COVID-19 Protocol

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Purpose

The purpose of this document is to outline the office’s policies and procedures for the novel coronavirus (COVID-19) pandemic. The novel coronavirus is a new coronavirus that has not been previously identified. The virus causing coronavirus disease 2019 is not the same as the coronaviruses that commonly circulate among humans and cause mild illness, like the common cold.

The virus that causes COVID-19 is thought to spread mainly from person to person through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Spread is more likely when people are in close contact with one another (within about 6 feet).

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. People with these symptoms or combinations of symptoms may have COVID-19, which include:

  • Cough
  • Shortness of breath or difficulty breathing

Or at least two of these symptoms:

  • Fever
  • Chills
  • Repeated shaking with chills
  • Muscle pain
  • Headache
  • Sore throat
  • New loss of taste or smell

This list is not all inclusive.

Screening Patients

Patients will be screened prior to their appointment. They will first be screened through a reminder call over the phone prior to their appointment. Patients will be asked the following three questions:

  1. Have you traveled to or from an area with a known high incidence of confirmed COVID-19 cases in the last 14 days (for example: Detroit and surrounding counties)?
  2. Have you had contact with anyone with confirmed COVID-19 in the last 14 days?
  3. Have you had any of the following symptoms: Fever (100.4 or higher), difficulty breathing, cough, extreme fatigue, or sudden loss of taste and/or smell in the last 14 days?

If the answer is yes to any of these questions, the appointment will need to be postponed and rescheduled for at least 14 days later. Patients will be asked the same questions upon arrival to their appointment, as well as having their temperature taken with an Infrared thermometer and should they have an elevated temperature (100.4 or higher), they will need to leave immediately and reschedule their appointment for at least 14 days later. Staff will also have their temperature taken and should anyone have an elevated temperature, they will be sent home immediately.

It is requested that patients attend their appointment alone to reduce the number of people in the office. Visitors are limited to a parent, legal guardian, care giver, or otherwise essential person to the patient. Anyone not essential to the patient is asked to wait outside or in their vehicle. If a patient would like, a family member, spouse, friend, etc. could call and join the appointment on speaker phone.

Personal Protective Equipment (PPE)

Patients will be required to wear a properly fitting mask (must cover the mouth, nose and chin) during their visit to the office, as long as they are able to medically. This will also apply to anyone identified as essential to the patient that must accompany them to the appointment. If they do not show up to the appointment with a mask, one will be given to them to wear. They will also be provided with hand sanitizer from the provider to use before coming back to their appointment. The provider will also use hand sanitizer prior to the start of the appointment and also through the duration of the appointment. After the appointment has concluded, the provider will follow CDC hand washing guidelines and wash their hands properly. The provider will wear a medical mask for the duration of all appointment types.

For clean and checks of hearing aids, the provider will also wear gloves while handling patient’s hearing aids. Should the patient need assistance with the hearing aid features on their smart phone, the patient will be required to have their phone disinfected prior the provider touching it. The patient will be given a disinfecting wipe to use and sterilize their phone.  If possible, hearing aid clean and check only appointments will be offered as a curbside appointment. The provider will come get the hearing aids from the patient while they wait in their car. The provider will clean and check the hearing aids in the office and then bring them back out to the patient’s car.

For cerumen (earwax) removal, extra PPE will be required, due to the nature of the procedure. Cerumen management often triggers a cough reflex, which can expose the provider to airborne particles. An N95 mask, face shield, and protective gown will be worn by the provider for added protection. The gown will be discarded after each use. The face shield will be sterilized using an ultraviolet (UV) light chamber and/or disinfecting Super Sani Cloth wipes and the N95 masks will be disinfected using the UV light chamber.

For hearing tests involving children, they will need to wear a mask, unless they are too young to do so or have sensory issues that would make wearing a mask difficult. The provider may wear an N95 mask and face shield for the appointment if the child is young enough that they will be unable to use proper methods for coughing and sneezing safely into their elbows. Disinfecting of the appointment room and equipment will be identified below. Any toys used for testing or conditioned play audiometry will be disinfected following the end of the appointment.

Disinfecting

Dr. Eimers Hearing Clinic has always adhered to recommended guidelines for cleaning and sterilization. Due to the highly contagious nature of COVID-19 and how easily it spreads, the office will be increasing their disinfecting of all areas in the clinic that patients and staff come into contact with.

Disinfection of all patient areas in the procedure room will occur at the end of each patient’s appointment, prior to taking the next patient back for their appointment. Patient chairs, provider chair, provider desk, door handles, and any equipment touched during the appointment will be disinfected. The office uses Super Sani Cloth, disinfecting sprays and disinfecting wipes for cleaning and sterilization. Any instruments used during an appointment requiring sterilization will be sterilized in either an ultrasonic cleaner, which sterilizes using a Wavicide solution or in a UV light chamber.  The Wavicide solution is utilized and replaced according to the manufacturer’s guidelines and for extra precaution, will now be changed out more frequently than recommended by the manufacturer and will be done bi-weekly.  The waiting room area has had all of the magazines and brochures removed, to prevent spreading of germs. Signs have been placed to inform patients of office procedures on the entrance doors. The signs will include CDC guidelines. There is signage in all bathrooms encouraging proper hand washing. Patients are required to wear a properly fitting mask, unless the medically are unable to, for the duration of their visit to the office. It is preferred that patients come to their appointment alone and have anyone that might be with them, to wait in their vehicle and not in the waiting room.

