Patient and Family Planning Guide

Thank you for choosing us to take care of your child. Below you will find an outline of what to expect before, during, and after your child’s surgery. There is also a description of actions that Packard Children’s has taken to keep you and your child safe during COVID-19.

Introduction

To help reduce the spread of COVID-19, we asked many of our families to postpone procedures. Now, with support from local health officials, Stanford Children’s Health is starting to schedule many of the delayed procedures.

We understand that many families have concerns about coming to the hospital during these uncertain times. We want to let you know that we continue to provide high-quality care to our patients, families, and community. We are in constant contact with local health officials to monitor COVID-19. Your safety and your child’s safety remain our top priority.

Thank you for choosing us to take care of your child. Included in this brochure you will find: an outline of what to expect before, during, and after your child’s surgery; and actions that Packard Children's has taken to keep you and your child safe during COVID-19. We are here to work with you and support you every step of the way. Knowing what to expect can help make things go smoothly on the day of your child’s procedure. We will use the word “procedure” in this guide to describe surgery or a medical intervention that requires anesthesia. Anesthesia is a combination of medications that puts your child into a sleeplike state.

How We Will Keep You and Your Child Safe

Packard Children’s has made many changes in the last few months to prevent the spread of infections, so you may notice some differences. Here are things we are doing to keep your family safe in the hospital and to reduce the spread of infection.

Limit the number of people coming into the hospital

We changed our visitor policy to limit the number of people in the hospital and at the bedside. Only one caregiver is allowed at the bedside for each child. No other visitors are allowed.

Complete health checks

Upon entering the hospital, the information desk will ask you if you have any COVID-19 related symptoms. Please let your child’s nurse know if you experience any COVID-19 symptoms during your child’s stay at Packard Children’s.

Provide masks for patient and caregiver

We ask that everyone wear a mask. This can help prevent the spread of germs. Our team has a mask for you.

Do video visits instead of in-person visits

To make sure that we follow all social distancing rules, care teams may have a video visit with your family before the procedure. We can do this using the iPad in the room or your smartphone, mobile device, or computer.

Discharge planning

The care team will work with your family when you are ready to leave the hospital. Information will be provided about safe ways to return home with your child. This will help lower the risk of COVID-19 infection and help in recovery.

Take extra care with cleaning

We regularly clean our rooms and common spaces. Due to concerns around COVID-19, we are cleaning these spaces more often and taking extra time. While you are here, you might see more of our housekeeping team around the hospital.

Special units for COVID-19 patients

We have a unit set aside for patients who have tested positive for COVID-19. Having this space reduces the spread of infection and helps families to heal in this difficult time.

COVID-19 testing for patients

All patients at Packard Children’s are tested, even if they do not have COVID-19 symptoms. Testing will occur when the child is admitted and also before procedures and diagnostic imaging.

Why testing is important

Patients may have COVID-19 before they start to feel sick. It can take 2 to 14 days after someone is exposed for symptoms to show up. Knowing if someone is COVID-19 positive will help us prepare for your child’s visit in the safest way.

When and where you will go for testing

A member of your child’s care team will call to schedule an appointment for testing. During that phone call, he or she will tell you where to go to get tested. You may go to a drive-through test site or have the test in the hospital.

What the test includes

When you and your child arrive at the test site, the care team will be wearing masks, gloves, eye protection, and gowns. The COVID-19 test uses a swab, like a long Q-tip. The swab will be placed in your child’s nose for 10 seconds.

How you can help prepare your child

This test will irritate the nose and will feel uncomfortable. Sneezing, coughing, and watery eyes are common after the swab is removed. Some things that might help your child during the test are:

• Letting him know you will be there to help him

• Telling him to take deep breaths

• Listening to music she enjoys

• Holding her hand, or holding her in your arms if she is smaller

When you get the results

The Packard Children’s laboratory will process the COVID-19 tests. Results are reported within a few hours. All results will appear in MyChart if your child has an account.

Results negative for COVID-19

If the test is negative, care for your child will continue as planned. You can assume that the results are negative if you do not get a call from the care team.

Results positive for COVID-19

• Your child’s care team will call to tell you the results. The results will also be in your child’s MyChart account.

