Becker's Hospital Review

62 CMO / CARE DELIVERY 'We can't do this forever': 8 nurses doubling as janitors at Oklahoma hospital on brink of closure By Ayla Ellison T he COVID-19 pandemic could scuttle the sale of Haskell County Communi- ty Hospital in Stigler, Okla., a bankrupt hospital that is relying on a skeletal staff to keep its doors open, according to ProPublica. Haskell County Community Hospital is one of several hospitals previously owned by Kan- sas City, Mo.-based EmpowerHMS that filed for bankruptcy last year. The 25-bed hospital entered bankruptcy in March 2019. In Octo- ber, the hospital laid off 85 percent of its staff and ended most services. The hospital, operating only as an emergen- cy department during the bankruptcy pro- cess, is down to eight nurses who double as a cleaning crew, an office manager and a part- time maintenance worker. The facility barely meets state and federal laws requiring the ED to be staffed with at least two nurses and an on-call physician, according to ProPublica. "We know we can't do this forever," Andrea Randall, RN, one of the nurses left at the hos- pital told ProPublica. Ms. Randall, who also serves as the hospital's interim administrator, said she is praying for a new owner to ac- quire the hospital. A company bid $200,000 in January to buy Haskell County Community Hospital out of bankruptcy. The sale was slated to close in March, but the COVID-19 pandemic has de- layed the deal. The company can no longer afford to operate the hospital and is waiting on federal stimulus money to help finance the purchase, according to ProPublica, which cited court documents. Thomas Waldrep, the trustee overseeing the transaction, said in early April that he expect- ed the sale of the hospital to close by the end of the month. However, as of April 21, he couldn't provide a specific closing date, ac- cording to the report. If the sale falls through, Mr. Waldrep would have to secure a new buyer or close the hospital. n N95 masks can only be decontaminated, reworn 2 or 3 times safely, study shows By Anuja Vaidya A National Institutes of Health study found that N95 masks can be decontaminated and reused safely only two or three times, ac- cording to MedPage Today. The study, which was not peer-reviewed as of April, analyzed four readily available and often used N95 mask decontamination methods, including ultraviolet light, a 70 percent ethanol solution, heat treatment and vapor- ized hydrogen peroxide. Researchers found that ultraviolet light and vaporized hydrogen peroxide both killed the virus on N95 masks without affecting the functional integ- rity of the masks for two rounds of decontamination, compared to control masks that were not treated. Filtration remained "acceptable" after the mask was reused a third time when those two methods of decontamina- tion were used. The decontamination method using vaporized hydrogen peroxide was the faster than the ultraviolet light method, eliminating viral growth in about 10 minutes, MedPage Today reported. The study also examined two other methods: using a 70 percent ethanol solution sprayed on the mask until saturated and heat treatment in an oven set to 158 degrees Fahrenheit for 10 minutes. The ethanol decontaminated the masks quickly but did not preserve the functional integrity; the heat treatment was slow and took an hour to kill the virus but did preserve functional integrity for two rounds of decon- tamination, according to MedPage Today. n 'COVID toes' could indicate coronavirus infection in asymptomatic patients By Anuja Vaidya P hysicians have noted a new coronavirus symptom, named "COVID toes," ap- pearing primarily in patients with no other symptoms, children and young adults, according to USA Today. Some patients who eventually test positive for COVID-19 have purple or blue lesions on their feet and toes, which are "typically painful to touch and could have a hot burn- ing sensation," Ebbing Lautenbach, MD, chief of infectious disease at the University of Pennsylvania Perelman School of Medicine in Philadelphia, told the newspaper. e symptom appears early in the timeline of the disease, Dr. Lautenbach said, meaning this might be an initial clue indicating a person has the disease, even if they are not showing other symptoms. The symptom can disappear in a week or 10 days for some patients, but in oth- ers, it could progress to respiratory symptoms. It appears mostly in children and young adults. First identified by a physician in Italy in March, COVID toes may be caused by an inflammatory response in a patient's feet and toes, or be the result of clotting blood vessels, Dr. Lautenbach told USA Today. n

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