Visiting the Hospital

MASKING POLICY FOR PATIENTS, VISITORS, AND STAFF

EFFECTIVE April 17, 2023, based upon the most recent Public Health of Ontario guidance Windsor Regional Hospital is amending its masking policy for patients, visitors, and staff.

WRH will continue to support those individuals who still choose to wear a mask at any time. All individuals who put on a mask should use a hospital-issued mask. Masks will be provided at hospital entrances.

Non-Clinical Areas:
(e.g. Main Lobby to Met and Ouellette campuses, Waiting Areas, Lounges, Cafeteria, Meeting Rooms, Elevators, Support Services Departments

• Maintain spatial separation
• Masking is supported for staff, patients, and visitors but is NOT required

All Clinical Areas:

Staff:

• Masks remain required within 2 metres of any patients unless there is a physical barrier present
• Masks are not required when not within 2 meters of a patient (e.g. at the nursing station, in hallways if no patients are present or in medication rooms)
• Routine Practices including a point of care risk assessment (PCRA) are required for all interactions
• Other PPE like eye protection, gowns, and gloves are required based on the Additional Precautions in place (refer to isolation order), PCRA, or procedural-based precautions (e.g. N95 for AGMP)
• Staff may continue to keep their mask on for multiple patient encounters and remove them when contaminated, wet, or when patient care is completed

Patients:

• All symptomatic patients should be masked when outside their bed space if tolerated
• All symptomatic outpatients are required to mask if tolerated

Visitors:

• Required as per the Additional Precautions in place for the particular patient
• It remains recommended that visitors mask when within 2 metres of patients

High-Risk Patient Populations - Cancer, Renal, Inpatient Oncology, Emergency Department, HIV Clinic

• Staff to follow the recommendations above for Clinical areas
• Masks are required for visitors and patients when in waiting rooms and lounges
• Patients are to wear masks when not in bed space (not required for those under 2 years of age)
• Visitor's mask within 2 metres of patients and as per Additional Precautions

Respiratory Outbreak Areas

• Universal masking for all staff, visitors, and patients when outside their bed space is required
• Staff are required to use an N95 for all suspect or confirmed COVID-19, and any patient considered a high-risk exposure

Due to the layout of the campuses, it will be difficult in some areas to delineate non-clinical versus clinical areas. When in doubt put on a mask.

Note we will continue to monitor the institutional outbreak frequency, hospitalizations, intensive care admissions and changes in other epidemiologic factors (e.g., markers of community transmission) that may indicate high transmission risk and warrant the re-implementation of universal masking.

ESSENTIAL CAREGIVER REQUIREMENTS

EFFECTIVE at 12:01 am on July 1st, 2022, any Essential Caregiver of an in-patient or attendance with a patient for an out-patient procedure will be required to perform self-screening for the following:

• Fever/chills
• New/worse cough
• New/worse shortness of breath
• Decrease/loss of smell or taste
• Sore throat
• Runny nose/nasal congestion
• Nausea/vomiting/diarrhea
• Tested positive for COVID-19 in the previous 10 days
• Exposure to a COVID-19 positive case in the previous 10 days (without a mask)
• Have been told to quarantine by a physician, PHAC, CBSA or the Public Health unit

Visitors should be prepared to provide proof of:

1. Their COVID-19 vaccination evidencing 14 days has passed since their second dose of a COVID-19 vaccine.
   OR
2. A negative community-based PCR (polymerase chain reaction test) or antigen test result taken within 3 days before their visit.

No visitation is allowed for patients with active confirmed or suspected COVID receiving an aerosol-generating procedure- Resolved cases may have Essential Caregivers as identified below. Limited exemptions are available for parents/guardians of a child with confirmed or suspected COVID-19.

ESSENTIAL CAREGIVER RESTRICTIONS

EFFECTIVE July 1st, 2022 WRH will allow TWO essential caregivers at the bedside at a time within the allotted visitation.

For palliative patients, 2 essential caregivers at a time, may visit 24/7 4 essential caregivers at a time, 24/7 for a patient that is actively dying/end of life, or having a planned withdrawal of life support. This may include visitors less than 18 years of age when accompanied by an adult.

Some limitations may apply to the number of visitors allowed at one time based on the clinical space restrictions.

All visitors must wear a medical-grade mask at ALL times and in ALL areas of the hospital. If visitors do not have one they will be provided with a medical-grade mask at the entrance. Cloth masks by themselves will not be allowed.

All visitors may be required to eye protection while visiting a patient. Face shields will be provided to visitors on the unit if required. Please refer to our policy regarding these issues.

No visitation is allowed for patients with active confirmed or suspected COVID-19, that are receiving aerosol-generating medical procedures including but not exclusive to non-invasive ventilation (BiPAP, CPAP) or high flow oxygen (AIRVO, Optiflow) due to the extremely high risk to patients, staff, and visitors. Please refer to the nursing unit for clarification. Virtual visits for these patients will be supported using technology such as iPads. Resolved cases may have visitors as identified in this policy.

