2020 Quality




Hospital COVID Response Stories - Marshfield Medical Center, Park Falls

In March 2020, Marshfield Medical Center-Park Falls began preparations as the spread of COVID-19 reached pandemic levels. This was a multidisciplinary initiative at many levels. 

With warnings early in the pandemic that personal protective equipment (PPE) could be scarce and to anticipate shortages, their infection prevention RN and nursing leadership evaluated stored materials from Ebola preparedness and located a supply source for masks, coveralls, face shields, etc. Staff were trained in PPE requirements, and a “buddy system” was initiated for all rooms requiring COVID PPE. For those staff who were unable to use N95s, powered air purifying respirators (PAPRs) were used after respiratory therapy trained staff on proper use. The medical emergency paperwork was revised to include confirmation of the appropriate PPE for all participants. This was done as a visual reminder to oversee that all staff were properly attired during a code response. 

Changes were also implemented to the hospital’s physical space. Negative air flow rooms were identified in collaboration with building services and a “pod” was created—a designated area on the medical/surgical floor that can house eight COVID positive patients. This area was sealed off from the rest of the floor and identified with appropriate restricted access signage. A nurse station is included in the area and it is staffed with one RN and one CNA, with the CNA acting as the “buddy” to ensure all appropriate PPE is worn by staff entering the patient rooms. The stress lab room right outside the ICU was also turned into a negative pressure room, and departmental managers created designated carts for PAPRs and a clean-and-dirty area was established. On exit from COVID patient rooms, all equipment is sanitized and staff are provided a place to store N95 masks for designated re-use.   

Marshfield Medical Center-Park Falls monitored COVID cases and implemented hospital visitor restrictions as the virus reached pandemic levels. With outpatient areas stopping services, those employees were used to staff screening tables and all patients, allowed visitors, and staff were screened daily. Hospital/emergency department (ED) communication concerns arose, so a nurse communication liaison position was created to assist with communication between the ED and family members who were asked to wait in their vehicles. 

Initially, COVID testing results took 48 hours to receive. But the lab manager worked to reduce this time and in April 2020, was able to implement a two-hour turnaround time. These tests were originally reserved for admissions and transfers, which enabled the facility to admit COVID positive patients to appropriate areas for enhanced isolation practices and non-COVID patients to other areas, which helped with preserving PPE. Their operating room (OR) staff implemented pre-procedure testing so surgical cases could continue and the ED began COVID testing after clinic hours to assist with getting the community tested. Nursing also initiated weekend drive-up testing to supplement the clinic’s weekly drive-up testing that was occurring. 

In order to deal with potential staffing concerns related to surges, additional staff was trained on the nursing floor to be able to assist if needed. In addition, Marshfield Medical Center-Park Falls developed a hospital wide surge plan. Concerns around patients’ communication with their loved ones were taken care of by the nurse liaison and iPad’s, an employee shower area was developed so staff could shower and change clothes prior to going home, UV lights were used to assist with cleaning patient rooms and ambulances, and physicians recorded public service radio announcements during the initial months reminding the community the hospital was open to assist with all healthcare needs and instructed the public on COVID recommendations/guidelines such as masking and hygiene.

As staff started experiencing COVID-related stress symptoms, including isolation, constant mask use, concern for co-workers and relatives, dealing with the stress of patients being unable to have family visits, a streaming montage on a TV screen was put up of staff family photos, vacation spots, pets, etc.  Staff were able to submit photos whenever they wanted. This has assisted with increasing staff morale through the pandemic. 

New COVID treatment options were followed as they evolved, which included the use of remdesivir and convalescent plasma, and nebulizer treatments were switched to inhalers whenever possible. In November 2020, bamlanivimab antibody infusion became available, and this was provided to the community as an outpatient visit.

This was a team effort—all departments came together to assist with our successful COVID response.