As Vaccinations Rise, Hospitals Ease Restrictions on Visitors

By Dennis Thompson
HealthDay reporter

THURSDAY, May 20, 2021 (HealthDay News) – Virginia Terrell knew she wouldn’t be allowed to visit after arriving at hospital with COVID-19 late last month, but being prepared for that reality didn’t. not done last week – and -an easier half-stay.

“You feel pretty lonely,” said Terrell, 59, who has been treated at WakeMed and Duke Health hospitals in Raleigh, NC. “It helps to know that that person will be there that day to see you, even if you are having a bad day or receiving bad news. You have someone who can hold your hand and comfort you. “

But hospitals understand the personal cost of COVID-19 lockdowns, and many have started to relax visitation policies over the past month as vaccination rates rise and the number of COVID cases decline.

Some hospitals have relaxed their visiting rules following the gradual release of new guidelines released in early April by the U.S. Centers for Disease Control and Prevention, said Ann Marie Pettis, president of the Association for Professionals in Infection Control and Epidemiology.

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New CDC guidelines say hospitals may consider allowing patients with one or two visitors if the community’s COVID levels remain under control.

“The CDC makes recommendations and then states have regulations in place that we must comply with,” Pettis said. “You’re really waiting to see how your condition interprets it, and even from there it can be very facility specific.”

Pettis Hospital, at the University of Rochester Medicine in Rochester, NY, recently approved two visitors per patient, which many other hospitals across the country have done.

The rules vary from state to state and from hospital to hospital. Typically, the visit is allowed for patients meeting specific conditions, and a person’s two visitors may need to go one by one, be on a registration list, and only visit during certain hours.

COVID patients like Terrell are generally not allowed at all. However, some medical centers, such as the University of Utah Health, even allow visitors to enter the rooms of COVID patients.

These visits are being made with great caution, said Alison Flynn Gaffney, executive director of the University of Utah Health System Teaching Hospital.

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Visitors of a positive COVID patient are asked whether they themselves have proof of vaccination or a previous positive COVID test, and are asked about any recent symptoms, Gaffney said.

“They must stay in the patient’s room, wear the required PPE [personal protective equipment], and meet all the conditions for further screening, ”Gaffney said.

“ Human beings are social beings ”

The value of visitors is well known to hospital workers, said Dr. Flora Kisuule, board member of the Society of Hospital Medicine and director of hospital medicine at Johns Hopkins Bayview Medical Center in Baltimore.

“We have learned over the years that patient care is a partnership between clinicians, patients and their families,” said Kisuule. “Human beings are social beings, and our well-being is very much supported by the support of our family members.”

Visit closures were needed at the height of the pandemic to protect hospital patients with weakened immune systems and other conditions that put them at high risk.

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“Our hospital patients are some of the most vulnerable citizens in our community, so additional mitigation efforts are needed to protect them,” said Pettis. “We take this very seriously, in terms of tour changes.”

But the lockdowns came at a cost.

“People didn’t have that cheerleader,” Kisuule said. “As much as clinicians work to be that person, they cannot replace a spouse, child, sibling, which our patients have sorely missed.

Duke Health changed its policy earlier this month from one to two authorized visitors per patient, said Katie Galbraith, president of Duke Regional Hospital.

“The combination of reducing the spread of COVID within our community and the communities we serve and increasing immunization in the same community certainly made us think we could grow at this point and do so. safely, ”said Galbraith.

The logistics of expanding tours can be tricky. It is easier to have visitors to hospitals with many private rooms compared to those with a lot of semi-private rooms, Pettis said.

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Medical centers should also stay informed about COVID rates in their communities as they expand the number of visits.

“If your COVID positivity rate is still above 3%, you are going to handle it differently than you would if you are in a community where you are below 2% or 1%,” Pettis said.

Need more staff to handle visitors

Staffing is another big issue for hospitals trying to open things up, Pettis said.

Centers typically allow visitors to enter through a single entry point, where staff members process IDs, check symptoms, and explain rules. A staff member then guides the person to the patient’s room.

In the event of a visit from a COVID patient, a staff member might also need to help people put on and take off required personal protective equipment such as gowns, gloves and a mask, Kisuule said. .

“Many of these institutions actually make it easy to put on and take off. [PPE] of their visitors, ”Kisuule said.

The staff leak for hospital visits also comes at a time when these medical centers are busier than ever, often operating at 120% of capacity, Pettis said.

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“A lot of people have stayed out of hospitals and out of health care because of their fear during the pandemic, and now we are bulging at the seams,” Pettis said.

Terrell showed up to WakeMed on April 26 because she had lost her sense of smell and taste, suffered from a swollen stomach, had difficulty breathing, and started to have swelling in her legs.

Doctors transferred her to Duke Health on April 30 because COVID appeared to have damaged a donated liver that Duke’s surgeons transplanted to Terrell years ago, she said.

“I had no associated pain, no muscle aches or aches,” Terrell said. “It made things a little less difficult because I didn’t feel in danger of going in and out of there, so I guess I could deal with it more.”

Even though she did not benefit, Terrell said Duke’s extended visit for non-COVID patients is a “good thing.”

“It’s hard to be alone and not be able to deal with your situation or discuss it with someone who can comfort you,” Terrell said. “It will speed up recovery for a lot of people and put them in a good state of mind. Being sick is difficult when you are alone.”

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More information

The US Centers for Disease Control and Prevention has more on infection prevention in hospitals.

SOURCES: Virginia Terrell, Raleigh, North Carolina; Ann Marie Pettis, RN, President, Association of Infection Prevention and Epidemiology Professionals; Alison Flynn Gaffney, MHA, Executive Director, Teaching Hospital, University of Utah Health System; Katie Galbraith, MBA, President, Duke Regional Hospital; Flora Kisuule, MD, director, hospital medicine, Johns Hopkins Bayview Medical Center, Baltimore

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