Important Information


The new guidelines issued by the Centers for Disease Control and Prevention (CDC) for fully vaccinated persons against COVID-19 do not apply to healthcare settings. Visitors, regardless of their vaccination status, should wear a well-fitting cloth mask, face mask, or respirator. Please go to COVID19.SanAntonio.gov to find information on public vaccine sites.

If you will be receiving care at one of our surgery centers, then please review our surgery center visitor policy instead.

Patient Visitation and Risk Screening for COVID-19

Purpose

Visitation guidance is designed for the safety of all patients and employees in the interest of limiting exposure to respiratory illness and containment of the COVID-19 virus while balancing patient needs for family support.

Procedure

Upon entry to the building, all visitors, will be screened for respiratory symptoms, exposure to COVID-19. This guidance will remain in place until further notice.

Procedural/surgical patients (inpatient or outpatient meeting) may have one (1) adult visitor throughout the duration of the procedure and during the discharge process. If the patient is admitted (or an inpatient) following the procedure, the visitor will be permitted to escort the patient to the inpatient area.

Inpatient and ED visitation is limited to one (1) visitor at a time. Facilities will develop an escalation pathway to discuss exceptions (ex. incident commander, administrator on call, or house supervisor).

COVID-19 Positive Patients/Patients Under Investigation (PUIs) may be roomed in the ED or inpatient areas and visitation highly regulated for patients that meet criteria (see Visitation for Patients with COVID-19).

Visitation expectations:

  • The use of alternative communication tools (tablets, phones, etc.) is encouraged for patients during this restriction of visitation.
  • The patient’s clinical team may designate a patient as “No Visitors Allowed” after discussion with the patient.
  • Exceptions to the restricted visitation guidelines may/should be considered in cases of palliative care, vulnerable patient populations, or other identified ethical circumstances:
    • All visitors must meet the visitor screening guidelines for entry into the building.
      • Patients who are at the end of life
        • Up to one visitor may accompany the patient during the end of life. In addition to the one visitor, a clergy member should also be made available upon request.
        • All visitors will be required to pass all screening guidelines
        • Duration of visitation is at the discretion of the healthcare team, and encouraged to be limited
  • Screeners should call the house supervisor each time for an exception decision. If the House Supervisor is unable to make a clear exception, escalation should move to the AOC. House supervisors should log all exceptions for awareness and future escalation decisions.

Visitor screening:

  • Be at least 18 years of age
  • Have no known close contact with someone confirmed to have COVID-19 within the last 14 days
  • Have no signs or symptoms of lower respiratory illness (per the screening guidelines)
  • Wear a mask at all times, in and outside the patient room. Visitors who refuse to comply will be escorted from the facility.
  • Follow social distancing guidelines at all times. Visitors who refuse to comply will be escorted from the facility.

Visitation for patients with COVID-19

Visitation for patients with COVID-19 will be evaluated by assessing risk for transmission. Brief and limited visitation will be granted for patients who are at lower risk for transmitting COVID-19. Alternative communication tools like tablets, and phones should continue to be made available to patients.

Exclusion criteria – The following patients are not eligible for visitation:

  • Requirement for high-risk aerosol generating procedures/therapies (AGPs) like BiPAP, and frequent bed-side bronchoscopies
  • Within the first ten days of critical illness
  • Combative or behavior concerns that are not conducive to safe visitation

Process for safe visitation – Follow these instructions to ensure safe visitation:

The clinical team will evaluate all requests for visitation on a case by case basis. The visitor will be contacted to review instructions prior to visitation upon approval.

Facilities may elect to set up specific visitation times, and to set limits for visitation duration. Visits should be brief, and should not impact care delivery to the patient.

Visitor screening:

  • Only one designated visitor will be allowed for visitation. Visitors should not be rotated, or change throughout the day.
  • Visitor must be age 18 or older
  • Have no known close contact with someone confirmed to have COVID-19 within the last 14 days
  • Have no signs or symptoms of lower respiratory illness (per screening guidelines)
  • A member of the clinical team will consult with the visitor about contraindications to visitation like immunocompromised status, high-risk category, etc.
  • Visitors will be notified of requirement to sign an attestation assuming risks of visitation

Visitation expectations:

  • Visitor will be provided a level one mask, and escorted to the unit or patient’s room by a facility staff member. Limit items brought into the unit and the patient’s room
  • Once the visitor is in the unit, in addition to the level one mask, provide the visitor with a face shield, and gown
    • The visitor will sign the COVID-19 Visitation Attestation
    • The visitor will have a staff member assist with putting on PPE, and perform hand hygiene
  • If possible, pause any of the patient’s AGPs. If it is not possible to pause an AGP, the visitor can visit from outside the patient’s room (via glass doors/windows), or at a distance greater than 6 feet from the patient and aerosol/droplet source.
    Patients who are not on mechanical ventilation and can tolerate doing so, will wear a mask during visitation
  • Visitors will be coached on:
    • Limiting contact with the face, mask and face shield
    • When to perform hand hygiene
    • A plan for communicating when he or she is ready to exit the room, as well as not exiting the room or removing PPE before a staff member is present
  • When the visit is over, ensure a staff member is present to coach:
    • PPE removal
    • Hand hygiene
    • Disinfection of any item brought into the patient’s room
  • Staff will escort the visitor to the hospital exit.

Circumstances may allow for specific exceptions to any visitation restrictions described on this webpage. Those circumstances include religious visitation as well as a designated support person for a patient with a disability to provide assistance with communication or other necessary components of the patient's treatment. All persons entering under an exception remain subject to appropriate infection control protocols.