Please note: the information found in this document is the most up-to-date information from professionals within our institution, local resources, and CDC guidelines. You can expect the information found in this document may change. Changes to this information will be provided to you in the COVID-19 module located on your Student Affairs course in Canvas.


During this difficult time, we want to remind you that we care for everyone at Research College of Nursing. As this situation continues to evolve, we understand that some among us may face unique challenges related to health or caregiving. We ask that you stay in close communication with your professors regarding any issues that may impact your ability to participate in class.

Each of us should do our part to minimize risk while simultaneously working to promote a safe environment during this time. Each of us has a responsibility to ensure that discrimination, shunning and bullying that sometimes accompany an outbreak never occur at RCoN.

“The Code of Ethics for Nurses with Interpretive Statements (2015) is the promise that nurses are doing their best to provide care for their patients and their communities and are supporting each other in the process so that all nurses can fulfill their ethical and professional obligations.”
- Nurses, Ethics, and the Response to the COVID-19 Pandemic

Last Update 3/1/2021

Topics covered:

  • Exposure or Symptoms – What to do
  • When to Return to School
  • Travel Guidelines
  • Definitions
  • PPE – Masks & Goggles; Guidelines
  • Resources

First - what do you mean "exposed"?


Yes

If your roommate, family member, or someone with whom you have had direct or close contact tests positive – you have been exposed*

Maybe

If someone with whom you have had close contact has potential symptoms, but not lab-confirmed or you have been in large groups** – you may have been exposed

No

If someone with whom you have close contact has been around someone else who has been exposed – you are not considered exposed

No

If you are in the clinical setting and following the CDC and institution guidelines; and someone in the clinical setting has or tests positive for COVID-19, you are not “officially” exposed.

*Exposed = Someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period* starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated.
**Large Groups = > 50 people in a location where social distancing is difficult

If you have been exposed (yes above):

  1. Email Amanda Gray or call 816-501-6174 as soon as possible.
  2. You will be asked a number of questions regarding your health and exposure.
  3. Await further guidance from RCoN – self-isolate at home until notified.

It is important that you do not make these determinations on your own. Once you contact Amanda Gray, she will collect your information and the Emergency Response Team will make a determination on further guidance for your specific situation.

Low risk 1

If you have been vaccinated, do not have COVID-19 symptoms, but have been exposed to a known case.

If you meet the criteria for vaccine protection (two weeks after your second dose of Pfizer or Moderna vaccine or two weeks after the one dose of Johnson & Johnson vaccine) you do not need to quarantine if:

  • You are fully vaccinated, and it has been at least 2 weeks since your final dose.
  • You are within 3 months of receiving your final dose.
  • You have remained asymptomatic since your COVID-19 exposure.

Low risk 2

If you have cold-like symptoms but not COVID-19 symptoms or have been in contact with a person with a suspected case of COVID-19:

You may continue to come to school, but you should contact your primary care provider. If you do not have a primary care provider and need advice, contact Maithe Enriquez, APRN, PhD at (816) 686-3242.

Moderate risk 1

If you have been exposed (no mask and close contact) to a person with a verified COVID-19 infection, you are not protected by vaccination, but you are not symptomatic:

Since many people transmit COVID-19 prior to exhibiting symptoms, following the event or known exposure to a COVID-19 person, you should:

  • Email Amanda Gray or call (816) 501-6174, AND
  • You may continue to participate in school activities, BUT
  • Monitor for fever, cough, and shortness of breath for 14 days, AND
  • Monitor for less common symptoms of COVID-19 such as sore throat, headache, loss of taste and/or smell, fatigue.

You may be contacted by a local health department if a person with a COVID-19 positive lab names you as a potential contact.

Moderate risk 2

You have received vaccines, but present with any of the following signs and symptoms unlikely to be from COVID-19 vaccination - cough, shortness of breath, rhinorrhea, sore throat, loss of taste or smell) or another infectious etiology (e.g., influenza) that are not typical for post-vaccination signs and symptoms.

You will be excluded from all face-to-face activities (e.g. clinical, labs, etc.) pending evaluation for possible etiologies, including SARS-CoV-2 infection, as appropriate. Criteria for return to are provided below.

High risk

If you are sick with significant symptoms:

If you have a fever above 101 degrees, shortness of breath, or other significant symptoms, seek urgent care (urgent care clinic or hospital emergency department). Wear a mask when you go to the clinic/hospital.

