How a negative pressure room lets families say goodbye

Minor engineering fix enables last visits


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Some of the most treasured rituals involved in end-of-life care have become out of reach as we put in place the necessary precautions to prevent the spread of COVID-19 illness.

To protect our most vulnerable Veterans, the Community Living Center at VA Black Hills was the first ward to close to visitors. Even with compassionate exceptions, hospice visitation had a time limit and families could only visit one at a time. The policy required families to nearly give up the experience of physical touch, sharing memories and long goodbyes.

VA Black Hills Hospice Family Room

Dr. Mary Clark knew these protective measures were difficult for grieving families to accept. Hospice services aim to relieve suffering and provide bereavement support to families. Under normal circumstances, hospice care provides a comforting environment for families to share uninterrupted, quality time with their loved one. Clark is the Rehabilitation and Extended Care associate chief of staff.

Social worker Renee Radermacher works closely with Veterans and their families on the CLC. She thought of a way to give back some of what some families lost. She recommended converting one of the family rooms adjacent to the patient hospice room to a negative pressure room. This would provide an additional safety measure allowing up to three family members to visit for one hour each day.

VA Black Hills Hospice Family Room

A multi-disciplinary team addressed engineering, infection prevention, clinical considerations and social work. The team quickly added a reverse air flow machine and ready the room to receive families. Negative air flow is effective to reduce the transmission of dangerous infectious diseases. Along with good hygiene and masking, it allows families to spend more time with their loved ones, providing relief to the family

“The families are relieved” Dr. Clark said.

“Dr. Clark deserves all the credit for the hospice patients’ family visits. If not for her sensitivity and concern there would be no family visits and the patients would pass away alone,” added Brett Krout, safety manager and workgroup team member.

Providing compassionate patient care during this pandemic requires us to focus on safety while never forgetting the experience of the patient and their loved ones.


Teresa Forbes is a public affairs officer for the VA Black Hills Health Care System (VA BHHCS). Photographer Katina Miller is a CLC assistant nurse manager for VA BHHCS.

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