“Desperate times call for desperate measures.” This phrase likely originated from the Greek physician Hippocrates who said, “For extreme diseases, extreme methods of cure, as to restriction, are most suitable.” Another similar Latin saying, "extremis malis extrema remedia," appears in print as early as 1596.
In this time of viral outbreaks, this saying appears to apply. However, first and foremost, stay calm! With a little care and planning, we can get through this with minimal interruption of care.
With the COVID 19 pandemic, it's prudent to add additional protocols in your office and optical.
These protocols have been updated as of March 15, 2020 by the CDC and WHO.
Clinic
The US Surgeon General warned that clinicians should postpone those outpatient visits and procedures that can be safely delayed, particularly in elderly patients and those with comorbidities. (The presence of one or more additional medical conditions.)
When phoning about visit reminders, ask to reschedule appointments for patients wo have upper respiratory illness, fever or returned from a high-risk area within past 2 weeks.
When patients arrive and if office setup permits, before they enter waiting room, ask the same questions as you did for visit reminder calls. If the answer is yes, they should be sent home and told to speak to their physician.
Keep the waiting room as empty as possible. One suggestion is to ask patients to wait in their cars until you call them in, using their mobile phones.
If a patient with known infection requires urgent ophthalmic care, they should be sent to a hospital.
The use of slit-lamp barriers or breath shields is encouraged as is continual sterilization of equipment between each patient.
Speak as little as possible and ask patients to refrain from talking.
Environmental cleaning and disinfection recommendations:
- Rooms and instruments should be thoroughly disinfected after each patient encounter, particularly where patients put their face and hands. Wear disposable gloves when cleaning and disinfecting surfaces.
- Slit lamps, controls and breath shields should be disinfected, especially where patients put their hands and face.
Recommended disinfectants:
- Diluted household bleach (5 tablespoons per gallon of water)
- Alcohol solutions with at least 70% alcohol
- Disinfecting wipes, multi-surface cleaner + bleach, professional disinfectant spray, etc.
Optical
If you don’t currently do so, now is the time to insist on scheduling ordering and dispensing of glasses. The same protocol as the clinic should be followed for optical clients if they’ve not come directly from the clinic. Ask walk-ins to schedule another time, or at the very least ask them to stay inside their cars until called in. (After correctly answering protocol questions)
Clean all surfaces that come into contact with the patients face and hands. Clean the pupilometer between each patient.
Consider asking patients to “hold their breath” while using the pupilometer. Inform them that you will too.
Consider handling the frames from your board yourself, rather than allowing patients to pick and choose themselves. You can ask them to point out which frames they would like to try on and you can remove and return them. Of course, this means you would put the frames on and off the patients as they try them. If this isn’t appealing or possible, simply have disinfecting wipes nearby and wipe each frame off before returning to board.
Wash your hands frequently or between each patient.
If you have additional protocols not mentioned above, by all means, use them! We at Frecker Optical, want every health care staff to remain safe and healthy.