NSHA is committed to keeping all physicians up to date with information from the provincial incident management team and all clinical information required to assist in our provincial response.
Designated Zone COVID-19 Inpatient Units
NSHA is working to create provincial capacity for in-hospital care for COVID-19 patients who may require it. Our planning and response includes: Primary Assessment Centres for people referred by 811; Secondary Assessment Centres in regional hospitals for patients requiring some care & treatment, and; COVID inpatient units for patients requiring admission.
The following hospitals have been designated, and are prepared to host COVID-19 inpatients:
• Halifax Infirmary
• Dartmouth General Hospital
• Yarmouth Regional Hospital
• Cape Breton Regional Hospital
• St. Martha’s Regional Hospital
• Colchester East Hants Health Centre
Units have been identified based on criteria such as access to negative pressure rooms, proximity to an Intensive Care Unit (ICU), etc. Other COVID-19 units may be identified as the situation evolves.
Work will continue to make sure units are ready, and staff are appropriately trained and prepared to run the unit and safely care for patients. This will require ongoing support from many departments and program areas.
Admitting to COVID Unit
A process has been created for admitting to the HI and Dartmouth General COVID units that may be adaptable to other sites around the province. View it
here
.
Guidance for disposition of adult patients presenting with confirmed or suspected COVID-19
Guidance for disposition of adult patients presenting with confirmed or suspected COVID-19
If a patient is identified through 811, 911, or presents in any Emergency Department in Nova Scotia and meets the COVID screening case definition (new or worsening cough plus travel outside Canada within 14 days OR contact with a presumptive or confirmed COVID-19 patient OR contact with a symptomatic person who has travelled outside Canada in the last 14 days) and has other “red flags”, the patient should be placed on contact/droplet precautions and arrangements made for the patient to be transferred to the nearest COVID hospital. In order for the transfer to be arranged, the COVID physician in the closest COVID unit should be contacted through locating to accept the patient in transfer. Patients should NOT be transferred until accepted by the receiving COVID physician. The patient may be observed in the Secondary In-hospital assessment area or admitted directly to the COVID unit or ICU as applicable.
Patients who do not meet the COVID screening criteria should be managed on contact/droplet precautions at the hospital they present in and tested for COVID (irrespective of travel history). If the COVID test is positive, the COVID physician at the nearest COVID hospital should be contacted to arrange transfer the COVID unit. If there are concerns about potential for COVID among patients who do not meet the COVID screening definition, the on-call COVID physician at the closest COVID hospital can be contacted to discuss appropriate disposition.
COVID secondary assessment and inpatient units are currently located in the following hospitals. This document will be updated as new COVID secondary in hospital assessment centres and inpatient units are opened.
- Central Zone- QEII (Halifax Infirmary)
- Eastern Zone - Cape Breton Regional Hospital, St. Martha’s Hospital
- Northern Zone - Colchester Regional Hospital
- Western Zone – Yarmouth Regional Hospital
For guidance and information on patient clinical pathways for COVID-19 in a secondary in-hospital assessment centre, click
here.
Draft Guideline - Management of COVID-19 Positive Surgery Cases in Halifax Infirmary OR
A group of provincial physician leaders request feedback from other physicians on their draft guideline for managing COVID-19 cases in the operating room. Feedback should be sent directly to
Andre.Bernard@nshealth.ca.
New Pediatric Admitting Order Set
A new order set has been posted to the site. This set is for pediatric admissions for known or suspected COVID-19. View it
here.
New Critical Pathway for COVID-19 Positive Intrapartum Care
Women’s and Children’s Health have posted a new critical pathway to guide those in treating patients who are COVID-19 positive. You can view it
here.
As a result of these new guidelines related to Labour and Delivery, there is now a new population of health care workers who will require N95 testing and availability of PPE. All obstetrical staff (physicians, nurses, and repiratory therapists) require fit testing.
For information about fit testing in your area, contact your zone Occupational Health and Safety Lead:
Eastern Zone
Craig Thiel: craig.thiel@nshealth.ca
Sheryl E MacDonald: sheryle.macdonald@nshealth.ca
Central Zone
Angela Keenan: angela.keenan@nshealth.ca
Northern Zone
Alison Dougan: alison.dougan@nshealth.ca
Laura Curley: laura.curley@nshealth.ca
Western Zone
Mike Carter: michael.carter@nshealth.ca
Coronavirus Primary Assessment Centres
Coronavirus Assessment Centres are moving locations and opening daily. To ensure you have the most up to date information about resources for your area, visit our website for a listing.
Contact information (fax referrals) and operating hours are now updated daily on
www.cdha.nshealth.ca/coronavirus.
This information is under the
Coronavirus Pathways for Care
resource section.
