Planned interventions in hospitals, including at a time of global resolution of the WHOID-19 pandemic, are given the green light, but with strict public health rules. The national clinical team prepared clear rules for hospitals in consultation with the head of the health department Marek Krajcí. Planned procedures may be initiated but under specified conditions.
The planned hospital healthcare will follow the Clinical Protocol.
The non-urgent operation shall be provided by a decision of the consiliary team of the healthcare facility, the consensus shall be composed of a representative of the operational discipline or other specialists who shall assess whether the execution of that performance is safe on the basis of a proposal from the indicating physician, stated Minister of Health of the SR Marek Krajčí.
The consensus shall comprehensively assess:
- level of urgency of planned healthcare
- the impact of an indicative diagnosis on the patient's health
- risk of consequences of possible delayed health care (including the risk of death or deterioration of health status)
- the risk arising from the epidemiological situation;
- the risk of possible need for subsequent treatment of complications and possible intensive care needs (including capacity and use of personnel and material and technical resources).
We must think primarily about dealing with COVID-19 and providing health care in this area, but we do not forget other segments of hospital health care, so when deciding on the planned operation, the Council will take into account the fact that the hospital is able to provide emergency health care in 100% condition. The current epidemiological situation of the establishment will also be an important dimension in the assessment,– explained Minister of Health.
Based on clinical assessment and prognosis, patients will be divided into multiple groups:
- GROUP 1 - medium-term emergencies:
- operating / intervention procedures in all healthcare establishments are recommended only in those patients who have a real risk of increased risk of death, permanent harm to health or intolerable signs of disease within 3 months without the necessary performance,
- GROUP 2 - Urgency States
- it is recommended to implement operational/interventional procedures in all healthcare establishments only in those patients who have a real risk of increased risk of death, permanent harm to health or unbearable signs of disease within 14 days without performance;
- - this is the phase of an uncontrolled increase in the COVID-19 epidemic,
- - at this time the healthcare provider has many patients with probable or confirmed COVID-19 disease and persons in contact.
Operational / intervention performances should be limited in situations of:
- - if the epidemic is taking place in the catchment area of a medical facility in a so-called "non-controllable" phase,
- - where the material and technical and/or personnel resources of the provider are limited and lack sufficient capacity to provide adequate healthcare in all fields,
- - the acceptance condition is testing for COVID-19 with negative result.
- GROUP 3 - emergency situations
- it is recommended to limit the operational/intervention procedures to patients who have a real risk of increased risk of death, permanent harm to health or unbearable signs of disease without performing a given exercise over the next few hours,
- - this is the phase of the so-called extreme health system burden in the COVID-19 epidemic,
- - in this period, all resources of the constitutional health care provider or healthcare provider are directed towards patients with probable or confirmed COVID-19 disease and persons in contact,
- - the supplier does not have sufficient material and technical resources (including the exhaustion of consumables) or sufficient personnel resources to implement the intended performance,
- - the acceptance condition is testing for COVID-19 with negative result.
If the hospital's capacity to deal with patients in an emergency situation is met, it would be ensured that they are redirected to workplaces with sufficient capacity. Such transfer should be carried out, where appropriate, in cooperation with health insurance companies, taking into account the reprofilation plans of constitutional healthcare providers, said Minister for Health of the SR Marek Krajčí.
A condition for admission to the medical institution and the planning of surgery is that the patient:
- - remained in home isolation for 14 days and monitored their health daily - especially repeated body temperature measurements during the day and monitoring clinical signs (coughing, shortness of breath, headaches and muscles),
- - submitted a solemn statement by the patient/legal representative that he had not been ordered another quarantine (VLD, RÚVZ) which would persist at the time of hospitalisation.
In the event of a 14-day quarantine or isolation in the home based on a positive travel history or contact with a sick person at Covid-19, the patient must:
- - completed the 14-day quarantine or isolation in the home and monitoring of clinical signs, with no clinical signs of COVID-19 (especially fever, cough, shortness of breath, headache and muscle) during and after the quarantine measures,
- - in the event of clinical signs occurring, the VLD/VLDD has been informed in good time,
- in case of positivity to COVID-19, the operation/intervention is postponed until full cure and 2 negative results taken at a minimum interval of 24 hours,