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Behind the front lines: Inside look at a Sterling hospital's COVID-19 response

(KWQC)
Published: May. 4, 2020 at 11:09 PM CDT
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As the COVID-19 pandemic unfolds, hospitals around the world have restructured their operations to keep staff and patients safe.

TV6 Investigates got an inside look at

which currently has 1,585 employees, and the steps taken to ensure the hospital is operating safely for both patients and staff.

Dr. Eric Kuhns, a Family Medicine doctor and the hospital’s Director of the Department of Medicine said, “We had one of the very early patients in the area, so we were all in very early and we took very drastic steps as did the nation at that time to shut down almost all routine appointments and surgeries. Our focus turned almost entirely to an all-in effort to think about, ‘how do we manage this well?’”

The CGH Coronavirus IC Group has met daily since March 14 to discuss personal protective equipment (PPE) and mask supply inventories, along with testing, and other COVID-19 and post-COVID-19 related planning.

“COVID touches everything. It touches the outpatient world, surgery, it touches how we care and interact and it touches how we bring families in,” said Kuhns. “All of those things have to be dealt with thoughtfully so I'd say the first two to three weeks were an all in effort to make sure we do that well.”

The hospital has taken measures to separate patients with suspected or confirmed COVID-19. “Bubble areas” can be found within the hospital.

Every person who enters CGH Medical Center is screened. Members of CGH staff are stationed at all of the entrances that are open and ask anyone who comes to the hospital questions regarding COVID-19 and potential exposures. Temperatures are taken before anyone, including staff, are admitted.

“We're very careful to care for everybody in their own separate space. We can take good care of everybody and we can keep the non-COVID people safe,” said Kuhns.

Masks are required by anyone who walks into the hospital or any of CGH’s clinic locations,

www.cghmc.com/news/releases/cgh-clinics-re-opening-may-1/”>which re-opened to patients at a reduced volume on May 1.

In March the hospital implemented increased visitor restrictions. Visitors are not allowed into facilities, except for extenuating circumstances. Those exceptions and decisions are made on a case-by-case basis.

In a letter to staff on April 27, Dr. Paul Steinke, CGH President and CEO wrote, “CGH is a tightly controlled environment with strict tolerances with temperature, humidity, and airflow. Our EVS staff clean the facility to the highest standards. I feel safer within the confines of CGH than anywhere else in public.”

Front line workers, particularly at hospitals, are not limited to medical workers. Kuhns said, "People like housekeeping – they're the unsung heroes here. They go into all of these rooms and make sure they're clean for us. That is critical. In some ways they're the most important people in the hospital right now."

Kuhns said of COVID-19, "This is new and different and in a scope…we've all been through H1N1. Those were tough. They were not at this level."

Elliott Mertes, a Registered Nurse at CGH Medical Center, who has worked at the hospital for 15 years said, “This is a legit pandemic-level virus. This is not the flu.”

Mertes said the hospital has always taken precautions in situations that warranted wearing additional PPE, but he has never seen something to this extent. “There are some disease states that would require isolation gears like this. Our tuberculosis patients and active shingles would be N95 and gowns but to do it on a consistent basis – daily basis – in every patient room, that's just the next level and that is nothing I've ever seen. Nothing like this to this magnitude,” he explained.

CGH leadership said, “On any given day, we have 0-5 coronavirus positive patients in the hospital and 0-15 patients in the hospital isolation bubbles awaiting test results.”

As many healthcare workers around the world cope with a shortage of PPE, staff at CGH tell TV6 they are grateful the hospital was proactive in their planning, and that they have not faced those same circumstances.

“We had emergency stocks things like masks, and fortunately, that's been able to keep up us out of a critical measure,” said Kuhns.

The hospital has emergency preparations in place in case things were to change, but at this time they are not re-using any masks or rationing PPE. The hospital is utilizing N100 respirators, which are used specifically when interacting with patients in isolation bubbles.

“PPE is always there it's always readily available and we never go into those rooms unprotected. We joke and say this is the safest room on earth in the ICU because you don't go into a room without your gear on. Your risk of exposure is negated by all of the protection,” said Mertes.

Mertes explained the doffing guidelines when medical staff leave a room. He said “We perform hand hygiene, remove isolation gowns, perform hand hygiene again while still in a mask and respirator. When we leave the room we perform another round of hand hygiene, clean gloves, and then without touching our face we remove the mask to wipe with a hydrogen peroxide-laced wipe. We wipe all of the surfaces and let them dry for one minute. Gloves off, hand hygiene and you're ready to go.”

Staff were trained on how to properly don and doff PPE by nurse staff educators.

Sara Stage, a Registered Nurse in the Acute Care Services Department and a nurse staff educator said, “when we got the masks we did fit testing for everybody to make sure they're fit tested for the appropriate mask and size. We came in on every shift, off hours, and on the weekends to educate staff to make sure they know how to correctly don and doff without having to break any of the PPE.”

Laurie Schroeder, a Registered Nurse and nurse staff educator said, “The hospital’s been amazing. They offered us a place to stay if we didn't want to go home. We wear different scrubs while we're here, they've offered us rooms to shower.”

With workers dressed in layers of protective gear and visitor restrictions in place, staff say they continue to strive to maintain the humanity in a time of the new coronavirus.

“In a community hospital we're very aware we're taking care of our friends and neighbors and we have to make sure we give them the “why” to push on. We don't want staff to burn out because we care about patients,” said Kuhns.

Staff help patients communicate with families through iPads and iPhones, and even meet in-person, if necessary.

“We sometimes meet family in the parking lot to talk to them about everything that's going on. We try and keep those channels of communications very open because that's a critical part of medicine," said Kuhns.

Kuhns said, “In a community hospital it's always that way. It is what separates us in many ways from larger systems have some resource advantages. We have the advantage of when my patient gets admitted to the hospital I know what their goals are, I know what they're worried about. They also have a level of trust in us because they know us. I think it helps with patients being able to trust and do the things they need to do.”

As of April 27, two patients at CGH had died following their battle with COVID-19.

At the end of day, the virus still impacts everyone and everything around it. CGH staff know it was important to take immediate steps to keep everyone safe.

“When you shut down earlier, you bend that curve harder. We've certainly benefited from that and that's good but that doesn't mean we haven't had patients come in and get sick and unfortunately pass away,” said Kuhns.

"It is kind of hard at the end of the day you know shift into normal civilian mode and reach to my respirator and think oh, I'm at home. I'm safe. There's always that fear you bring it home with you. Thankfully we wear enough PPE that it mitigates the risk, but it's still there, you know."

The hallways are a bit quieter at the hospital, but staff want to emphasize if you need help, their doors are open.

"It's a place for anybody to come. You can come at any time of day. My emergency might not be your type of emergency. Everybody has their own type of emergency. If you feel like it's an emergency come see us. We'll take care of you,” said Jouquenia Johnson, a Registered Nurse in the CGH Emergency Department.

Staff at the hospital told TV6 the community support has been incredible, from businesses to the school system, and people offering to make PPE.

CGH continues to keep their community educated on the virus through Facebook LIVE chats with doctors. They said people are able to contribute questions to have answered. “Our CEO is also a physician,” said Kuhns.

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