COVID 19 UPDATE Physician Employed Personnel - Vidant ...
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Physician Employed Personnel
COVID 19 UPDATE
Vidant Health’s priority is the health and well-being of patients, families
and team members. We have processes and protocols in place across our
system to safely care for all. Please review the important COVID-19
information provided in this document.
1. VH OSHA Emergency Temporary Standards
2. COVID19 Vaccination Information
3. COVID Vaccination Exemption Form
4. PEP COVID19 Self-Reporting
5. PEP Screening and Masking
6. OSHA Standards
7. Education Record of Attendance
a. Please fill in the following sections
1. On page (1) Today's Date
2. On page (2) provide your first name, last name, employer,
manager and signature in the designated areas.
b. Return completed form two ways
1. Scan and email to Beverly.Whichard@vidanthealth.com
2. Fax to 1.800.290.8617VH OSHA Emergency
Temporary Standards
The Occupational Safety and Health Administration (OSHA) recently announced temporary standards to reduce the risk
of contracting COVID-19 in the workplace and protect the rights of team members. These standards include guidance
specifically for health care workplaces, and address personal protective equipment (PPE), vaccination and testing,
patient screening, physical distancing, and more.
Release of these emergency temporary standards (ETS) recognize the higher risk to workers in healthcare settings due to
the likelihood of interacting with people who are sick, length of potential exposure, and the need for close contact when
providing care or services. Prior to these standards, national recommendations were available, and are now more
enforceable. These standards strengthen the responsibility of employers to adopt best practices. The full text of the
OSHA ETS is available online . For most recommendations, you will notice little to no change from our current practices.
18TU U18T
Vidant Health continues to review these standards to strengthen workplace protections and may recommend practice
changes accordingly.
COVID-19 is a contagious respiratory illness. Symptoms of COVID-19 and the flu are similar and it may be hard to tell the
difference. Some people can carry the virus without any symptoms. Symptoms of COVID-19 include: fever or chills,
cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, or headache, new loss of taste or smell,
sore throat, congestion or runny nose, and nausea, vomiting or diarrhea.
People with advanced age or chronic illnesses such as cardiovascular disease, diabetes, chronic lung disease, or chronic
kidney disease are at greater risk for experiencing more severe COVID-19 illness. Seek immediate medical attention for
any shortness of breath or difficulty breathing.
COVID-19 is most often spread through the air by coughing or sneezing, through close personal contact (including
touching and shaking hands) or through touching your nose, mouth or eyes before washing your hands. To combat
COVID-19, get vaccinated, practice hand hygiene, wear a mask, observe physical distancing, clean and disinfect shared
workspaces, complete the COVID screening tool and complete daily temperature screening when entering any Vidant
Health facility.
Prevention Strategies:
• Vaccination
• Screening and Masking
• Cleaning and Disinfecting Workspaces
• Instructions and Signage for keeping meeting rooms safe
• Visitor Screening and Restrictions.VH COVID-19 Vaccine Information
Physician Employed Personnel Update
Vaccination Requirement Deadlines and Details
Vidant Health is a mission-driven organization with a strong, steadfast responsibility to serve and care for all of eastern North
Carolina. With the rising trend in positive COVID cases locally and across the nation, and the exponential growth of the Delta variant
and expectations for future variants, the importance of getting vaccinated cannot be emphasized enough.
Vidant has carefully reviewed national, state and local data regarding COVID, the variants and the vaccine – and it comes down
to protecting those we serve and one another. The vaccine has proven to be safe and effective and data show it reduces the
severity of the virus and/or hospitalizations in those who become infected. Vidant will require the COVID vaccine as a condition for
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employment for all team members, physicians, credential providers and contract workers.
