DOH orders emergency measures at Albany Med unit after COVID breakout, union says

Albany County

ALBANY, N.Y. (NEWS10) — The New York State Nurses Association (NYSNA) announced Tuesday that New York’s Department of Health (DOH) ordered immediate emergency measures inside Albany Medical Center’s oncology unit.

NYSNA, which represents over 40,000 frontline medical workers, said DOH ordered that no new patients enter the unit and no floating of nurses in or out. The oncology unit will then be closed “indefinitely” once the remaining patients safely leave. The union also said the emergency action comes in the wake of months of complaints by its members, including official complaints to the state and the Occupational Safety and Health Administration, the federal agency meant to regulate workplace safety.

NYSNA says dozens of patients, nurses, and other caregivers were infected with COVID-19 at three different outbreaks since November:

  • 54 infected
    • 28 staff
    • 26 patients
  • At least one individual has died of COVID complications
  • Several patients remain intubated

NYSNA says that nurse complaints have consistently called out:

  • Inadequate personal protective equipment
  • Not following infection controls, like patient cohort protocols
  • Ignoring frontline nurses

Matthew Markham, Vice President of Communications at Albany Med, sent a statement to NEWS10 that contradicts the union’s version of events:

Albany Med proactively contacted the state when cases were identified on this particular unit. The state has not “ordered changes” on the unit. Rather, we are working closely with the Department of Health, as we have been since the very beginning of the pandemic. Patients on the unit are kept in private rooms as much as possible and are wearing masks when providers are in the room; providers are wearing masks, too. The numbers in the union’s press release are inaccurate—22 patients and 26 staff members have been impacted. Enhanced cleaning protocols are being implemented on these rooms, which includes the use of hydrogen peroxide between patient stays. The unit has been closed to new admissions and a limited number of staff members are working on the unit. During the pandemic, any issues have been promptly investigated by epidemiology and nursing supervision. Safety is our top priority—and we count on our staff to follow those policies for everyone’s protection. It bears repeating that personal protective equipment was not an outstanding issue during contract negotiations before the Dec. 1 nurses strike, and supply of federally-approved PPE remains adequate.

Albany Med routinely updates its YouTube channel with the latest from hospital leadership. In Tuesday’s update, CEO Dr. Dennis McKenna and Dr. Ferdinand venditti briefly addressed the issue.

“The article would suggest that the Department of Health had come in and was essentially running operations on our cancer floor. That, point of fact, is not true at all,” Dr. McKenna said. “It is unfortunate but not unusual that there are times when you have staff or patients who test positive during a situation like this.”

“I would say one more thing,” said Dr. Venditti, the hospital’s general director. “The Medical Center is safe.”

Also on Tuesday, NYSNA released a redacted version of a state complaint filed on January 18, in between the most recent outbreaks:

Department of Health complaint re: Albany Medical Center

From: [REDACTED]

I am currently employed on the Oncology/Hematology floor at Albany Medical Center, where I care for immunocompromised cancer patients, many of whom are receiving life-saving cancer treatments that severely impact their immune systems.

I trust that you will follow your policy regarding hospital complaints and keep my name confidential. I am concerned about retaliation so please do not share my name with the facility as I wish to remain anonymous.

The Oncology/Hematology floor has experienced 2 COVID-19 outbreaks. The first began Thanksgiving week and included 12 staff and 8 patients. The second is ongoing and has included 12 staff since 1/1/21 and multiple patients. Current total affected counts as of 1/18/21 are approximately 28 infected staff and 17 infected patients. There are only a handful of RNs on my unit who have not tested positive.

Please note that the first outbreak was chronicled in the New York Times in this article.

I am imploring the Department of Health to take action now to protect the lives and health of the cancer patients that I care for and the RNs and care partners providing that care.

Contributing conditions that have not changed between outbreaks include: lack of N-95 mask fit testing for all unit staff, lack of N-95 mask availability for all unit staff, lack of training on and adequate availability of PAPRs. The previous congregate living policy, which requires COVID- 19 precautions for 14 days for all congregate living patients regardless of initial test results, has been suspended. [REDACTED]

Two hospital-wide policies have been changed recently. The first was a policy which went into effect December 22nd, 2020. This policy requires PAPRs or N-95 masks for staff in the care of all patients (including COVID negative patients) with certain characteristics/procedures, such as tracheostomy, bipap/cpap, and high flow nasal cannula. Additionally, CPR and intubation are considered aerosolizing procedures and anyone participating in a code should have an N-95 mask or PAPR per the new policy. The second policy is the COVID testing of all admitted patients, which went into effect on Monday, 1/11/21. Per the algorithm, however, asymptomatic patients and pre-procedure tested patients do not have to have their tests results come back negative before being brought to the floor. They can be put into a semi-private, non-negative pressure room, with a roommate, on a non-covid floor. As we have had both asymptomatic and pre-procedure patient tests come back positive in the recent past, this is a concern.

Currently, the unit continues to operate normally, with admissions, transfers, and roommates in semi-private rooms with shared bathrooms, despite multiple staff and patient infections since 1/1/21. Those patients cared for by confirmed positive staff have been placed on COVID precautions for 10 days and are being tested (frequency unknown). However, other patients, to my knowledge, are not undergoing serial swabbing every 3 days, as was done in the initial outbreak in November. Staff is not undergoing every 3-day swabbing. Staff continues to float to other units, including COVID units, and returning to the home unit. Multiple patients have tested positive after being housed in a room with another positive patient. Epidemiology announced on 1/14 that the rooms of positive patients would no longer be treated with Tru-D afterward, an ultraviolet light treatment used until now. Per Epidemiology, it is not necessary.

After the aforementioned aerosolizing procedure policy went into effect, a list was generated of types of patients not allowed to come to this unit due to a lack of fit-testing and access to proper PPE. [REDACTED]

On [REDACTED], 2 codes occurred on the unit. All code staff had proper PPE, however, this unit’s floor staff did not, as they still have not been fit tested for N-95 masks and PAPRs were not available. Thus, both these codes created exposure events for all staff in the rooms not wearing proper PPE. Said staff actively participated in compressions. On [REDACTED], 2 patients came back positive, including one of the patients who had coded.

These are but a few examples of improper patient placement, lax infection control policies, and exposure events occurring on a regular basis on this unit. More specific information is available upon request. Concerns regarding patient placement and infection control have been expressed to Epidemiology, Nursing Supervision, and the Unit Manager. Typically, these have been met with no changes on this unit and dismissiveness.

Copyright 2021 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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