  • Do not come to school or clinical activities until you are cleared to do so.

You must also email Amanda Gray or call (816) 501-6174.


If you have mild symptoms consistent with COVID-19, you should contact your primary care provider. If you need information on how to obtain a COVID-19 test, call your primary care provider. If you do not have a primary care provider, you may contact Maithe Enriquez, APRN, PhD at (816) 686-3242.

It is important that you do not make these determinations on your own. Once you contact Amanda Gray, she will collect your information and the Emergency Response Team will make a determination on further guidance for your specific situation.

Vaccinated student

  • Two weeks after last vaccination

Symptomatic student with suspected or not confirmed COVID-19

Symptom-based strategy (preferred until adequate testing available)

Exclude from work, classes, clinical, or labs until:

  • At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications AND absence of respiratory symptoms (e.g., cough, shortness of breath); AND,
  • At least 10 days have passed since symptoms first appeared
  • Daily temperatures will need to taken

Students with laboratory-confirmed COVID-19 who have not had any symptoms

Time-based strategy (preferred until adequate testing available)

Exclude from classes, clinical, or labs until:

  • 10 days have passed since the date of their first positive COVID-19 diagnostic test assuming they have not subsequently developed symptoms since the initial positive test. If they develop symptoms, then the symptom-based or test-based strategy outlined above should be used.
  • Note: because symptoms cannot be used to gauge where these individuals are in the course of their illness, it is possible that the duration of viral shedding could be longer or shorter than 10 days after their first positive test.

From the CDC - If you are thinking about traveling outside the Kansas City metropolitan area, ask yourself:

  • Is COVID-19 spreading where you’re going?
    You can get infected while traveling.
  • Is COVID-19 spreading in your community?
    Even if you don’t have symptoms, you can spread COVID-19 to others while traveling.
  • Will you or those you are traveling with be within 6 feet of others during or after your trip?
    Being within 6 feet of others increases your chances of getting infected and infecting others.
  • Are you or those you are traveling with more likely to get very ill from COVID-19 (see high risk groups below)?
    Individuals who have and increased risk of severe illness from COVID-19 should limit their travel.
  • Do you live with someone who is more likely to get very ill from COVID-19?
    If you get infected while traveling you can spread COVID-19 to loved ones when you return, even if you don’t have symptoms.
  • Does the state or local government where you live or at your destination require you to stay home for 14 days after traveling?
    Some state and local governments may require people who have recently traveled to stay home for 14 days.
  • If I get sick with or am exposed to COVID-19, will I have to miss school?
    People with COVID-19 disease need to stay home until they are no longer considered infectious; usually 10 days from first symptom AND three days symptom free. People exposed to others diagnosed with COVID-19 may have to quarantine for 14 days. During your time home you may miss class work, labs/simulation, or clinical experiences – this may lead to taking an incomplete or postponing graduation.

The recommendation is that you do NOT travel at this time unless absolutely necessary.

Social Distancing

Social Distancing, also called “physical distancing,” means keeping space between yourself and other people outside of those who you live with. To practice social or physical distancing:

  • Stay at least 6 feet (about 2 arms' length) from other people
  • Do not gather in groups
  • Stay out of crowded places and avoid mass gatherings

Quarantine

Quarantine is used to keep someone who might have been exposed to COVID-19 away from others. Someone in self-quarantine stays separated from others, and they limit movement outside of their home or current location. A person may have been exposed to the virus without knowing it (for example, when traveling or out in the community), or they could have the virus without feeling symptoms. Quarantine helps limit further spread of COVID-19.

Isolation

Isolation is used to separate sick people from healthy people. People who are in isolation should stay home. In the home, anyone sick should separate themselves from others by staying in a specific “sick” bedroom or space and using a different bathroom (if possible).

  • Cloth masks: Cloth face coverings are not personal protective equipment (PPE). Cloth face coverings are recommended as a simple barrier to help prevent respiratory droplets from traveling into the air and onto other people when the person wearing the cloth face covering coughs, sneezes, talks, or raises their voice.
  • Level 1 masks: Masks with or without plastic shields are used as a physical barrier to protect the user from hazards, such as splashes of large droplets of blood or body fluids. Level 1 masks also protect other people against acquiring infection from the person wearing the surgical mask. Level 1 masks trap large particles of body fluids that may contain bacteria or viruses expelled by the wearer.
  • Level 3 masks: Level 3 masks are hospital grade masks that protect hospital personnel from airborne particles that can lead to infection.
  • Respirator and N95 masks: Devices used to protect health care personnel from airborne particles that can lead to infection. Includes N95 filtering facepiece respirators and higher-level “mask-like” respirators (ex. N99, N100) and powered air purifying respirators (PAPRs) and controlled air purifying respirators (CAPRs).

