March 28: DAILY COVID-19 UPDATE

March 30, 2020  //  FOUND IN: Updates & Resources

NEW TODAY: Here’s the latest information about Michigan Medicine’s management of the COVID-19 pandemic:

  • DAILY STATS
  • TOWN HALL VIDEO
  • PPE REMINDER
  • OPIOID PRESCRIBING
  • MASK AND GLOVE DISPOSAL

DAILY STATS

Today’s census for COVID-19 inpatients and those patients under investigation (PUI) are noted below: 

As of March 28, 4:30 p.m.

TOWN HALL VIDEO

A virtual town hall was held Friday to provide updates on COVID-19 related activities and planning for the future. If you missed it, view the town hall here.

PPE REMINDER

In response to multiple questions, we are providing clarification and an updated grid on PPE use. N-95 masks (or PAPRs if not fit tested for N-95 mask and trained in PAPR use) should be worn by all healthcare workers in the room during intubation, extubation, bronchoscopy, or bag mask ventilation for ALL patients in ALL care locations, regardless of patient symptoms or isolation precautions unless they have recently tested negative for COVID in the prior 48 hours.   

For more information, click here.

OPIOID PRESCRIBING

Recently the DEA announced that it is waiving the in-person requirement for opioid prescribing in light of this unprecedented pandemic and is allowing telehealth to substitute for the face-to-face requirement.  

Over several years, our approach to appropriate use of opioids has been very effective. In the coming weeks and months, we will need to develop approaches to ensure that those who need opioids receive them, while supporting the overall goals of our opioid program. Below are a number of relevant updates. More will be provided in coming days.

As you are aware, the State of Michigan Start Talking Form (STF) law requires education on risk of opioids be delivered at the time of prescribing and a physical signature collected on the form. That form must be imaged into the medical record.

Given the extenuating circumstances and recent exemption in Federal Requirements for face-to-face meetings prior to Opioid Initiation, it is reasonable to use telehealth to document the dangers associated with an opioid as indicated on the Start Talking Form. Bringing a patient to clinic for opioid initiation increases risk for COVID-19 exposure and does not support the “shelter at home” order by the Governor.

If an opioid prescription is initiated, please document this conversation in the EHR and note that due to the risk of COVID-19 exposure the patient could not safely be physically present to sign the STF. Please make sure they acknowledge receipt of the education and have no further questions on the dangers of opioids.

To be clear, this process is not yet a State sanctioned exemption. However, it is the safest option for patients at this time and work continues with the State to formalize this process.

Reminder: The STF is not required for all controlled substances, only opioids, and it is not required for patients previously established on opioid therapy prior to June 1, 2018.

Please direct any questions to paulhill@med.umich.edu.

MASK AND GLOVE DISPOSAL

With increased use of PPE, we need your help in keeping our facilities clean and safe. All masks and gloves should be removed and properly disposed in standard trash receptacles before leaving buildings.

Still have questions?

We are also posting all daily bulletins and policies on Michigan Medicine Headlines at https://mmheadlines.org/covid-19-updates/.  Please bookmark that site and refer to it throughout the day for the most up-to-date information. An FAQ for staff is also posted and updated frequently.

If you still can’t find what you’re looking for on these web pages, please email coronavirus-info@med.umich.edu and your question will be answered as quickly as possible.  Do not use this email for sharing patient health information.

Jeffrey Desmond, M.D.
Chief Medical Officer

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