Lippincott® NursingCenter®

Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, Chief Nurse of Wolters Kluwer Health Learning, Research & Practice, adjunct faculty for Drexel University, and a critical care nurse practitioner for Penn Medicine, Chester County Hospital, and Collette Hendler, RN, MS, MA, CIC, Editor-in-Chief for Lippincott Solutions and certified by the Certification Board of Infection Control and Epidemiology, Inc. as an Infection Preventionist, answer questions related to managing multiorgan dysfunction in COVID-19 patients. These questions were submitted by attendees of the webcast, Calming the COVID-19 Storm: Delivering Effective Clinical and Nursing Care, which took place on May 7, 2020.  This podcast covers the following questions:

• I have heard that the inflammatory response is responsible for the multi-system effects of COVID. What is the cytokine storm?
• I heard that patients with COVID-19 develop a coagulopathy and have excessive clotting. How do you manage their clotting and why is this so important?
• Do COVID-19 patients also have bleeding issues besides clotting issues?
• I hear patients are discharged on anticoagulation; how long are they on lovenox and what is the dose?
• Have you noticed COVID positive patients going into a new onset rapid a fib?
• If a patient presents with heart failure due to COVID, will the ejection fraction be affected?
• Is there a role of aspirin in the early stages of covid-19?
• Can you review the difference of CRRT, SLEDD and PIRRT? How do you keep the circuit from clotting?
• Is peritoneal dialysis helpful for acute kidney injury associated with COVID-19 or only CRRT or hemodialysis?
• Do you have any information about the use of Actemra in COVID-19?

*Note: this podcast was recorded on May 19, 2020. For the most up to date information, please visit our Coronavirus (COVID-19) Resource page, where you’ll find links to the on-demand webcast (earn 1 free contact hour!), CDC and WHO, plus free access to our point-of-care tools and more.

Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, Chief Nurse of Wolters Kluwer Health Learning, Research & Practice, adjunct faculty for Drexel University, and a critical care nurse practitioner for Penn Medicine, Chester County Hospital, and Collette Hendler, RN, MS, MA, CIC, Editor-in-Chief for Lippincott Solutions and certified by the Certification Board of Infection Control and Epidemiology, Inc. as an Infection Preventionist, answer questions related to oxygenation and prone positioning of COVID-19 patients. These questions were submitted by attendees of the webcast, Calming the COVID-19 Storm: Delivering Effective Clinical and Nursing Care, which took place on May 7, 2020.  This podcast covers the following questions:

• Can you explain why COVID-19 patients go into acute hypoxemic respiratory failure and ARDS?
• What is silent hypoxemia?
• How do you manage they symptoms of shortness of breath and anxiety in a non-intubated patient?
• I heard the goal is to not intubate the patient; is this true? How do you optimize oxygenation in patients before they are intubated and placed on the ventilator?
• We had several questions about positive end expiratory pressure, or PEEP. Can you talk about the role of PEEP please? Is there an average or maximum level of PEEP that is recommended?
• If you have a patient who has COPD, is your management of the ventilator any different?
• Do you recommend proning a nonintubated patient? What is the trigger to start proning patients with ARDS?
• I know you said that CPR can be performed with the patient prone. Isn’t it difficult to do CPR with the patient prone? How do you do CPR in a proned patient?
• Can a laryngeal mask airway, or LMA, be used to oxygenate a patient with COVID-19?
• Have they tried administering surfactant as they do in the NICU for respiratory distress syndrome?

*Note: this podcast was recorded on May 19, 2020. For the most up to date information, please visit our Coronavirus (COVID-19) Resource page, where you’ll find links to the on-demand webcast (earn 1 free contact hour!), CDC and WHO, plus free access to our point-of-care tools and more.

Betsy Todd, MPH, RN, Nurse Epidemiologist and Clinical Editor for American Journal of Nursing answers questions related to COVID-19 testing. These questions were submitted by attendees of the webcast, Calming the COVID-19 Storm: Delivering Effective Clinical and Nursing Care, which took place on May 7, 2020.  This podcast covers the following questions:

• Can you please review the different kinds of COVID-19 tests, and what each is for?
• If we still don't have enough tests, why doesn't the US adopt the WHO test?
• What about rapid, point-of-care tests for the virus?
• Why are we seeing a positive COVID-19 test after a second or third negative swab?
• Am I immune if my antibody test is positive?
• How can we get the best antibody test, with the highest accuracy?
• Are USA numbers so high because we are well-traveled, or are other countries not testing the general public as well?

*Note: this podcast was recorded on May 18, 2020. For the most up to date information, please visit our Coronavirus (COVID-19) Resource page, where you’ll find links to the on-demand webcast (earn 1 free contact hour!), CDC and WHO, plus free access to our point-of-care tools and more.

Betsy Todd, MPH, RN, Nurse Epidemiologist and Clinical Editor for American Journal of Nursing answers questions related to COVID-19 transmission. These questions were submitted by attendees of the webcast, Calming the COVID-19 Storm: Delivering Effective Clinical and Nursing Care, which took place on May 7, 2020.  This podcast covers the following questions:

• Should we be following droplet or airborne precautions, or what??
• What is the evidence for airborne transmission of the virus?
• Some media reports say COVID-19 is more and more being diagnosed in people who have followed stay-at-home recommendations and rarely went outside.  How can this be?
• How long does the virus remain in the air after intubation in a negative pressure room?
• How many negative COVID tests are needed before we can take a patient off of isolation?

