Covid-19 and Keeping Patients Safe at Milton Keynes University Hospital
Friday 20 November 2020
We have received a number of questions about what happens when a patient comes into the hospital during the COVID-19 pandemic.
You will find below an overview of how we admit patients to the hospital and the measures in place to keep them safe.
What happens when a patient comes to the Emergency Department?
People continue to come to our Emergency Department (ED) with illnesses and injuries and we want to encourage local people to access emergency care when they need it.
Every patient attending the Emergency Department has a Covid-19 test as part of their triage (clinical assessment). Those test results are available within four to 24 hours, with priority given to our sickest patients first.
If someone attends our ED with the symptoms of Covid-19 or are likely to be Covid-19 positive (for example because someone in their household is positive), they are treated on what is known as the red pathway. This means they are treated in a separate part of the ED (known as the red zone). This happens even if we don’t have the results of their Covid-19 test – they are treated as probably positive based on their symptoms or because they have been in close contact with someone known to be Covid-19
If patients on the red pathway need to be admitted to hospital, they will be admitted to a red ward (a ward caring for Covid-19 patients) – currently those are wards 2, 15 and 22. Ward 2 takes patients who are ‘probably positives’ awaiting test results, while 15 and 22 take patients whose test results confirm they have Covid-19. They may also be admitted directly to the Intensive Care Unit.
There may be some exceptions to this if a patient on the red pathway needs specialist care – for example because they have had a stroke. In these instances, the patient will be admitted to a side room (an individual room) on the appropriate specialist ward. Particular care will be taken by staff on entering and leaving side rooms – for example they will change their face mask, gloves and apron and any other personal protective equipment (PPE) it is appropriate for them to wear.
If someone attends our ED with symptoms of an illness or injury and no Covid-19 symptoms, history of being in close contact with someone known to be Covid-19 positive, or who is part of a household currently isolating awaiting a Covid-19 test result, they are treated on what is known as the amber pathway.
If patients on the amber pathway need to be admitted to hospital, they will be admitted to an amber ward.
The green pathway is for patients who have had COVID-19 tests and undertaken self-isolation ahead of coming into the hospital for an elective procedure.
What happens when a patient is Covid-19 positive in hospital?
Every patient who is admitted to the hospital via the ED is tested for Covid-19. Some of those patients will need admitting to hospital after they have been assessed in ED.
Those patients who are known to be Covid-19 positive, displaying symptoms of Covid-19, or are potentially infectious because they live/ have been in close contact with someone who is symptomatic or isolating are admitted to a red ward.
Those patients who are not displaying symptoms of Covid-19 and are not likely to be potentially infectious (not previously Covid-19 positive, not living/ in close contact with someone isolating or Covid-19 positive) are admitted to an amber ward.
Having had a Covid-19 swab test on admission, all patients are then swabbed again prior to being discharged from hospital, or on day seven of their hospital admission.
Due to the length of the incubation period for Covid-19, and because people with Covid-19 can be asymptomatic (display no symptoms of the infection), patients who are Covid-19 negative on their first swab occasionally test positive on their second swab test.
If this happens, those patients are moved to a red ward or a side room. Any patient who has shared a bay with them is also swabbed again (regardless of the length of their stay).
Throughout the pandemic, the hospital has worked closely with Public Health England and followed all national guidance to ensure robust testing and tracing measures are in place where required, as well as ensuring the correct PPE and cleaning regimes are always in place and adhered to.
Why isn’t everyone isolated until you get their Covid-19 test result?
Unfortunately, the number of people who require treatment during the busy winter period means the hospital does not have the bed capacity to isolate all patients as soon as they are admitted to hospital as a precaution while we wait for test results.
We have defined red and green clinical pathways for admitting patients to the hospital depending on their risk factors for Covid-19 infection. These are described in the answers to the preceding questions on what happens when a patients attends ED and is admitted to the hospital.
Do you have enough PPE?
We currently have no reported issues with the supply or quality of PPE.
Different types of PPE staff are worn by staff when caring for patients in line with national guidance for preventing the spread of infection.
As an organisation, we have lots of ways staff can raise questions or concerns about PPE. These include multiple safety huddles throughout each day, weekly virtual all staff question and answer sessions with executives, PPE and Health and Wellbeing helplines, as well as ward managers and senior sisters on each ward.
If a member of the team is concerned about the level or quality of PPE they have been given, we would urge them to use any of these channels to escalate their concern.
Are staff being tested for Covid-19?
Throughout the pandemic, staff have been tested if they start experiencing COVID-19 symptoms.
From today (Friday 20 November) we are distributing test kits (known as lateral flow tests) to all staff so they can test themselves twice a week, for the next 12 weeks. These tests are designed to detect potential infection of staff who are not displaying any symptoms of the virus (asymptomatic). This testing of asymptomatic staff will help us to further reduce the risk of spreading the virus by detecting the potential presence of Covid-19 early, and asking positive staff to self-isolate.