Five Questions

Good morning!

It’s the final Friday of the month, so today I’ll respond to some of the questions and comments you’ve sent to me over the past several weeks.

The first topic I’d like to address today is one that has come up many times and has been sent to me by several of you. Many of you hopeful, expectant and new mothers have concerns that may be holding you back from getting a COVID-19 vaccination. I think it is completely understandable to be extra careful when it comes to the health and safety of your new or soon-to-be-born child and yourself and to want to be fully informed if you are planning to get pregnant in the near term or in the distant future.

I went to our resident experts on these topics, leaders from our Department of Obstetrics and Gynecology. As far as the vaccine goes, they are steadfast in the opinion that science is on your side. The nation’s leading medical experts, including those at the American College of Obstetricians and Gynecologists, say there is no scientific evidence that the vaccine will affect a woman’s fertility or cause her to miscarry. In fact, the evidence shows the vaccine may have additional benefits for pregnant women and their unborn babies, or babies that are breastfeeding. Many of the current recommendations that apply to women as it pertains to childbearing and breastfeeding were detailed in this article.

To make certain their messages to women are fully explained, Dr. Marty Tucker, professor and OB-GYN chair and the sitting president of ACOG - so he’s a national resource on these topics, and Dr. Rachael Morris, associate professor of obstetrics and gynecology, took some time to respond on video to many questions that have come up.

Now on to your questions.

Just as a reminder, I read all of your questions and comments and enjoy hearing from you. I’m not able to respond to them all in this space, but I pass the rest along to senior administrators for their review and possible action.

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Q: What is being done about the recent medical equipment recall issued by Philips Respironics regarding their CPAPS, BiPAPS & respirators? I work in Ambassador Services and have been in 2 rooms this week where the patient was using their personal CPAP machine. With the 1st patient I asked the visitor if they knew about the recall. The visitor didn't know. With the second patient no visitor was in the room, so I informed the nurse and the nurse seemed to not have a clue about the recall and would notify the family of the information I shared with the nurse. Also how do we get the information on this recall out to the other non UMMC medical clinics & hospitals in the area?

A: Since UMMC is considered a Durable Medical Equipment client, the manufacturer immediately contacted us about this recall and they provided information and materials in response. To make sure everything is as safe possible, corrective action has already taken place on all affected UMMC-owned and rented devices.

It’s possible members of a care team won’t be aware of equipment recalls or adjustments per manufacturer recommendations because these actions are handled by teams specially trained to make sure all of our devices are in good, safe working order and fully compliant to any applicable standard.

As far as patients bringing their own devices into the hospital, we have a policy that covers that, which can be found here. (An updated version of that policy is pending approval.) Patient-owned devices are only allowed to be used in a UMMC facility if a physician order for home use exists and can be shared with the care team. The device must be checked by our Clinical Engineering team to make sure it is safe and compliant. If a patient-owned device fails this check, it will not be permitted to be used and UMMC-issued equipment should be used.

If anyone doesn’t know about or how to deal with a recall or other manufacturer recommendation for a piece of equipment, they should contact the vendor that issued or sold them the device.

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Q: I have a question in regards to scanning documents in patient charts ex consents, HIPAA and reports. Once we have scanned these documents is it necessary to send these documentations to medical records or can they be shredded since we are electronic? Thanks for your advice.

A: I believe this is a pretty straightforward issue but checked with our Health Information Management team to be sure.

Yes, after a patient’s document is scanned into their medical record at the Point of Service, the next step is to send it to our HIM department, which manages all medical records. This step is important for accuracy because sometimes documents aren’t scanned in properly to make them completely legible and sometimes a document is scanned in for the wrong patient. A quality check on all scanned documents is done by the HIM team. There’s a policy - found here - that covers all of the required actions and their purpose when putting paper documents into a patient’s record.

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Q: I'm an employee here at the U and recently took my Johnson & Johnson vaccine. Vaccination Card on hand.
My questions:

     •  Will this be accepted as full vaccination?
     •  If not, is it safe to take another brand of COVID vaccine within the same year?

A: First off, thank you for getting your COVID-19 vaccination and doing your part to protect our patients and their visitors, your fellow co-workers, your family and friends and anyone else you come into contact with. You are in a growing group of UMMC employees and students who have stepped up to get their vaccine shot and I look forward to being able to announce we are at 100% vaccinated. The vaccines are our best defense against the spread of the virus and its devastating impact. Now that we are experiencing a fourth wave of new cases and hospitalizations, it’s certainly important that more Mississippians get vaccinated.

I checked with Dr. Bhagyashri Navalkele and Dr. Jason Parham about your question. These two physicians are our infectious diseases experts who have done an amazing job, even before this pandemic hit our state, helping to care for patients, manage infection prevention efforts and provide expert advice to medical professionals here and all over the state. We all owe these two and their staff a huge debt of gratitude.

