By Richard A. West
New Jersey Attorney General Gurbir S. Grewal and Department of Health Commissioner Judith M. Persichilli have announced practice guidance for outpatient healthcare professionals statewide during the COVID-19 outbreak.
Doctors, nurses, physician assistants, respiratory care therapists and others are advised to follow best practices set by the Centers for Disease Control and Prevention and the Department of Health when treating patients for COVID-19-related concerns or symptoms. Additional state guidance was developed by the Communicable Disease Service within the Department of Health and the Division of Consumer Affairs within the Department of Law & Public Safety.
Here are some key recommendations:
- To protect all patients and staff, use telephone screenings prior to office visits to prepare for seeing potential COVID-19 patients
- Wear appropriate personal protective equipment (PPE) when evaluating symptomatic patients in person
- Utilize telemedicine as an alternative if unprepared (PPE unavailable in office) to see potential COVID-19-positive patients
- Avoid recommending referrals or testing for non-symptomatic or low adverse effect-risk patients so as not overwhelm the healthcare system and conserve resources for those most in need of urgent care
- Testing availability is limited; priority is reserved for symptomatic patients with comorbidities and risk factors
- When obtaining specimens, take all recommended infection control precautions
- Symptomatic patients should be initially evaluated via telephone screening focusing on risk factors (recent areas traveled, exposure to COVID-19-positive person, older than 65 years, underlying conditions)
- Medically stable symptomatic patients can be advised to stay home and self-isolate for a minimum of 7 days after onset of cough and for 72 hours after resolution of fever
- Self-isolation means isolating from others within the home in addition to not leaving the home
- Patients that are symptomatic and not medically stable can be evaluated in office if proper PPE is available for all staff performing hands on services – mask for patient and gowns, gloves, eye/face protection (goggles or face shield) and N95 respirators for staff (surgical masks may be substituted only when performing non-aerosolizing procedures — swabbing for a COVID-19 test is non-aerosolizing)
- If PPE is unavailable in the outpatient office setting, refer medically unstable patients in risk categories to emergency departments of other facilities, but alert the facility in advance regarding patient risk factors and physical condition
- Routine outpatient practices unrelated to COVID-19 can be continued during the outbreak provided procedures are in place to minimize risk of transmission from asymptomatic persons within the facility such as disinfecting door handles, chairs and restrooms, removing magazines, toys and other objects patients touch while waiting and avoiding long stays in the waiting/reception area
- Finally, postpone elective procedures and surgeries for non-life threatening conditions
Additional information may be obtained at https://www.nj.gov/health/cd/topics/covid2019_healthcare.shtml
For further guidance about protections for licensed health care professionals in New Jersey during the COVID-19 crisis, please contact Brown Moskowitz & Kallen partner Richard A. West at (973) 376-0909 ext. 1126 or mobile: (973) 229-7928.
This article is for informational purposes only and is not intended to constitute, and does not constitute, legal advice.