Patients are encouraged to practice appropriate social distancing and keep 6 feet away from any patient or staff member they might come into contact with while in attendance of their appointment. The waiting room and patient restroom will be disinfected daily, as well as door handles. Staff areas will also be disinfected, such as light switches, door handles, break room area and copy machines. Staff and providers will also use appropriate social distancing and will refrain from any gestures, such as handshakes.

Should a patient be undergoing a hearing test, which will require them to be tested in the sound booth, the booth will be disinfected following the hearing test. The chair will be wiped down, as well as the headphones and/or inserts, response button, bone oscillator and door handles. Any toys used to perform conditioned play audiometry with children will be properly disinfected. The fan that circulates air in the sound booth will be run for at least 15 minutes prior to the next patient having a hearing test in the sound booth. This has been stated by e3 diagnostics as the proper amount of time between patients needing a hearing test in the sound booth.

If a patient is having real ear measures of their hearing aids, the real ear equipment will be disinfected upon completion of the appointment. Fresh probe tubes are used on each patient and discarded at the end of the measures.

Safety is of a high priority to us and we want to ensure that our patients hearing health needs are met as safely as possible. The office is adhering to CDC and state guidelines for infection control during this COVID-19 pandemic. As we are given any new recommendations, the guidelines will be adjusted accordingly.

 

Resources

https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html

https://www.cdc.gov/coronavirus/2019-ncov/

https://www.michigan.gov/coronavirus/0,9753,7-406-98178_98156—,00.html

http://aubankaitis.com/infection-control-anxiety/

http://aubankaitis.com/qualified-disinfectants-for-covid-19/

https://www.oaktreeproducts.com/covid-19-qualified-disinfectants

 

 

To all of my patients,

I am sure many of you are aware of the COVID-19 pandemic that is sweeping the globe right now. These are difficult and unknown times for us all and I want to assure you that I am monitoring the situation very closely. Some of you may have seen my update last week on my practice’s Facebook page, but I made the decision to close my office, which was made carefully and was not easy. I chose to close and postpone appointments out of concern for the safety and well being of my patients. We know that COVID-19 spreads very rapidly and easily. Many people are unaware they are spreading it, as the incubation period can be 2-14 days. There is a population that is at a higher risk to severe symptoms, which includes elderly, compromised immune systems, patients that have undergone cancer treatment or are undergoing treatment currently, diabetes, asthma/breathing issues and pregnancy. I see many patients in these categories on a daily basis and wanted to provide the highest level of safety and consideration for them. Symptoms of COVID-19 include fever, cough and difficulty breathing/shortness or breath. Anyone experiencing these symptoms should call their primary care providers immediately. Individuals that have these symptoms or who may have been contact with anyone with these symptoms or known diagnosis of COVID-19 should self-quarantine for 14 days. EVERYONE is being asked to practice social distancing at this time. If you do not need to be out, stay home and keep 6 feet of distance from you and others when you are out in public. COVID-19 should be taken seriously and we need to take caution to minimize the spread, so we do not exhaust our hospitals and their resources.

My office closed on Wednesday, March 18th and I had been hoping to be able to open my office again April 6th, but right now that is unknown. While I was writing this email, the governor declared a stay at home order, which will now have the office closed until April 13th. When the office will open back up will depend entirely on how things continue to unfold in our country, as well as the direction I am receiving from the CDC, state government and my National Audiology Associations (AAA and ADA). My practice utilizes a practice management software called Sycle, which just released telehealth to all of its providers. I will be utilizing this feature with my patients. This will allow me to see you face to face and trouble shoot any issues you are having with your hearing aids during this time. If you are low on hearing aid supplies, I do have some available to me from home that I can mail to those in need. You can request a telehealth appointment by calling the office and leaving me a voicemail, as I do check those periodically from home. You can also go to the website at www.dreimershearingclinic.com and submit a contact form requesting a telehealth appointment as well. I will do my best to accommodate these requests in a timely manner, but I am at home with two toddlers, so please be patient with me. I also want my patients to know that I will be providing my telehealth to any of you who are feeling isolated and alone at this time. If you are lonely and just need someone to talk to I am hear and want to provide telehealth to you as well. Telehealth is HIPAA compliant and secure. The video is not saved or recorded anywhere. I know the toll feeling isolated can take on people and I want everyone to know they are not alone right now. I am here for you and we are all in this together. I have been trying to update my Facebook page with any useful information that may benefit my patients, so if you do not already follow my page, please do so. I will also be posting any office updates on there, as well as the practice page.

Please know we are in this together. I miss my office and look forward to seeing patients again, but right now your safety and health are of the highest importance to me. I will try to help my patients to the best of my ability right now. Stay healthy and safe.

Sincerely, Dr. Eimers

The following is a list of resources about COVID-19 that can be helpful to you during this time.

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://www.michigan.gov/coronavirus

https://www.who.int/emergencies/diseases/novel-coronavirus-2019