compliant visitor.

Homes Response – Any non-compliance with this policy could result in the visit being terminated immediately, the resident being placed in 14 days of isolation while monitoring for Covid-19, and future visits being discontinued. In addition, the Home will complete a letter outlining the non-compliance to serve as a written warning. We kindly ask that you review the CDC information on social distancing and its purposes prior to your next visit found at the link below:

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html

 

  1. Include a process for gradual resumption of family visitors that stipulates:
  2. Visits should be pre-arranged

Homes Response – As above #4.

 

  1. Family visitors to begin with one visitor at a time.

Homes Response – with exception for conversations stations #4 option #2.

 

  1. Must only visit the one resident they are intending to visit, and no other resident.

Homes Response – As above #4.

 

  1. Family visitors should use a face covering if the visit is outdoors. If the visit is indoors, a surgical/procedure mask must be worn at all times.

Homes Response – A surgical/procedural mask will be provided for all visits and must be worn at all times. The Home will provide face masks (with the exception of #9).

 

  1. Family visits are not permitted when: A resident is self-isolating or symptomatic, or the Home is in an outbreak.

Homes Response – All visits will be suspended if resident is self-isolating or symptomatic, or if the Home is in an outbreak.

 

  1. Specify that essential visitors:
  2. Be defined

Homes Response – The following are considered essential visitors:

Physiotherapy

Oxygen Therapy

Phlebotomy Care

Emergent X-ray

Dental Care

Hair Services

Spiritual Care

Pharmacy Services

Physicians

Geriatric Care

Food delivery

MOH Inspector

Maintenance

Person visiting a very ill or palliative resident

 

  1. Providing direct care to a resident must use a surgical/procedure mask surgical/procedure mask while in the home, including while visiting the resident that does not have COVID-19 in their room.

Homes Response – all essential visitors will use a surgical/procedure mask while in the home.

 

  1. Who are in contact with a resident who is suspect or confirmed with COVID-19, must wear appropriate PPE in accordance with Directive #5 and Directive #1.

Homes Response – all essential visitors will use proper PPE as per droplet/contact precautions if a resident is isolated as a suspect of confirmed Covid-19.

 

  1. Are the only type of visitors allowed when: a resident is self-isolating or symptomatic, or the Home is in an outbreak.

Homes Response – Only essential visitors will permitted in the Home if resident is self-isolating or symptomatic, or if the Home is in an outbreak.

 

General Notes:

 

Please do not call the Public Health Unit for results, if you require assist with obtaining results, please call the Fiddicks Secretary at 519-882-0370 and have your health card available.

 

The visiting area will be cleaned and disinfected between every visit.

 

Please do not arrive until 5 minutes before your scheduled visit – Many people are coming and standing 10-15 minutes early. This poses risk to staff coming and going from their shifts.

 

We ask you do not arrive too early so you are not crossing paths with other visitors. In addition, the front parking area will be available for parking and/or drop offs.

 

Visitors are to ensure physical distancing with others on the site (6 feet).

 

We ask you to please follow the steps below to ensure a safe visit:

 

Go to the front entrance of the facility – note there are social distancing steps on the pavement for you to follow.

 

Do not bring pets or any outside beverages or food items.

 

Any packaged items that you would like to leave for your loved one should be left at the green table after screening to be sanitized. Please ensure it is labelled prior to arrival.

 

Exit the home’s property immediately at the conclusion of the visit. Please do not socialize with the staff walking by, at the screening stations, or with managers in their offices.

 

If you are unsure what to do, look around there will be signage on walls and flooring.

 

The Home does keep a log of all visitors. In the event an outbreak occurs, Public Health may request this log as part of their infection tracking/tracing.

 

Enjoy your visit! It is great to see you again and we hope to continue to move forward to open up the Home safely to further visiting in the coming weeks.

 

Michael Fiddick

Administrator