UNCH 2021 Nursing Annual Report - 8

MAGNET® STORIES
UNC Hospitals was
among the first in the
area to allow routine
visitation for COVID
patients. This was
initiated by nursing
staff, who shared
families' stress when
they could only connect
with patients virtually.
UNC Health (UNCH) Psychiatry Services was one
of many areas challenged with providing COVID
care. UNCH Psychiatry Services is unique, in
that there are congregate setting environments
where group therapy modalities are common, and
infection control compliance is challenged by the
behavioral health population. These challenges
inspired their team to think outside the box for
ways to keep their patients safe.
An interprofessional team, consisting of nursing
and physician leadership, infection prevention,
therapy services, environmental services,
quality improvement, educational specialists,
and hospital leadership worked together to
design a safe environment for delivering care
and preventing the spread of COVID. The
creation of psychiatric COVID containment
areas was part of the solutions devised, where
COVID patients could be safely cohorted.
Additional interventions employed included:
risk assessments for all patients, provision
of masks, hand hygiene encouragement at
interval periods, and the transition of group
therapy sessions to a virtual format. During
peaks of COVID, some therapy groups were
limited or canceled to help protect patients.
This work was published in the American
Journal of Infection Control.
During the Delta variant surge, patients were
extremely ill and many required extracorporeal
membrane oxygenation (ECMO). The demands
of this high-acuity population challenged
the nursing and ECMO teams. It was a
heartbreaking period, where staff struggled
to care for young adults, many of whom had
poor clinical outcomes despite aggressive
therapies. In the three-year period prior to
COVID, there were an average of 56 adult and
19 pediatric ECMO patients per year. In 2021,
there were 140 adult and 60 pediatric ECMO
cases, with 77% of those due to COVID. In an
effort to balance the workload, staff from SICU,
MICU, TICU, PICU, and ECMO worked together
to provide care for these resource-intensive
patients, many of whom required 1:1 nursing
care. It was a relief to staff when fewer patients
required ECMO therapy during the Omicron
variant surge.
8 | 2021 Nursing Annual Report
UNCH 2021 Nursing Annual Report

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