Research College of Nursing is following the HCA Healthcare guidelines for PPE (see below). PPE will be provided to students consistent with these guidelines. For labs and simulation – Level 1 with eye protection will be required. In clinical situations – follow the guidelines of the hospital or institution.

Older adults and people of any age with a serious underlying health condition are considered to be at higher risk for severe illness related to COVID-19. The following are considered health conditions that put people at higher risk. Individuals in the situations listed below should take special infection prevention precautions.

  • Asthma
  • Chronic lung disease (e.g. COPD, pulmonary fibrosis of any origin)
  • Diabetes (Type 1 and Type 2)
  • Immunocompromised (cancer, leukemia, HIV or AIDS, long-term prednisone/steroid use)
  • Liver Disease (including cirrhosis)
  • Serious/ chronic heart conditions (heart failure, coronary artery disease)
  • Chronic kidney disease and individuals on dialysis
  • Organ or bone marrow transplant recipient
  • Severe obesity (BMI over 40)
  • Age 65 years or older
  • Blood disorders (e.g. sickle cell disease)
  • Currently pregnant (or pregnancy in previous two weeks)

If you have any of the above conditions - in addition to practicing social distancing, good hand washing and using CDC recommended protective face covering (i.e. masks) – please consider further limiting your exposure to others. These enhanced measures can help prevent the acquisition/spread of COVID-19 disease and increase collective good.

If a student believes that the risk of exposure is too great to return to school, labs, or clinical, they should contact their Program Director to work on a resolution.

Any student found not complying with the outlined policies and procedures regarding COVID-19 may be subject to misconduct sanctions.

If there are additional questions or concerns, please email Amanda Gray or call (816) 501-6174.

Additional resources:

Level of Mask Protection*

The purpose of this table is to provide a high-level overview. Refer to PPE Guidance Documents on COVID Connect Atlas site for additional information. For OR areas, see the last references slide.
Level 1
  • Patients in common areas / outside of room
  • All Visitors (can wear own)
  • Vendors / Contractors ( can wear own
  • Non Direct Care Providers
    • Caregivers in non clinical areas who do not enter patient rooms (i.e., Supply Chain, Office staff, FANS, Education, Etc.).
    • Cloth face coverings are acceptable if one’s work is based in a non clinical area, and work does not bring one into a patient care area.
Level 1 w/ Eye Protection*
  • Entrance Screeners
  • Direct Care Providers NOT caring for COVID + or PUI patients
  • EVS NOT entering COVID + or PUI patient rooms or those entering rooms greater than 30 minutes after patient discharge
Level 3 w/ Eye Protection*
  • Direct Care Providers performing Moderate Fluid Risk procedures (i.e., non COVID risk droplet precautions, dressing changes)
Non Fit Tested N95 - Level 3 acceptable if supplies are limited w/ Face shield
  • Caregivers caring for COVID + or PUI patients when NO aerosol generating procedures and NO High Risk procedures
  • Dialysis Caregivers
  • Patient Transporter
  • EVS entering COVID + or PUI patient rooms when NO aerosol generating procedures
  • ED caregivers if NO aerosol generating procedures
Fit Tested N95 w/ Face shield or Goggles (*PAPR if unable to fit test)
  • Respiratory Therapists
  • Intubation Extubation Team
  • ED Caregivers if performing AGPs
  • Endoscopy Teams
  • ICU Direct Caregivers caring for ventilated patients
  • Anyone in the room during or within 30 minutes following Aerosol Generating Procedures regardless of COVID status
  • Direct Care Providers caring for COVID + or PUI patients receiving AGPs
  • Direct Care Providers in room during HIGH RISK procedures

Recommendations subject to change based upon CDC recommendations
* Universal eye protection is warranted in areas with high COVID activity in the community, per CDC guidance. Double masking should not be utilized
REVISED 7/13/2020