*Note: this podcast was recorded on May 18, 2020. For the most up to date information, please visit our Coronavirus (COVID-19) Resource page, where you’ll find links to the on-demand webcast (earn 1 free contact hour!), CDC and WHO, plus free access to our point-of-care tools and more.

Betsy Todd, MPH, RN, Nurse Epidemiologist and Clinical Editor for American Journal of Nursing answers questions related to personal protective equipment. These questions were submitted by attendees of the webcast, Calming the COVID-19 Storm: Delivering Effective Clinical and Nursing Care, which took place on May 7, 2020.  This podcast covers the following questions:

• How safe is it to wear N95 masks more than once during patient care?
• Are there any guidelines about re-using N95s?
• Is a P100 respirator safe to use?
• Do we have other options for respiratory protection?
• Wearing N95s for hours has caused the skin on my face to blister.  What can I do?
• Is there any evidence to show that wearing masks in public is helpful?
• What other PPE should we be wearing in the hospital?  What about shoe covers?
• What PPE should workers in non-hospital settings be wearing?

*Note: this podcast was recorded on May 18, 2020. For the most up to date information, please visit our Coronavirus (COVID-19) Resource page, where you’ll find links to the on-demand webcast (earn 1 free contact hour!), CDC and WHO, plus free access to our point-of-care tools and more.

More Resources:

• Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings 
• Prevention and Management of Skin Damage Related to Personal Protective Equipment (PPE) 

This podcast is an interview with Dr. Anne Dabrow Woods, Chief Nurse of Wolters Kluwer Health Learning, Research & Practice, adjunct faculty for Drexel University, and a critical care nurse practitioner for Penn Medicine, Chester County Hospital, and Collette Hendler, RN, MS, MA, CIC, Editor-in-Chief for Lippincott Solutions and Certified Infection Preventionist. Anne and Collette share their expertise on acute respiratory distress syndrome, or ARDS, and how what we are seeing with COVID-19 patients differs from the ARDS clinicians are used to seeing and managing. We also discuss prone positioning – what it means, how it works, and managing patients.

*Note: this podcast was recorded on April 14, 2020. For the most up to date information, please visit our Coronavirus (COVID-19) Resource page, where you’ll find links to the CDC and WHO, plus free access to our point-of-care tools and more.

This podcast is an interview with Lynne Rudderow, MSN, RN, CRNP, WHNP-BC, CCE, a women’s health nurse practitioner for Penn Medicine, Chester County Hospital. While evidence on COVID-19 in pregnancy is lacking, Lynne shares what current recommendations are for prenatal care, care during labor and delivery, postpartum care, and breastfeeding.  

*Note: this podcast was recorded on April 10, 2020. For the most up to date information, please visit our Coronavirus (COVID-19) Resource page, where you’ll find links to the CDC and WHO, plus free access to our point-of-care tools and more.

This podcast is an interview with Robin Haskell, an acute care nurse practitioner for Penn Medicine, Chester County Hospital. Robin reviews the background of the new Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19),  and discusses each element of the recommendations and suggestions, including infection control, laboratory diagnosis and specimens, hemodynamic support, ventilatory support, and COVID-19 therapy. Highlights of how these guidelines differ from the guidelines for sepsis management and acute respiratory distress syndrome (ARDS) are also presented.

*Note: this podcast was recorded on March 27, 2020. For the most up to date information, please visit our Coronavirus (COVID-19) Resource page, where you’ll find links to the CDC and WHO, plus free access to our point-of-care tools and more.

This podcast is an interview with Dr. Anne Dabrow Woods, Chief Nurse of Wolters Kluwer Health Learning, Research & Practice, adjunct faculty for Drexel University, and a critical care nurse practitioner for Penn Medicine, Chester County Hospital. Our discussion covers topics such as personal protective equipment (PPE) – both availability of resources and the time necessary to put on full gear to protect ourselves, decisions on supportive care when faced with ventilator shortages, and the lack of social support for patients when visitors are restricted. Dr. Woods closes with inspirational words on resiliency and recovery when this crisis is over.

*Note: this podcast was recorded on March 26, 2020. For the most up to date information, please visit our Coronavirus (COVID-19) Resource page, where you’ll find links to the CDC and WHO, plus free access to our point-of-care tools and more.

This podcast is an interview with Dr. Anne Dabrow Woods, Chief Nurse of Wolters Kluwer Health Learning, Research & Practice, adjunct faculty for Drexel University, and a critical care nurse practitioner for Penn Medicine, Chester County Hospital. The discussion is around COVID-19 and the resulting surge of patients overwhelming the healthcare system. In some areas, hospitals have increased their bed capacity to accommodate more patients, which brings up the question – who will care for these patients? Dr. Woods shares specific recommendations for strategies to increase staff quickly, including alternative staffing and onboarding models.

*Note: this podcast was recorded on March 26, 2020. For the most up to date information, please visit our Coronavirus (COVID-19) Resource page, where you’ll find links to the CDC and WHO, plus free access to our point-of-care tools and more.