U Timeline
Vidant will implement the requirement in two phases:
• Leaders (managers and above), physicians and credentialed providers – Deadline to receive full dose of vaccine: Oct. 1,
2021
• Team members, supervisors, new hires, contract workers, students and volunteers – Deadline to receive full dose of
vaccine: Dec. 1, 2021
U Exemptions and Deadlines
The COVID vaccine will be added to Vidant’s conditions of employment; which means in order to be employed by or work at Vidant,
you must complete your vaccine series by the deadlines outlined above or have an approved medical or religious exemption. For
those requesting exemptions due to religious beliefs or medical reasons, you will be required to submit a COVID Vaccination
Exemption Request to Occupational Health.
Based on input from our Infectious Disease experts and hearing team member feedback around specific situations, such as
pregnancy and COVID antibody positive, medical exemptions will include:
• Deferred vaccination for pregnancy
• Severe allergy to any component of the vaccine
• History of COVID infection: details about how this is defined and documented can be found on the COVID vaccination
exemption form.
• Other: must provide rationale for requesting permanent or time-limited exemption request. Each request will be reviewed
by medical leadership in Occupational Health.
• Religious belief, practice or observation that prohibits vaccination
Religious exemption requests will be reviewed by the Accommodations Committee, similar to the process for other requests for
workplace accommodations.
Ongoing requirements for those who receive approved medical/religious exemptions may include periodic COVID-19 testing, remote
work and/or potential reassignment from working on units with immuno-compromised patients. More details are forthcoming.
Deadlines: All exemption forms are due one month before the vaccine due date: Team members, supervisors, new hires, contract
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workers, students and volunteers: exemption forms due by Nov. 1, 2021COVID-19 Vaccination
Exemption Form
Vidant Health will require the COVID-19 vaccine for all employees, contract employees, residents, fellows, members of the medical
staff and other credentialed professionals, volunteers, clinical education students, vendors, representatives and any other individual
who has been granted a Vidant Health identification badge. The expectation is that the vaccine series is complete by the required due
date. All exemption forms are due one month before the vaccine due date:
Managers and above, physicians and credentialed providers: exemption forms due Sept. 1, 2021
Team members, supervisors, new hires, contract workers, students and volunteers: exemption forms due Nov. 1, 2021
You may request that Vidant consider granting you an exemption to the COVID-19 vaccine if any of the following applies:
1. Severe allergy to a component of the COVID-19 vaccine.
2. You are pregnant and although not a contraindication, you or your provider may prefer delaying the vaccine. This is a time
limited exemption and team member must be compliant before returning to work post-delivery.
3. History of COVID-19 evidenced by a positive serology (COVID IgG Spike Protein) dated within the last 6 months with or
without a prior positive PCR. Must be drawn within the past 6 months and must be completed through a Vidant Health
provider or Vidant Occupational Health, or, if completed through outside provider, processed through a Vidant/ECU or
other approved laboratory with equivalent testing standards*
Background: Vidant’s primary responsibility is the safety of patients and staff. We want to create an environment that is as
safe as possible from COVID transmission. Additionally, knowledge of COVID-19 is an ever changing science. From what we
know at this juncture, we recognize there are two ways to ensure the needed safety; vaccine-induced immunity and
immunity acquired from being infected with SARS CoV-2, aka natural immunity. Furthermore, we also believe the evidence
to date suggests that vaccination is the best way to ensure adequate protection (whether you have had COVID19 previously
or not) and we therefore recommend vaccination to patients and staff who have previously had COVID19 (as per current
CDC guidance). However, it is also unlikely (from what we know at this ti me) that an individual with antibodies could
transmit the virus to coworkers or patients. Thus, Vidant recognizes both vaccine induced-immunity as well as natural
immunity as means to this end. We will continue to follow the data (whether regarding vaccine induced or natural
immunity) to make decisions going forward. Vidant also reserves the right to require ongoing proof of immunity and adapt
this policy as scientific knowledge dictates.
4. Other special documented circumstances you wish to have considered for a medical exemption.
5. Because you have a sincerely held religious belief, practice or observance that prohibits vaccination.
*Most major reference labs meet this standard. Occupational Health will contact you via email if any clarification or additional
testing is needed.
