The numbers of Covid positive cases in Jamaica are climbing. During the short period from March 2020 to now, we are seeing how much protocols, recommendations and guidelines can change. Therefore, regardless of level of staff, or when health care workers are interacting with patients, all of us must do an initial covid screening before engaging in patient care.
Covid screening is generally done through a series of questions and temperature checks. At the point of entry to a healthcare facility, such as at triage, the HCWs at that point will do screening and triage patients based on their answers. Though we know it is done and documented, that does not remove the responsibility from the rest of us, whether doctors or nurses, from repeatedly asking patients questions.
Screening questions will include questions such as, but not limited to:
Do you have a cough?
Any history of fever?
Any recent travel?
Anyone interaction with anyone who has travelled recently or has covid?
In many instances our screen can be expanded to meet the changing presentations of the virus and the circumstances in our country. As of this moment we must include anosmia (loss of smell) and interaction with persons who come from covid hotspots.
Why do continuous screening?
Challenges arise in how patients and HCWs communicate. We often find that when one person asks a question and another person asks the same question, but in a different way, we sometimes get different responses. Not only that, patients for whatever reason may initially withhold information. And you, as a HCW, may ask a question that was initially overlooked.
Basically, we are trying to increase our pickup rate so that persons who need to be tested, isolated or quarantined can be found.
If the patient comes with someone, ensure that it is clear that the screening questions are for both the patient AND the relative/ guardian.
Ask the questions in a way the patient will understand based on their cultural and educational background.
Do not ask the questions in a biased way “You didn’t travel recently?” versus “Any recent travel?” be as neutral as possible.
Be specific and clear.
Explain to patients why the questions are being asked and that there are no wrong answers.
Fear around covid-19 is real, and so is stigma! We as HCWs play an important role in dispelling stigma, quieting fear and picking up potential cases.
During this time, stay safe, wash your hands and always protect yourselves first!
Samantha C. Johnson