Another Best Practice Monmouth Medical Center

Best Practice: COVID-19 Nurse Liaison Task Force

Lauren Fleming, MA, BSN, RN-BC, Monmouth Medical Center, Long Branch, NJsmlaura. Lauren is a staff nurse and the former chairperson of the Patient Care Coordinating Council, and former chairperson of and current consultant to the Medical-Surgical Shared Governance Council.

A diagnosis of COVID-19 makes it difficult for family members to communicate with their hospitalized loved ones at most hospitals. However, not so at Monmouth Medical Center (MMC) where nurses have intervened. MMC’s shared governance model empowers frontline clinicians to make team-oriented decisions at the point of care for the betterment of patients and the organization. At MMC, a needs assessment revealed an obligation to restructure the organization’s flow of communication disrupted by recent events in our nation’s history

Many hospitals have shut down visiting hours indefinitely to protect its staff, patients, and the community-at-large during the pandemic. And, while patients use phones and other smart devices to communicate with family, this technology is not available to some of the patient population, especially those with disabilities, sensory deficits, cognitive deficits, or language barriers. To remedy this, staff nurse Lauren Fleming, MA, BSN, RN-BC and other frontline nurses launched the COVID-19 Nurse Liaison Task Force to bridge communication between the healthcare team, the patients, and their loved ones with a new role and structure. Lauren is the former chairperson of the Patient Care Coordinating Council, and former chairperson of and current consultant to the Medical-Surgical Shared Governance Council.

Six professional registered nurses, operating in a designated office with telephone and computer capabilities, while maintaining appropriate social distancing and infection control precautions, fill a liaison role in the medical-surgical division. They each have a telephone number that corresponds with their workstation and access to electronic medical records. Nurses clock in for eight-hour shifts, five days a week, providing coverage Monday through Sunday. Schedules are in two-week increments and relayed promptly to the nurses’ respective directors of patient care, the MMC Command Center, and staffing department.

These nurse liaisons work directly with the designated COVID-19 units. Each nurse is responsible for an ongoing caseload of positive COVID-19 patients and persons under investigation for COVID-19 (PUI); they remain with their patient group through discharge or until a change in care plan. This continuity of care builds a trust and rapport with the patients and their loved ones.

In accordance with the Health Insurance Portability and Accountability Act, a designated loved one (“Point of Contact” person) is determined for each patient. Once permission for correspondence is obtained, the nurse liaison serves as the main line of communication between the healthcare team and the Point of Contact. Nurse liaisons report directly to the Magnet Office and work with directors of patient care, unit nurse leaders, physicians, advanced practice nurses, medical residents, case managers, social workers, other healthcare providers, dieticians, and the Patient Satisfaction department on the COVID-19 units to which their patients are admitted. Predetermined topics of discussion with Points of Contact include questions for the primary nurse, physicians, or the care team; the plan of care; medications and adverse effects; and discharge instructions. Nurse liaisons follow up with patients after discharge to ensure they were comfortable, their concerns were addressed, and recommended infection safety guidelines were understood.

The main goal of this role is to enable open channels of communication in the best interest of the patient. In addition to this enhanced communication, the nurse liaison position permits the interprofessional team directly caring for COVID-19 patients to spend valuable time in the isolation rooms, instead of answering multiple of phone calls throughout the shift. The position helps to conserve personal protection equipment as well. The task force has been so successful in the medical-surgical division that it was replicated in the Intensive Care Unit.

To further share this new program, the task force’s accomplishments and family feedback through the Patient Satisfaction department were presented to the Patient Care Management Council and the Patient Care Coordinating Council as a model of best practice within MMC.

For more information about this best practice, contact Lauren Fleming, MA, BSN, RN-BC at Lauren.Fleming@rwjbh.org.