• Your child’s care team may still do the procedure. If the procedure is urgent, the team will tell you the precautions that will be taken, including:

° Use of special personal protective equipment for the care team, patient, and caregiver

° Placement of the child in a special unit to prevent spread of COVID-19

° County reporting for public health safety

• Your child’s care team may delay the procedure. If the procedure is not urgent, the care team will tell you how to quarantine at home. The care team will work with you to make sure that your child gets the right care.

Coming to the Hospital

Health checks at the front desk

We do health checks at the entrances of both Main and West buildings. Everyone who enters the hospital is checked for COVID-19 related symptoms, such as:

• Fever

• Chills

• Cough

• Shortness of breath

• Headache

• Extreme fatigue or muscle aches

• Loss of smell and/or taste

• Runny nose

Keeping space between you and others

• Sneezing

• Diarrhea

• Nausea

• Vomiting

Social distancing is when you put physical space between you and other people. Keeping 6 feet (2 meters) of space between you and others is one of the best ways to prevent the spread of infection. During your stay, you may notice fewer members of your child’s care team visiting you in person. Your care team may talk to you by phone or through video visits.

You may also notice that when a provider comes into the room, he or she will stand farther away from you. This is to make sure that the provider maintains the right physical distance. We want to make sure that your child has the best medical care possible, but not everything can be done at a distance. The team will do physical exams when they need to, but they will use precautions to minimize exposure to infection.

Wearing masks in the hospital

At Lucile Packard Children’s Hospital Stanford, we will ask that you and your child wear a mask while you are here.

• Get a mask from the front desk. We have masks for you upon arrival at the hospital. If your child is able to, the care team will ask him or her to wear a mask as well. We know that cloth masks or covers are common when you are outside of your home. Our care team will ask you to wear one of the masks provided by Packard Children’s.

• Wear your mask at all times around other people. You may remove your mask when you are in your child’s room after his or her procedure. Masks will be required if you leave the room or visit common areas like hallways, elevators, the cafeteria, and the lobby.

• Ask your nurse for a new mask if you need one. If your mask gets dirty, wet, or damaged, ask your child’s nurse for a new one.

What to Expect at the Hospital

Caregivers at the bedside

One change we made early on was to limit the number of people coming into and going out of the hospital.

For COVID-19 negative patients

• Only one caregiver can be with his or her child at the bedside.

• All caregivers must be 18 years of age or older.

• If your child needs to stay for a few days, you can switch with one other person. Only two caregivers will be identified for each patient.

• Caregivers can switch every 24 hours. To help keep track of everyone coming into the hospital, we require all caregiver swaps to be done between 4:00 p.m. and 6:00 p.m. each day.

For COVID-19 positive patients

• Only one caregiver can be with his or her child at the bedside.

• Caregivers cannot switch.

• The care team will ask caregivers to stay in their child’s room while in the hospital and to wear protective gear.

All other visitors

At this time, we are not allowing any other visitors, like extended family or siblings, in the hospital. We know this will be hard for many families. Having fewer people in the hospital helps keep your family safe and reduces the risk of exposure to COVID-19.

Video visits

We understand how important it is for you to get support from friends and family during your child’s procedure. We recommend that you stay connected with video calls.

Before your child’s procedure, we recommend:

• Talking to friends and family about how you want to connect during your time at the hospital.

• If you want to make video calls, choose an app to use (such as Zoom or FaceTime). Download it to your phone or laptop.

• Do a few test video calls with friends and family at home, before you come to the hospital.

• Bring chargers for your phone, iPad, and/or laptop.

How Packard Children’s Hospital is keeping our staff safe

Making sure that our patients and families are safe goes hand in hand with making sure that our health care workers are safe. Here are some of the things we are doing:

• Testing for all providers

Doctors, nurses, and other providers directly treating your child are tested for COVID-19.

• Daily health checks

We do health checks with all team members every day to make sure that they do not have any COVID-19 symptoms.

• Supplying protective equipment for all of our providers

Packard Children’s provides masks, gowns, and gloves for everyone on your child’s care team. You might see more team members wearing these items in the halls and common areas. This is to help protect your family and our team from infection.

• Updating policies and practices often

We work closely with local and national health officials to make sure that we have the right practices and policies in place to protect patients, families, and the staff.