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5.11.20 COVID-19 UPDATE




Our response to the COVID-19 was “plan for the worst,”  “hope for the best” and “trust God.”

As a nation, we were not prepared for COVID-19. Locally, our Mardi Gras celebration and robust tourism industry that bring people from around the nation and the world seem to have positioned New Orleans for early infections that grew at an alarming pace, quickly overwhelming hospital emergency rooms.  

Overnight, our world changed: stay at home orders, social distancing, economic downturns, lost jobs and so much uncertainty.  For many of us, people we loved, died as a result.

What would we need to survive the COVID-19 pandemic?  At Notre Dame Health System, we quickly determined what our four Big Initiatives would be: limit access to the building, test residents and staff, assess and purchase supplies, and secure staffing.

Action Item #1: Limit access to the building

We immediately notified families, volunteers, and medical vendors of our policy limiting access to our facilities and requiring all people entering the building to have a temperature check, use hand sanitizer, and answer questions about potential symptoms before being allowed to enter the building.

We then quickly moved to only allowing staff and medical personnel to enter the building, with the same screening process.

Action Item #2: Test residents and staff

Testing kits were not available until recently, which made it impossible to diagnose COVID-19 residents and staff onsite.  Even when residents were sent to the hospital with symptoms, they were often returned within hours with orders to isolate for 14 days. This obviously  presented challenges in a semi-private environment and with staff who didn’t have appropriate protective equipment to remain safe.  

Action Item #3: Supplies – Personal Protective Equipment, hand sanitizer, and cleaning chemicals recommended by the CDC. 

It is possible that our situation could have been much different if we had initially had the ability to diagnose COVID-19 quickly and would have had the personal protective equipment to care for those infected safely. 

The primary shortage that existed was with N95 masks, face shields, and gowns needed to protect both staff and residents. As we understand now, even a positive staff member with no symptoms should not be able to pass the virus to another person if they are wearing an N95 mask.  

When we identified that PPE would be limited, we began to create a COVID-19 unit at Wynhoven Health Care Center to better isolate residents to prevent infection and to make limited PPE available to staff working the COVID-19 unit.

Action Item #4: Ensure enough nurses and certified nursing assistants to care for residents.

There was a severe shortage of nurses and certified nursing assistants even before the COVID-19 pandemic. To ensure that we were adequately staffed, on April 1, 2020 we went into disaster mode and converted staff to 12-hour shifts.  Nursing staff were paid at overtime rates and nursing staff working the COVID-19 units were paid double time.  In addition, we contracted with several travel nurse agencies and brought nurses and certified nursing assistants into town to supplement our staff should there be a need.

We also contracted to provide interim Directors of Nursing who have helped relieve our nursing leadership from some of the hardships of working through a pandemic.

Looking Ahead

Today, we are pleased to report that we have had success in seeing many residents admitted to our COVID-19 units recover. We are seeing a slowing in the number of residents and staff presenting with signs and symptoms of COVID-19. We look forward to the day when these isolation units are no longer needed. We believe the lessons learned from this event will help us be better prepared for the future and give us a glimpse into what the world can be when we pull together and trust. 

The real heroes of this pandemic are the women and men who showed up and did their jobs to care for our residents and their patients. It would be easy to assume that the spread of the virus in a nursing home is the result of poor care or lack of infection control. The reality is this virus has traveled the globe, causing chaos and uncertainty in healthcare and virtually all areas of society. 

Despite the challenges of the COVID-19 pandemic, we will continue our mission to care for our residents and strive each day to earn the trust that our residents and families put in us. 

A few other facts:

  1. COVID-19 units were opened onsite at our facilities to improve isolation, preserve PPE, and better meet the needs of infected residents (a recommendation that was later made by the CDC);
  2. Chateau de Notre Dame, where our first COVID-19 diagnoses was confirmed, did not account for the largest number of residents moved into the COVID-19 unit at Wynhoven Health Care Center;
  3. Healthy residents were moved from Chateau to Our Lady of Wisdom to make room for a COVID-19 unit on the east bank and to better respond to the needs of our hospital partners;
  4. We have and will continue to work closely with the CDC and with our medical directors in setting up the isolation units; we have been surveyed by the State for compliance with CDC guidelines and had no issues;
  5. We have unfilled beds in our COVID-19 units at present and hope that this trend continues, but we are prepared should there be another wave;
  6. Despite our best efforts, we have had limited success in preventing the spread of COVID-19; like many health care organizations, we have lost both residents and staff to the virus.
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