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The Signature: 2020 Year In Review
U.S. NAVAL HOSPITAL SIGONELLA
020 has been quite a year for the hospital at Sigonella, with the most significant global pandemic since the Hong Kong 2 flu killed up to four million people in the late 1960s. Some of the differences in the COVID-19 pandemic have been the increase in rapid communication, including social media and the ease of spreading inaccurate or incomplete information, and
the use of newer medical technology, such as the equipment used to detect viral genetic material (beginning in the 1970s) and the advent of telemedicine in the 1950s with exponential growth beginning in the 1990s. Here, a few of our local subject matter experts share our responses to COVID-19. Nurse and Head of the Emergency Department (ED) Lt. Christopher Parker: We implemented the screening, treatment and disposition of infectious patients in the ambulance bay on Feb. 23. Care was executed in the ambulance bay utilizing an out of service ambulance and socially distanced seating throughout the ambulance bay as an overflow. On March 26, NAS Sigonella Fire & Emergency Services provided a decontamination tent to the hospital, and since this time, we have met enterprise-level standards of care while separating possibly infectious patients from physical hospital interaction. On April 8, the NAS Sigonella emergency management team provided a larger tent which was outfitted with dividers and easier to clean structure surfaces. On April 9, we initiated the use of a closed circuit video teleconference (VTC) system to improve patient interactions while we continued to use alternate screening processes and environments of care during the pandemic. These tents and VTC not only minimize in-person interactions between staff and possibly infectious patients, they also mitigate non-essential foot traffic throughout the hospital since radiology can collect portable images within the bay and the pharmacy delivers prescription medicines directly to patients. Nurse Anesthetist Cmdr. Jeremy Kilday and Anesthesiologist Lt. Cmdr. Brigid Maruszak: To maximize the care of our beneficiaries during the COVID-19 pandemic, we established a six-room intensive care unit (ICU), which, prior to the pandemic, was not a capability. While the ICU has not yet been needed, the planning and training of our staff has allowed us to prepare in the event our patients may require this advanced level of care. This was a command-wide initiative working across directorates to revamp our staffing model, tailor training towards COVID-19 specific healthcare, and practice utilizing personal protective equipment in both controlled and urgent/emergent situations. Working with the facilities department, we were able to reconfigure airflow to four additional patient rooms to expand the ICU and split the multiservice ward into COVID-19 and non-COVID-19 wards, ultimately ensuring the safety of all our patients and staff. While we hope that our beneficiaries will not need this asset, we are standing by. Please take care – wash your hands and wear a mask so that you will not need us! Virtual Nurse Manager Lt. Kayla Peterson: Our virtual health (VH) program allows beneficiaries to take advantage of 52 specialties in additional military treatment facilities (MTFs) across Europe. Since its inception as a collateral in February 2019 thanks to the efforts of nurse Lt. Jacqueline Canfield, it has grown considerably. Once COVID-19 began distressing healthcare systems, local network specialty providers were unable to continue seeing non-urgent patients, creating obstructions in access to specialty care. Our resolution was to heighten the VH program and dedicated an active duty nurse to running it full-time. We have expanded the program from an average of 19 to 32 appointments per month and have ensured the program stands in compliance with Defense Health Agency guidelines. We established new services for our clinic in Bahrain, spearheaded a new pilot to open services to our clinic in Souda Bay, and enhanced the referral processes for three MTFs and 11 specialties. During the restrictions, we coordinated 51 initial VH appointments with Naples ENT (ear, nose and throat) clinicians in preparation for upcoming site visits. This allowed clinicians to assess and prioritize patients, successfully maximizing time in the operating room during the visit. The same approach was used in preparation for the four-day site visit of the developmental pediatrician from Landstuhl Regional Medical Center, Germany. This was critical for our beneficiaries, many of whom have
