Nursing body wants frontline testing on demand

With four Queen Elizabeth Hospital staff testing positive for COVID-19, including two nurses, President of the Barbados Nurses Association (BNA) Joannah Waterman on Friday called for testing on demand for nurses and frontline workers.

Waterman said while BNA is aware that the source of infection for the infected nurses was not within the hospital, safety practices should be reinforced and Personal Protective Equipment (PPE) made readily available according to the World Health Organization’s guidelines.

The BNA president said she noted the assurance given by QEH executive chairman Juliette Bynoe-Sutherland that thousands of supplies and reserves of PPE are in place.

Waterman said in a statement: “Two critical areas related to the science of transmission are respiratory airborne droplets and fomites on contaminated surfaces. In relation to airborne droplets, this warrants the need for readily available N95 or KN95 masks for nurses carrying out aerosol-generating procedures on all suspected and confirmed COVID-19 patients. In fact, we recommend use for all patients during such aerosolized procedures. For regular levels of care delivery, the recommendation is for surgical or medical masks,” she said.

Waterman also indicated that while ready availability of masks is the key, the duration of mask-wearing must not be compromised, as the filtration efficacy of masks can be reduced due to moisture build-up. She said the loss of efficacy of the mask in such situations, will lead to exposure to infection and stressed that nurses need to be always cognizant of these facts.

She said: “We note that physical distancing is virtually impossible, while one is delivering care to patients, but outside of direct care delivery while on duty, nurses should strive for some degree of distancing. This, therefore, reinforces the importance of donning PPEs.

“The second critical area related to the science is the ability of the virus to adhere to fomites or surfaces; so nurses, healthcare workers, and especially ancillary staff must-have resources for sanitizing by housekeeping. Nurses have always practised hand hygiene through frequent washing before and after procedures. This must now be ramped up along with the wearing of gloves as required.”

Waterman appealed to nurses to protect themselves by adhering to the protocol in wearing PPEs. In situations where these PPEs are not available, she urged them to remove themselves from likely risks; because ‘safe workers save lives’, according to a slogan used by Public Services International (PSI) and adopted by the Professional Nurses body.

She said: “During this time, nurses will be expected to operate under the classification for levels of exposure which is primary and secondary exposure or second and third generation exposure. According to the classification, primary exposure (high risk) due to close contact (within 6 feet), warrants mandatory quarantine.

“However, according to the science related to secondary exposure (low risk) nurses will be required to be on duty to fulfill the mandate of care delivery. We therefore reiterate the availability of PPEs & crisis intervention for our nurses, in the form of counseling, to give reassurance and assist with coping in this current crisis.”

The nursing leader pointed out that nurses across the globe have unfortunately feared worse than their colleagues in Barbados and the Caribbean, as millions have been infected. The International Council of Nurses reports that over 1,500 have died from coronavirus infections across 40 countries.

“We are grateful that the situation for our nurses and healthcare workers in Barbados is not out of control and satisfied that the hospital management had continued to put in place, measures for protection of the acute care facility, while the health authority continues its commendable efforts for containment, despite the recent spikes,” Waterman said. (AH)