IMPORTANT MESSAGE
If you are granted an exemption to the COVID-19 vaccination, Vidant may, in its discretion, require you to participate in scheduled
interval PCR testing according to your work status. Other exemptions may include removal of caring for immunocompromised patients,
remote work and/or reassignment to other areas in the organization.
EXEMPTION BASED ON MEDICAL CONTRAINDICATIONS
If you are requesting an exemption due to your medical condition, you must submit a completed Exemption Request Form (included
below). You also may be asked to provide supporting medical documentati on that must include information that supports the rationale
for granting the exemption (i.e., results of an allergy test, etc.).EXEMPTION ON THE BASIS OF RELIGIOUS BELIEF
If you are requesting an exemption based on your sincerely held religious beliefs, you must submit a completed Exemption Request
Form (included below) along with supporting information in the form of a written statement or other documentation. Although it is
permissible to provide a letter from a faith leader, it is not necessary for exemption purposes. Supporting
information/documentation should include: (1) identification of the sincerely held religious belief (note: social, political or economic
philosophies, or personal dietary or lifestyle preferences, are not generally considered religious beliefs under applicable law); and (2)
how the religious belief specifically conflicts with receiving the vaccine.
Previous exemptions for vaccines on file in Occupational Health do not carry-over in the COVID-19
exemption process. New exemption forms must be submitted.
The recommendations in this document represent the state of the Coronavirus literature and
recommendations as of Aug. 10, 2021, to the best of medical certainty, and is subject to updating in the
future.
COV ID-19 Vaccine E xempt ion F orm Updated 8.10 .21 Page 2 of 3Occupational Health COVID Vaccination Exemption Request
Work Status:
Name: ___________________________ Employee ID#: Date: ________________
Onsite ☐
Department: Department ID#: ___________________________________
Remote ☐
Job Title: Manager: _________________________________________ Hybrid ☐
I have attached and/or will provide supporting documentation to this request. I understand the deadline to submit acceptable
medical documentation or information documenting my religious basis for an exemption is Sept. 1 for manager level and
above, physicians and credentialed providers and Nov. 1 for team members (including new hires and contractors). I
understand exemption forms will not be considered after these due dates.
My signature on this form is my attestation that I am requesting an exemption in good faith, and the information I am
providing or causing others to provide on my behalf is true and correct. I understand that providing false or misleading
information may be grounds for corrective action up to and including separation from employment.
Signature: Date:
EXEMPTION CERTIFICATION SECTION
______ MEDICAL EXEMPTION
Severe allergy to any a component of the COVID-19 vaccine (supporting documentation required)
Pregnancy (supporting documentation and expected due date required)
History of COVID-19 evidenced by a positive serol ogy (Spike protein antibody) dated within the last 6 months .
Must be drawn within the past 6 months and must be completed through a Vidant Health provider or Vidant
Occupational Health, or, if completed through outside provider, processed through a Vidant/ECU or other
approved laboratory with equivalent testing standards.
Other: ________________________________
(Please see attached supporting documents)
______ SINCERELY HELD RELIGIOUS BELIEF/PRACTICE/OBSERVANCE (supporting documentation required)
OFFICIAL USE ONLY:
Documentation Received on:
Approved Time Limited Re-evaluation date:
Denied (reason for denial)
Provider Signature: Date: _______________________________
ADA Meeting Representative: Date: _______________________________
Testing Interval Bi-weekly Monthly Other
Remove from immunocompromised patients
COV ID-19 Vaccine E xempt ion F orm Updated 8.10 .21 Page 3 of 3Physician Employed Personnel
COVID-19 Self-Report Declaration
Please answer the following questions. If you answer YES to one or more of the questions, COVID-19 testing is required
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through a provider of your choosing.
Yes No
Are you experiencing a recent loss of taste and/or smell, with no other ☐ ☐
explanation; or are you experiencing both fever (≥100.4° F) and a new unexplained
cough associated with shortness of breath?
Since your last shift, have you been diagnosed with COVID-19 or have been told ☐ ☐
that you are suspected to have COVID-19 by a licensed health care provider?
