Ten COVID-19 gems for nurses

Task force briefings and news updates are happening multiple times a day, but what do nurses have to learn about COVID-19? Here are the takeaways from a few of our recent posts and podcasts…

1. Limit the variety of staff in COVID-19 patient rooms, especially when aerosol-generating procedures are being performed.

2. Consider the appropriateness of initiating and continuing cardiopulmonary resuscitation, discuss goals of care with patients or their proxies, and implement policies to guide clinicians.

3. After placing the patient within the prone position, allow 10 to quarter-hour to get well before considering returning to the supine position. Temporarily increasing oxygenation and hemodynamic support must be considered.

4. In case of acute respiratory failure with hypoxia, oxygen therapy must be used to take care of SpO2₂ not more than 96%.

5. Screen patients with severe COVID-19 for markers of excessive inflammation, similar to increased ferritin, decreased platelet count, or ESR, to differentiate patients who would profit from immunosuppressive therapy.

6. When implementing a team approach to care, be sure that additional staff report on to an experienced medical-surgical or intensive care unit nurse.

7. In adults with COVID-19 and shock, the dose of vasoactive agents must be adjusted to realize a goal arterial blood pressure (MAP) of 60–65 mmHg.

8. If possible, designate a nurse superuser who’s knowledgeable in regards to the proper use of non-public protective equipment and ask her or him to act as a resource and advisor to other staff.

9. When faced with a difficult decision, deal with what you possibly can control; focus your attention on the patient who’s in front of you right away.

10. A positive test result for one more respiratory virus doesn’t rule out COVID-19 and shouldn’t delay testing if there’s a high suspicion of COVID-19.

What gems are you able to share? Now greater than ever, it is important to learn from one another.