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VISITATION PROCEDURE FOR CONFIRMED I SUSPECTED PATIENTS WITH

MERS-CoV
IPP-IPC-066 I Infection Prevention and I MERS CoV Unit and I 8 May 2018
Control Department Isolation Rooms

1.0 PURPOSE:
1,1 To limit the number of visitors & minimize the exposure of visitors to Middle-East
Respiratory Syndrome Corona Virus (MERS-CoV) patient.

2.0 DEFINITION:
2.1 Case Definition:
21.. 1 S uspecte dC ase:*
Clinical Presentation Epidemiological Link
I. Severe pneumonia (severity score ;:::3points) Not Required
(Appendix A) or ARDS (based on clinical or
radiological evidence)
II. Unexplained deterioration** of a chronic Not Required
condition of patients with congestive heart
failure or chronic kidney disease on
haemodialysis
III. Acute febrile illness (T ;:::380C) with/without
Within 14 days before symptom onset:
respiratory symptoms OR 1. Exposure*** to a confirmed case of MERS-
IV. Gastrointestinal symptoms (diarrhoea or CoV infection OR
vomiting), AND leukopenia (WBcs3.5x109/L) 2. Visit to a healthcare facility where MERS-
or thrombocytopenia (platelets < 150x109/L) CoV patients(s) has recently (within 2 weeks)
been identified/treated OR
3. