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ESSENTIAL CAREGIVER REQUIREMENTS & RESTRICTIONS
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:
- Their COVID-19 vaccination evidencing 14 days has passed since their second dose of a COVID-19 vaccine.
OR
- 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.
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.
ESSENTIAL CAREGIVERS WILL BE RESTRICTED IF THEY:
- 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
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- 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
DEPARTMENT-SPECIFIC EXCEPTIONS:
- 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.
ADDITIONAL INFORMATION FOR THE ABOVE
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
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ADULT & PAEDIATRIC RESPIRATORY CARE CLINIC (APRCC)
For ALL RESPIRATORY ILLNESSES such as COVID-19, Influenza, and Respiratory Symptoms.
The following people are eligible for a PCR at the COVID-19 Assessment Centre:
- Patient-facing healthcare workers
- Staff, volunteers, residents/inpatients, essential care providers, and visitors in highest-risk settings
- Highest risk settings include: hospitals (including complex continuing care facilities and paramedic services), and congregate living settings with medically and socially
- Vulnerable individuals living in Long-Term Care, retirement homes, First Nation elder care lodges, group homes, shelters, hospices, correctional institutions
- Symptomatic people aged 60 and older
- Symptomatic people aged 18 years of age and older who have one or more comorbidity that puts them at higher risk of severe COVID-19
- Symptomatic people aged 18 years of age and older who are unvaccinated or have not completed their primary vaccine series
- Symptomatic people aged 18 years of age and older who completed their primary vaccine series AND received their last COVID-19 vaccine dose more than 6 months ago AND have not had a SARS-CoV-2 infection in the past 6 months
- Symptomatic people who are immunocompromised
- Symptomatic patients seeking emergency medical care or other outpatients for whom a diagnostic test may guide clinical management, at the discretion of the treating clinician
- Symptomatic people 18 years and older with one or more of these high risk conditions
- obesity (BMI ≥ 30kg/m2)
- cancer
- cerebrovascular disease
- diabetes
- chronic liver disease
- HIV infection
- mental health disorders
- heart disease, hypertension, congestive heart failure
- chronic respiratory disease, including cystic fibrosis
- smoking, current or former
- cerebral palsy
- intellectual disability
- use of corticosteroids or other immunosuppressants
- sickle cell disease
- chronic kidney disease
- Tuberculosis
- solid organ or blood stem cell transplant
- Home and community care workers
- Household members of staff in the highest-risk settings and patient-facing healthcare workers
- International Agriculture Workers in congregate living settings
- Other outpatients for whom a diagnostic test is required for clinical management, at the discretion of the treating clinician (AC Physician’s discretion)
- Pregnant people
- People who are under-housed or experiencing homelessness
- First responders, including fire, police and paramedics
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- Individuals who are from a First Nation, Inuit, or Métis community, and/or who self-identify as First Nation, Inuit, and Métis and their household members
- Individuals travelling into First Nation, Inuit, and Métis communities for work.
- On admission/transfer to or from the hospital or congregate living setting.
- Close contact and people in the context of confirmed or suspected outbreaks in the highest-risk settings as directed by the local public health unit
- Individuals, and one accompanying caregiver, with written prior approval for out-of-country medical services from the General Manager, OHIP
- Asymptomatic testing in hospitals, long-term care, retirement homes and other congregate living settings and institutions as per provincial
Even if you do not meet the criteria above, you should still visit if you have COVID-19 symptoms and any of the following apply to you:
- You are at higher risk of getting seriously ill from COVID-19 and need to get tested and assessed for COVID-19 treatment
- You have been directed to visit a COVID-19 clinical assessment centre by your primary care provider
- You feel that you cannot safely monitor your COVID-19 symptoms at home and need to be seen by a healthcare provider
You do not need to have a positive test result to visit. You should bring a list of your medications and a list of any important medical conditions.
If you develop severe symptoms requiring medical attention, such as shortness of breath, chest pain, loss of consciousness, or confusion, call 911 or go to the emergency department.
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