Interim Associate Zone Medical Executive Director – Northern Zone
I am pleased to announce that Dr. Aaron Smith has accepted the role of Interim Associate Zone Medical Executive Director, Northern Zone. Dr. Smith is a graduate of Dalhousie Medical School with a MSc in Community Health and Epidemiology and is currently a family physician practicing in Westville, NS. Dr. Smith is the Director of Medical Education for Pictou County and is a Cabinet member for the newly created North Nova Residency Program and currently has one of the first residents of this program working with him. Please join me in welcoming Dr. Smith to this new role.
Laboratory Services
A group of new lab requisitions for Coronavirus Assessment Centres, Corrections Facilities, and Primary Health Care settings are now posted to
www.cdha.nshealth.ca/coronavirus
.
An additional document on Alternate Collection of Throat and Nares was added today as well. View it
here.
*New* Autopsy Process for COVID-19
During the pandemic, autopsy will not be indicated for COVID-19 positive cases of respiratory illness. Clinicians seeking an exemption to this
must contact their zone pathologist on call (or Medical Examiner’s office if indicated)
before obtaining consent from families
. For deaths suspected to be due to COVID-19, swabbing (without autopsy) for COVID-19 can be done.
COVID-19 Results Available in Provincial SHARE
Effective March 20th, COVID-19 results for patients across the province will be available for reference within the patient record in the SHARE system. As well, for reference, results are being sent to the primary care provider, if there is one available. Public Health is responsible for the follow up on all COVID-19 results. The link to SHARE is
https://novascotia.ca/dhw/ehealth/share/user-access/
Reminder: Drug Information System and SHARE Access Process
With more health care providers treating patients remotely as a result of the COVID-19 epidemic and the need for paperless prescriptions and access to drug profiles, this is a reminder that all user access requests to SHARE and the Drug Information System (DIS) must be submitted through
IT Self-Service.
This will help users and SHARE coordinators avoid delays due to incomplete forms being submitted.
Please note that paper-based forms will no longer be accepted and will be returned to requestors, advising them to re-submit the request using
IT Self-Service. We thank you for your support and if you have any questions, please contact your SHARE coordinator or
SHARE@novascotia.ca or your local IT
Service Desk.
Infection Prevention and Control for Primary Care
A document was posted to the physician site to guide Primary Care offices on appropriate cleaning and disinfection of the environment and devices for Primary Care Practices. You can view it
here.
Privacy for Positive COVID-19 Patients
We are asking all clinicians and health care providers to refrain from speaking about locations and personal details of individual COVID-19 positive cases.
NSHA Perioperative and Interventional Radiology Services during COVID-19 Pandemic:
Recommendations for Triage of Urgent, Benign and Cancer Surgery
This is a follow up communication concerning triage of surgical and interventional radiology services during the COVID-19 global pandemic. As previously communicated, all non-urgent operative and IR procedures have been suspended in all NSHA facilities effective March 18, 2020. This communication concerns approaches to defining more clearly elective from urgent cases to assist in triage of surgical and IR resources in a given hospital. For more information, click
here.
Women's Choice Clinic Remains Open
The Women's Choice Clinic remains open as an essential service to provide surgical and medical abortion based in the Victoria General site of the QEII.
There is a provincial self referral line (1-833-352-0719) for information about accessing medical and surgical abortions at the QEII and other locations across the province. Women can work with the referral line to learn more about accessing services closer to home.
Privacy Considerations when Working from Home: Printing
Although NSHA does not usually facilitate the capability of end-users to print while working at home, there will be limited accommodations allowed due to the unique circumstances we are now facing. Best practice would be to keep printing of patient and/or confidential information to a minimum to prevent inadvertent breaches – print only what is absolutely NECESSARY. It is mandatory that any print jobs done while working at home are kept secured and the end-user is in constant control of the information – this means safe storage, safe disposal and safe travel of the information.
Self Monitoring and Self Isolation Tools
Coping with COVID Resource
For many of us, COVID-19 is creating an uncertain future. People worry about their own health,
the health of their loved ones, school, work, or finances. This is an anxious and stressful time
for everyone. It's okay to take time for your mental health – good mental health and positive
wellbeing can help you better cope during this time.
Occupational Health information & Guidelines for Healthcare Workers
NSHA’s Occupational Health Safety and Wellness is offering a provincial phone line for symptomatic health care workers to be able to call and be screened and then tested if required.
NSHA Occupational Health line 1-833-750-0632
Select your zone when prompted. Please do not call all lines.
Provide your name, phone number and brief description of how you meet the criteria for screening. Calls will be triaged based on this information.
Staff and Physician Parking
Today, President and CEO Dr. Brendan Carr, in a
message to staff, announced that parking will now be available free of charge at Nova Scotia Health Authority (NSHA) hospitals. Parking gates will be open beginning this afternoon, Friday, March 20. In recognition of their commitment to patient care during COVID-19, staff and physicians will not be charged for parking during the pandemic. Management is working on a reimbursement process for staff and physicians currently paying for parking. Updated communications will follow in the coming days.