• 10 am to 8 pm (except Critical Care units)
• 10 am to 6 pm, and 8 pm to 10 pm (Critical Care units only)
• For Mental Health and Renal Dialysis please see below

• Are under the age of 18, unless they are the parent/guardian of the patient or are accompanied by an adult visiting a palliative/end-of-life patient.
• Are symptomatic
• Have been outside of Canada in the last 14 days and have been advised to quarantine upon their arrival.
• Have tested positive for COVID-19 (and are not resolved cases)
• Have had close contact with a confirmed case or probable case of COVID-19
• Have had close contact with a person with an acute respiratory illness who has been outside of Canada in the 14 days before their symptom onset

• Cancer Program - For scheduled outpatient cancer appointments with a provider, the patient may have two essential caregivers accompany them. For treatment appointments in the systemic therapy suite, for radiation therapy or to attend the Cancer Program Lab or Diagnostic Imaging, the patient may have one essential caregiver accompany them.
• Emergency Department - 24 hours, one Essential Caregiver per patient- may not enter until the patient has been brought in from the waiting room unless the patient requires support due to cognitive, mobility or other disability or is pediatric- in this event, one Essential Caregiver may accompany in the ED waiting room. Department will contact when Essential Caregivers can enter.
• Lab and Diagnostic Imaging - Patients with cognitive, mobility, or other disability, is pediatric or their appointment is after 1700 will be allowed one Essential Caregiver who will remain with the patient for the entire visit or in a space designated by the clinical team if a procedure requires it. Obstetrical and Cancer Program patients may have one essential caregiver attend for support.
• Labour and Delivery/Postpartum care - Two essential caregivers may be at the bedside at a time, including the use of any private support services such as a doula (however, only 1 person is permitted during a C-Section delivery). Only one person (the primary support person) may stay at the bedside overnight in postpartum care (8:00 pm - 8:00 am).
• Obstetrical Triage - One Essential Caregiver with a mom presenting to OB Triage.
• Maternal Newborn Clinic/Women's Health Clinic - One Essential Caregiver with a mom going to scheduled appointments at the Maternal Newborn Clinic or Women's Health Clinic.
• NICU - 4 visitors maximum. (2 primary/2 additional) One of the primary must be a parent. 2 allowed at the bedside at any one time. Must be the same 4 people no switching. No children/siblings under the age of 18. The 2 primary visitors are allowed in the unit 24/7. The 2 additional can only visit during regular hospital visitation hours.
• Paediatrics - 4 visitors maximum. (2 primary/2 additional). One of the primary must be a parent 2 allowed at the bedside at any one time. Must be the same 4 people no switching. No children/siblings under the age of 18. One of the primary visitors may stay overnight. The 2 additional can only visit during regular hospital visitation hours
• Mental Health Department - Two Essential Caregivers may be chosen with 1 Essential Caregiver per patient for 30 minutes between 4:00 pm - 8:00 pm. To avoid overcrowding in common areas, we have limited visitation to a maximum of 4 Essential Caregivers being allowed into 3N and 3S and a maximum of 2 Essential Caregivers into PICU at a time. Visits must take place in the designated common area and are not allowed in patient rooms.
• Renal Dialysis Program - In-center dialysis - outpatients (Bell/JM/ESHC): 8:30 am - 10:00 am, 1:30 pm - 3:00 pm, and 7:00 - 8:30 pm (1 fully vaccinated Essential Caregiver per patient). In-patients in JM - to follow hospital visitation hours. Home Programs and MCKC - 1 fully vaccinated Essential Caregiver with patient per clinic visit.

If the patient in labour is confirmed or suspected of COVID-19:

• Only one Essential Caregiver may be with the patient throughout the patient's stay (no alternating Essential Caregivers)
• The Essential Caregiver remains with the patient in the same physical environment throughout the care delivery
• The clinical team is able to provide Essential Caregiver with a safe environment and teaching necessary for infection control
• The Essential Caregiver is masked and reports to Public Health as they may be required to self-isolate, depending on test results

• Exceptions are only considered in rare and truly exceptional circumstances.
• If a family member wishes to seek an exception to the above visitation policy, they should discuss it with the health care team.
• For any concerns with the visitation policy or if support is required with the exception to the process please contact Patient Relations:
• Ouellette Campus: Phone: 519-254-5577 Ext. 34404
• Met Campus: Phone: 519-254-5577 Ext. 52317
• After Hours: Phone: 519-254-5577 dial zero for switchboard and ask for the After Hours Manager
• The family member will be contacted once the review process is complete with an answer.

STAY CONNECTED WITH PATIENTS

We recognize the impact of isolation on patients and families during this difficult time and we are doing everything we can to help patients and loved ones stay connected.

If you have a family member at WRH, please consider alternatives to in-person visits.

• WRH's Guest Wi-Fi is available for patients to allow video calls to family and friends. The "Guest" network can be found through your wireless settings and is free of charge.
• Call your loved one in their room through the switchboard at 519-254-5577.
• Patients can bring their own devices when possible to stay connected to loved ones through FaceTime, Skype, etc.
• When patients do not have access to their own personal devices, assistance may be provided to access technology and assist with virtual visitation. Please ask your nurse for assistance.
• Send an E-card to your loved one. E-cards are a free service enabling you to send a personalized message to your loved one or friend. These are printed and delivered to patients who do not have access to email.