Coronavirus pandemic leads to expanded role for RVNAhealth

“If our mission was ever tested, it’s right now,” Theresa Santoro said.

Santoro is the president and CEO of RVNAhealth (formerly the Ridgefield Visiting Nurse Association), a private, non-profit organization that provides home health care services — primarily at private residences, assisted- and senior-living facilities, and hospices — in Ridgefield and 27 other Connecticut towns.

With a large staff of registered nurses, licensed practical nurses, rehabilitative therapists, and home health aides working 24/7, RVNAhealth is busy in usual times.

Which these, of course, are not.

The coronavirus (or COVID-19) pandemic has led to a spike in demand for medical services — some related to the virus and others linked to more traditional health care that is now harder to access.

“We are making over 1,000 visits a week,” Santoro said. “We are on the front lines of care in local communities as this virus continues to spread.

“Home health needs have increased as more patients are staying home for treatment and recovery,” Santoro added. “We are seeing increases in wound care and triage needs as we all work to stave off hospitalizations. We are using telehealth to facilitate FaceTime and video-conferencing visits with physicians to treat patients collaboratively.”

On Friday morning, RVNAhealth was admitting a 25th patient who had tested positive for the coronavirus, according to Santoro.

“The cases continue to come at us,” Santoro said. “I’m sure we will keep getting referrals.”

RVNAhealth has created a five-person COVID-19 response team dedicated to serving only patients who have tested positive for the coronavirus. “That team is going to grow,” Santoro said. “We might be adding to it every day.”

For both COVID-19 home health and hospice patients, RVNAhealth is providing symptom and pain management, social work services, and advance care planning. Initial assessment and monitoring is part of the treatment program for home health patients, while comfort and pastoral care are offered to hospice patients.

Ridgefield Crossings

RVNAhealth’s COVID-19 team has “provided significant support” at Ridgefield’s hotspot: Benchmark Senior Living at Ridgefield Crossings. As of Thursday night, nine of the 10 people in Ridgefield who have died from the coronavirus were residents at the facility.

Santoro declined to say whether any RVNAhealth staff have tested positive for COVID-19 through their work at Benchmark Senior Living.

RVNAhealth’s non-COVID-19 team is treating patients who have not been infected with the virus. That effort now includes expanded on-site nursing — at the RVNAhealth Center for Exceptional Care on Governor Street, Ridgefield — to cover services which physicians typically handle for their patients. Most of those services are drive-up only, although several are performed inside the building, including PT/INR tests to measure blood clotting.

“Some doctor’s offices have closed, so we are getting patients who would normally go there,” Santoro said.

Santoro said 10% of RVNAhealth’s home visits are now being conducted via telehealth.

“Telehealth is moving forward as the team and patients get increasingly accustomed to the technologies and medium,” she said. “Scripts have been developed to ensure effective and purposeful visits. Telehealth visits are as long as in-person visits and cover key points. When possible, a family member in the home helps with the visit.”

In addition, RVNAhealth nurses and staff are facilitating FaceTime and video-conferencing visits with family members who are not currently allowed access into assisted-living and hospice facilities.

“Some of the patients are really isolated and their families are frustrated and worried,” Santoro said. “We’re trying to provide some form of communication.”

‘PPE’ scramble

Like most medical organizations, RVNAhealth is scrambling to acquire enough Personal Protective Equipment (PPE) for its workers. The shrinking supply of PPE — which includes gloves, gowns, respirators, and eye protection — is a global worry.

“PPE is a tremendous need. All day long I’m searching for it,” Santoro said. “If the current pace continues, we have a supply that will last a few weeks. But if we start getting a lot more referrals that are COVID-19 positive, then our supply will go down faster.

“All nurses, clinicians and healthcare personnel are trained extensively in infection control, so the standard health precautions are already an imperative,” Santoro added. “But the need for all clinicians to don PPE for all visits is a new and critical layer of protection for both patients and our team.

“All of our clinicians have complete PPE kits and are wearing surgical masks and gloves for each patient visit. Staff within facilities are also wearing gowns at all times. These supplies are discarded after the visit. In instances where we are called to serve upon a known COVID-19 case, our team members wear surgical masks, gloves, long-sleeved gowns, and shoe covers. Again, these are disposed following their one-time use.”

The experience is giving Santoro deeper appreciation for RVNAhealth’s employees.

“Their performance has been so commendable,” she said. “The admiration and gratitude that I have for my staff ... it’s really amazing what they are doing.”