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Coronavirus: The Rossi Hospital protocol for a …

A La Plata hospital, the Interzonal General de Agudos “Dr. Rodolfo Rossi”, designed a protocol for the ones relatives of palliative care patients with coronavirus could accompany them. In fact, it has been implemented since May. The Buenos Aires hospital initiative now acquires special interest, after the committee of health specialists that advises President Alberto Fernández put the accent on “recommend follow-up to terminally ill patients”
.

Although in all hospitals there are health professionals who assist critically ill patients until the moment of death, Rossi devised a specific protocol to incorporate the family. And it is not by chance that it happened there: it is the first hospital in the Province of Buenos Aires to create a Palliative Care service, in December 2001. Since 2003, the doctor Cecilia Jaschek, current executive director of this public establishment, worked in this pioneering unit in this type of care aimed at people with incurable and advanced diseases.

Jaschek remarks that the axis of palliative care is “the accompaniment of the family and the patient” by an interdisciplinary team. That is why within the area “the question quickly appeared” about how to continue with this accompaniment in a pandemic that imposes another way of dying
and also another way to start a duel
. The question is very complex but there are a single “knot”According to the perspective of Juan Carlos Tealdi, a member of the Bioethics Committee that advises the Government: “how is it done to maintain the security measures, keep the patient in their contacts. And eventually if he is about to die he may have a proper farewell. This is what began to be debated, because at the beginning it was’ I isolate you and bye ‘: you don’t see anyone anymore’”.

The key points of the protocol

These are some of the points that are established in the Rossi Hospital protocol so that palliative care patients with coronavirus can be accompanied:

* The presence of a family member is approved, who can accompany the patient of the suspected / confirmed case for the duration of the hospitalization. In case it is positive, or until the moment the coronavirus is discarded, when withdrawing, you must comply with fourteen days of isolation. They can withdraw at any time and be replaced by another companion who meets the requirements.

* You cannot have risk factors for covid-19 (over 60 years, cardiovascular disease, kidney disease, chronic lung disease, diabetes, pregnancy).

* You are trained with written material and videos for the correct use of Personal Protective Equipment (PPE). You must wear a surgical mask, eye protection, gown, and gloves throughout your stay.

* You must sign three copies of a consent.

* Upon arrival, the companion is given both equipment to change. Street clothes and accessories are placed in a double plastic bag that will be placed in the closet of the patient’s room, to protect it from contact until the time of departure.

* The PPE equipment is changed every six hours, like those of the health personnel.

* In the event that the patient maintains autonomy for feeding, the companion and the patient will feed at different times. In addition, while one feeds, the other must remain with a chinstrap and maintain a minimum distance of two meters. Accompanying persons may not roam the corridors of the hospital.

Rethink the end

For Jaschek, after four months since the start of the pandemic, it is necessary to “rethink these issues and prevent both hospitalization and the end of life from being a lonely and devastating process for both the patient and the family.”

With the idea of ​​humanizing care as much as possible, Rossi also implements a system of daily telephone calls to give the report to relatives and a device for mental health assistance both for the patient and for loved ones who need it.

“The protocol is written in detail and is available to all health teams that want to implement it to, finally, provide care that includes, in addition to physical care, aspects that are so important for the patient and their loved ones such as mental health and spiritual, ”explains Jaschek.

The full protocol

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