Since your last shift, have you been unmasked and in close contact with a person ☐ ☐
who is COVID-19 positive? If yes, testing must be completed 3-5 days after
exposure.
Are you experiencing other COVID-like symptoms that are not associated with ☐ ☐
other chronic conditions you may have? For example, nausea or vomiting,
diarrhea, congestion or runny nose, headache, sore throat, muscle/body aches, or
fatigue?
If a Physician Employed Personnel responds YES to any questions, testing for COVID-19 is required. Submit results to
PEPConfidential@vidanthealth.com before entering a Vidant Health facility.
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If the physician employed personnel tests positive, they are required to quarantine until the following conditions are
met:
• 24 hours have passed since recovery (defined as resolution of fever without use of fever-reducing medication),
AND improvement in respiratory symptoms (i.e. cough, shortness of breath) AND
• At least 10 days have passed since symptoms first appeared.
I certify that the information provided in this form is true and complete.
_______________________________________________________ _________________________
Signature Date
8/16/2021Physician Employed Personnel
Screening and Masking Guidelines
Screening
In response to the COVID-19 pandemic, Vidant Health implemented screening stations across visitor and team member
hospital entrances in an effort to ensure a safe environment for all. As Vidant restores and reimagines our work and
processes in a world with COVID-19, the organization has adjusted its screening efforts, while keeping the safety at the
forefront of all decisions.
What is the screening process for Physician Employed Personnel?
Physician Employed Personnel must enter any Vidant Main Lobby Entrance and go through the visitor screening station
daily for screening.
What is the PPE policy for Physician Employed Personnel?
Surgical masks are required for all physician employed personnel in clinical areas . Each unit/department will have
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designated areas for mask pick up before start of shift. Masks will be located at main lobby entrances upon entering the
facility as well.
Homemade or sewn masks can be worn in non-clinical areas only (any non-hospital and clinic facility). Homemade or
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sewn masks are not considered PPE since their capability to protect health care workers is unknown. In addition, they
cannot be worn under or over a Vidant-issued face-mask in clinical care areas. When providing care of COVID+ patients,
patients being screened for COVID-19, or patients requiring any type of PPE – Team Members
Mask Guidelines within Hospitals and Clinics
• Vidant-issued masks are to be worn by team members and providers for the duration of their shift. Once the
shift is over, dispose of the mask, perform hand hygiene and wear your personal mask when leaving the facility
until offsite.
• Team members and providers who do not all start their shift/work-day in a central location, should visit a visitor
screening station and receive a mask by showing their Vidant badge.
Reminders for all:
• Switching between masks increases the potential risk for self-contamination. Wear a facemask for the care of
patients with same illness without removing for duration your shift. Exceptions: patients with respiratory
illness caused by different pathogens, change mask between patients.
• Perform hand hygiene immediately before and after any contact with your Vidant-issued or personal mask.
• If mask is removed, must be stored in appropriate clean sealable paper bag or breathable container.
• Do not store mask on extremities or around neck. Mask is only worn on face covering mouth and nose.PPE – Physician Employed Personnel Caring for Suspected COVID-19 (PUI) and Confirmed COVID-19 Patients
• Clearly identify essential personnel who will be caring for any suspected or confirmed COVID-19 patients, and
limit entry into patient rooms to those essential individuals.
• PPE for COVID+/Suspected (PUI): modified airborne + contact + eye protection (gown, gloves, respirator (N95,
PAPR/CAPR), face shield/goggles).
• For COVID +/Suspected (PUI) aerosolizing procedures, place in negative pressure room, if available. Clean and
disinfect all horizontal surfaces in the room post aerosolizing procedure.
• Extended use of respirator and eye protection is preferred. Limited re-use is also acceptable.
• Limit the number of individuals in the room when performing high-risk aerosol generating procedures.
Page 2 of 2COVID-19
CODE CLEAN
TIP SHEET
To increase the safety of team members, patients and loved
ones, team members are responsible for disinfecting their
work spaces at the beginning and middle of their shifts.
