COVID-19 continues to stress bed capacity at North Shore Health

In her January North Shore Health management report, Administrator Kimber Wraalstad noted, “As of January 12, 2022, there have been five hundred fifty-four cases (554) confirmed cases of COVID- 19 affiliated with Cook County; this is an increase of 102 cases in the last six days! Obviously, the transmission rate for Cook County remains in the high category.”

That number of sick people—some needing hospitalization— has proved daunting. “It has been difficult to almost impossible to transfer patients,” wrote Wraalstad. “This is particularly true for those needing ICU and COVID-19 ICU level care. This is because the ambulance only has a 2.5-hour range of oxygen available when transferring a patient using a high flow oxygen device. The only option then is transport, but the weather frequently complicates that option.”

With limited supplies, guidelines for the advanced care of COVID-19 patients who require significant respiratory support have been developed at NSH. While it has been verified that four high-volume oxygen devices can be used simultaneously, a patient will not be intubated unless a facility accepts them for transfer.

Recommended Isolation time dropped from ten days to five for those asymptomatic folks who tested positive for COVID-19. That notification came from the Center for Disease Control and Prevention (CDC) on December 27. Wraalstad said the CDC recommends five days of isolation followed by five additional days of wearing a mask when around people to minimize infecting others. The Minnesota Department of Health adopted the new quarantine guidelines on January 11, 2022. The CDC also updated guidelines for health care workers who have COVID-19 and have high-risk contacts.

Increases in COVID-19 patients have caused the hospital to use significantly more N95 masks. With that, N95 mask conservation measures have been put into place to keep from running out of masks. Employees are taught the proper techniques for reusing, storing, donning, and doffing these masks. An employee who has been fitted and trained in the use of powered air purifying respirators (PAPR) will be using those before wearing the N95 mask. Wraalstad said orders had been placed for N95 masks, but there are no estimated shipping dates for any of the orders.

North Shore Health is still seeking increasing bed capacity from 16 to 25. In addition, North Shore Health would like to place several nursing home beds in layaway status and use those beds for swing beds. This modification of the hospital’s organizational structure will allocate costs differently, and NSH would receive an average of $800,000 more revenue per year from Medicaid. But first, the Minnesota Legislature must exempt NSH from the bed moratorium and the Minnesota Department of Health’s Public review process. It could be an uphill fight because Wraalstad notes that Tina Liebling, Chair of the Minnesota House Health Finance and Policy Committee, “opposes any legislation that allows for exceptions to the Public Interest Review.”

A Fall Prevention and Screening Day was held on January 11, with seven individuals taking part and being screened for elements in their lives that can contribute to an unwanted fall. In addition, participants had an opportunity to talk to physical therapists and ask what they should work on to what plan would be best for them to reduce the risk of falls.

An NSH licensed practical nurse will attend Lake Superior College through the North Shore Health Educational Scholarship/Loan Program to become a Registered Nurse. “We are excited to support this student employee and look forward to other individuals taking advantage of this program,” said Wraalstad.

So far, 74 percent of NSH employees have received a flu shot with the goal to be at least 90 percent.

All of the self-administered over the counter antigen tests the hospital ordered have been sold. More kits have been donated to NSH and Sawtooth Mountain Clinic came from Public Health who received them from the Minnesota Department of Health. These test kits are free but are limited to five test kits per person or one kit per household member.