VNA adapts to meet ongoing pandemic needs
In the space of a few weeks, the COVID-19 pandemic has forced the Visiting Nurse Association of Cape Cod (VNA) to transform how it operates its many services.
“It’s changed our world a lot,” said Ann-Marie Peckham, president and CEO of the VNA.
- Prior to a home visit, patients are screened over the phone for COVID-19 symptoms or possible recent contact with an infected person.
- Patients are required to wear a face mask and visiting staff is also required to wear a mask and gloves, and, if necessary, a protective gown and goggles.
- Home visits have been changed to telephone or video calls, when possible.
- Patients who don’t have a computer or smartphone are assisted with the use of staff iPhones so doctors can perform a virtual visit.
- Some patients have been provided with an inexpensive blood pressure cuff they can use and report results by phone.
- Disposable stethoscopes that are left at patient homes are now in use in some homes.
- Staff from a senior daycare program, closed by governor’s order during the state shutdown, are now assisting with the reporting and tracing of COVID-19 cases for the state Department of Public Health.
- Staff members call in each day prior to work to report on their health status.
- The distribution of protective gear has been changed from delivery to individual employees to pick up at one of the VNA’s nine offices.
- Protective covers for staff member’s computer tablets are in use.
The VNA provides a host of services, from mother and new baby visits, wound care and post-surgical therapy, to ostomy and catheter care and maintenance of chronic conditions, as well as public health infection tracking, and palliative and hospice care. Its staff of 650 includes nurses, aides, social workers, homemakers, plus physical and occupational therapists, as well as administrative and support employees.
The VNA’s infection control practices have evolved since mid-March, keeping up with increasingly strict guidelines from the federal Centers for Disease Control and Prevention, Peckham said.
Looming large among the changes has been increased use of masks, gloves and gowns.
“PPE (personal protective equipment) distribution has taken on a life of its own,” Peckham said.
For cases requiring full gear, such as patients in isolation, the staff had to be trained to suit up before entering a patient’s home and, at visit’s end, to properly bag and dispose of the gear in a designated trash can inside the home. The VNA began seeing patients recovering from COVID-19 in the past two weeks, Peckham said.
“You have to think about what you can bring in,” she said. “Some households manage isolation well and others have tighter living arrangements.”
Home health aides and homemaking staff have been very adaptable to new infection control procedures, she said. These employees help patients shower and bathe, clean their homes and shop for groceries.
“Right from the get-go, they were comfortable,” Peckham said.
Prior to the pandemic, post-operative patients accounted for about 25 percent of VNA visits. The average daily count of patients was 2,300-2,400, Peckham said. The pandemic caused hospitals to postpone non-emergency surgery, eliminating many of those patients. Prior to the pandemic, 1 percent of visits were by telephone. Now, 22 percent are, she said.
Phone visits allow new mothers to stay home and still get their questions answered. Nurses can teach patients how to deal with chronic conditions and even view wounds via a video call.
“Our primary role is to educate,” Peckham said. “We have iPhones, FaceTime. They can even be used to teach you how to change your dressing.”
Older patients, often living alone, sometimes suffered from isolation prior to the pandemic. Social distancing mandates have increased loneliness, as relatives and friends can no longer drop by. The situation is especially difficult for hospice patients and their families.
“This has increased the outreach work of our hospice bereavement coordinators and social workers, who provide emotional support at such a life-altering time,” Peckham wrote in an email.