Clean and disinfect the following items with approved wipes/
cleaning solutions and cloths located in your work areas.
• Phones
• Computer keyboard & mouse
• Desk/counter top surfaces in your immediate area
• All visible items you have touched (pen, stapler,
notebook, coffee mug, etc.)
• Light switches/lamps
• Door handles
• Chair arms/seat
• Always clean shared items in-between individual
use (phone, keyboard, mouse, etc.)
* Follow your normal ordering process through Central Supply to obtain supplies.
04-03-20
#StandUpForENC | #ENCStayHomeFOR YOUR SAFETY
Meeting Room Sanitation Kit Guidelines
These kits should be implemented in any room that is used for meetings.
+ + +
Contents
• Cleaning and Disinfection Wipes
• Meeting Rooms Sanitation and Cleaning Guidelines
• Food Consumption Guidelines
• Signs for Social Distancing and Mask Wearing
11/24/20FOR YOUR SAFETY
Cleaning and Disinfection Wipes
Patient Care Equipment/Surfaces
Use the Code Clean Tip Sheet. High Touch Surfaces should be disinfected daily and as needed:
• Bed side rails & controls • Sink/faucet handles
• Call bell/Telephone • Chair/chair arms/ additional furniture
• Bedside table & Handle • Room & Bathroom light switches
• IV Pole (grab area & pump control) • Room & Bathroom door knobs/push plates
• Cardiac monitor controls & touch screen • Purell & Soap Dispensers
Product and Contact / Wet Time:
(Length of time surface must stay wet)
Clorox Hydrogen
1 minute
CaviWipes 3 minute
Peroxide Wipes
Oxivir 1 minute
PDI Santi-Cloth AF3 3 minutes
PDI Super Sani Cloth 2 minutes
CleanCide Germicidal Wipes 5 minutes
A-456* 10 minutes
VersaSure 2 minutes
*Can be used with paper towels
LCD/Touch Screens
Alcohol Clean Wipes Allow Air Dry
Exceptions: Manufacturer’s instructions must be followed and only approved disinfectants used.
20-VH-787 04/06/21FOR YOUR SAFETY
Meeting Rooms Sanitation and Cleaning Guidelines
The safety of team members and patients is our top priority at Vidant Health. In an effort to
increase the safety of team members in Break Rooms, conference rooms, etc., all team
members should follow the guidelines below.
1 | Team members must be free 2 | Team members must
of COVID-19 symptoms and have perform hand hygiene upon
completed the AskPhin COVID-19 entering room.
screening prior to arrival.
4 | Eating is permitted in
3 | Masks must be worn by
meeting rooms with updated
all team members.
guidelines.**
5 | Conference room seating 6 | Auditorium seating:
capacity is based on room size Capacity is based on room size
and ability to distance 6 feet. and ability to distance 6 feet.
Maintain 6 feet distance.
7 | After each meeting, assign
team members to wipe down the
8 | At least daily, the
hard surfaces and all major touch
conference room will be
points (i.e. table tops, seats and
thoroughly cleaned per current
arm rests) with a hospital-grade
protocol.
cleaner.*
* Non-bleach disinfectant wipes should be used for team members to wipe down surfaces
** Refer to Food Consumption Guidelines
20-VH-787 04/06/21FOR YOUR SAFETY
Food Consumption Guidelines
Prepare:
• Determine the number of individuals that can attend based on room size and ability to
maintain spatial separation of 6 feet.
• Clean all surfaces.
• Separate seats 6 ft apart. Assigned seating/physical guides are preferable.
• All meeting attendees perform hand hygiene prior to entering room.
+ + +
During Meeting:
• If meeting and eating in same room, prior to meal consumption, remove meeting materials and clean
surfaces prior to consuming meals/beverages.
• A separate area designated for food and beverages is preferable.
• Assign someone to hand out individually boxed meals with disposable utensils and single service
bottles/cans for beverages.
• After consumption of food, allow trash to be collected allowing social distancing for collection and
disposal of remaining products.