They confirm that getting the one-shot Johnson & Johnson vaccine does qualify you to be listed as fully vaccinated because that is what the manufacturer recommends, at this time. And your vaccine card will contain all of the needed information to prove you are fully vaccinated.

For the J&J vaccine and others, if the manufacturer updates its guidance – say for instance, another shot is required as a booster – our policy already covers this. Getting the number of shots that matches what the manufacturer recommends will be necessary to remain in the “fully vaccinated” category. For now, none of the vaccines requires a booster and the CDC and the Advisory Committee on Immunization Practice does not recommend booster vaccinations for any population groups. However, on Friday, the Mississippi State Department of Health issued a health alert that advises, based on early clinical trial data, Mississippi physicians to consider some vulnerable groups like the elderly and those who are immunocompromised to get an additional shot.

If you want to consider getting a second shot of the Johnson & Johnson vaccine for yourself, Drs. Parham and Navalkele suggest you consult with your primary care provider.

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Q: The Thursday/Friday nightline bus driver frequently turns off the GPS so the that bus cannot be seen on the app. Many times, I wait over 45 minutes before he makes a round. Sometimes while waiting at the front of the hospital, I can see the bus sitting in the stadium parking lot for up to 30 minutes. I would just like to know who to contact in order to have these issues addressed. I reached out to physical facilities and nobody knew how to contact the bus line manager. I am very thankful that we have a night bus, but this driver has actually told me "Yes, I turned it off" when asked if he knew the bus wasn't showing up on the app. Given the crime in Jackson, I do not feel safe walking to my car parked in overflow after dark.

A: Groome Transportation is the vendor under contract to supply our shuttle system vehicles and drivers so our Facilities Services group contacted them about your concern. While drivers are allowed to take breaks during their shifts, we’ve asked that they not do this during peak hours, especially during normal shift changes. This has been reiterated to the vendor who will remind the drivers.

Also, Facilities is working with the vendor to improve communications at night to quickly address any situations that occur outside of normal business hours.

It is understood that many of you frequently use the GPS application available online and through a smartphone app (called ETA Spot) that shows the location of each shuttle. It’s a handy tool for limiting the amount of time you are standing in the heat, cold or rain. Groome recently proposed shifting GPS tracking to a different vendor which will improve reliability and tracking precision. The new technology will get tested and proven before implemented and will be announced campus wide if/when ready for your use.

Our UMMC Police Department offers to escort you to your car at night if for some reason the shuttles aren’t running. If you require this assistance, please call the non-emergency number, 4-1360.

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Q: With the shortage of staff on the floors, there has been lots of recruiting for people to work extra to help fill in spots. Incentives have been offered which are fantastic. However, RNs that work in an ambulatory setting have been told they cannot receive the same incentives if they come in and help on the inpatient side. There are a lot of RNs that are willing to help out the floors, but it is not fair if the same incentives are not offered to them. Another issue is that the incentive offered will only be given if the nurse HELPING out has gotten all of their hours in a pay period. Should it not be given regardless since someone is coming in to help out the hospital?? Can any of these issues be fixed?

A: Thanks for submitting this question. I checked with our nursing leadership on this topic and they said there haven’t been many inquiries from ambulatory RNs or CMAs to do fill-in shifts in inpatient settings. However, that activity is an available option and could help with some of the staffing issues experienced in the hospital settings.

In doing this though, an employee’s primary position should not be negatively impacted at all when taking on additional shifts outside of the normal working days/hours of the primary job. For instance, if you work 8 a.m. – 5 p.m. each weekday in your primary job, then it’s not advisable to take on an overnight shift Monday through Thursday in a secondary position. And you certainly wouldn’t want to do anything, like taking on too many extra shifts, that will have a negative impact on your work in your primary job.

Nurses in secondary-inpatient positions do receive the same differential pay for working night and weekend shifts as nurses in primary-inpatient positions. As far as incentive pay, any incentives offered to inpatient nurses for working a minimum number of hard-to-fill shifts could also be available to nurses who fill an extra shift in a hospital setting outside of their normal position, so long as the qualifying criteria can be met without interfering with their primary job.

Again, thanks for sending in your comments and questions. They are very helpful.

Before I end this week’s column, I want to take a moment to express how appreciative I am of the dedicated work Dr. Thomas Dobbs, state health officer, has done over the past 18 months. Mississippi is lucky to have a public health leader that cares so much for every single person who lives or visits here and we all owe him a huge debt of gratitude. He’s done everything possible to get more people to take steps to curb this pandemic and lessen its devastating effects, and I’m not sure he’s gotten nearly the credit he deserves. If you ever have a chance, tell him thank you. (Like me, he’s a Twitter user, so you can show him your support by mentioning his account, @TCBPubHealth. I’m at @LAWoodwardMD.) It’s vital we have more people who are willing to go any extra mile to encourage people to do what is needed for A Healthier Mississippi.