• After consumption of food, clean entire area.
• No congregating prior to eating/after eating, maintain 6 feet of spatial separation.
• A face mask must be worn when not actively eating or drinking
• Perform hand hygiene prior to return to meeting.
No food/beverage consumption allowed in Auditoriums.
11/24/20FOR YOUR SAFETY
Please Practice
Social Distancing
10/1/20FOR YOUR SAFETY
Please Wear
Your Mask
10/1/20Thank you for trusting Vidant Health to care for you and your loved ones. The safety of our patients,
visitors and team members is our top priority. As Vidant monitors and responds to the COVID-19
pandemic across North Carolina, we are taking steps to ensure the safety of all. Vidant remains vigilant
with its screening process for all visitors, entry requirements and visitor restrictions by department.
Vidant continues to closely track local data, including COVID-19 cases in our region and hospitals, and
will adjust visitation restrictions accordingly.
In following the ADA (Americans with Disabilities Act) guidelines, visitors who need assistance due to a
disability may have an additional individual with them when visiting a loved one in a Vidant Health
facility to help navigate the current visitor guidelines.
All visitors will be screened and masked and asked to follow the entry requirements below.
Vidant strongly encourages visitors to consider virtual visitation options such as FaceTime and phone
calls. Assistance with virtual visits, including iPads for patients without the necessary technology, is
available on request. Virtual visitation is the safest way to stay connected with a loved one.
Visitor Screening Process: Entry Requirements:
1. Have you tested positive for COVID-19 within the 1. Temperature check: Temperature must be under
past 14 days or waiting on the results of a COVID-19 100°F degrees
test? 2. Masking: Wear mask at all times in the building.
2. Have you had close contact with a person with Screeners will provide you a hospital mask if you
do not have one. Cloth masks are permitted.
confirmed or suspected COVID-19 in the last 14 days?
3. Have you had any of these symptoms in the past 48 3. Hand washing: Visitors must gel or use hand
hours: sanitizer on entry.
• Fever or chills 4. Social distancing: Avoid close contact with others.
• Cough 5. Limit personal belongings during your visit.
• Shortness of breath or difficulty breathing 6. Limit your visit to the patient room, and kindly do
• Fatigue not go elsewhere in the hospital except for the
• Muscle or body aches Café.
• Headache
• New loss of taste of smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea
• Any other symptoms of illness
If yes to any of the above - Visitor may not enterEducational Record of Attendance
Incomplete forms will be returned to you for completion.
Today's Date Facilitator/Instructor VMC Occupational Health (252) 847-7609
Phone
VH OSHA Emergency Temporary Standards COVID-19 Exposure Safety Plan
Program/Session Title Is this a new program? Yes No
Responsible Entity Vidant Health ______ Event Type Click to choose event type
List course description/objectives that complete the statement, "Upon completion of this program, participants will be able to..."
comprehend COVID-19 transmission, tasks, and situations in the workplace that could result in infection, and relevant policies and procedures.
See NCPD File
Target Audience (select all that apply)
All Clinical Staff Dept. Staff ✔ Housewide RNs in Specialty Areas
See NCPD File All RNs Leadership Interprofessional
Needs assessment for this program was based on (select all that apply)
Advances in health care mgmt. (including new equipment Performance appraisals Peer review
Patient population served / type & nature of care provided ✔ Infection control findings Staff identified
Plant technology / Safety management Annual requirement need See NCPD file
QI / Performance Improvement data
Teaching/Learning Methods (select all that apply)
Lecture/Discussion Scenario-Based Demonstration/Return
Other Review of information Demonstration See NCPD file
Course Logistics
Type of Credit ✔ Instructional Trauma NCPD (Contact) Leadership Other
# of Credit Hours 0.25
Page 1
Rev. 1/2020Facilitator VMC Occupational Health
Please print your name clearly to assure credit for attending class
If you do not have a Vidant Health employee#, write in student, MD, intern, etc.
Last Name First Name Employer Manager Signature
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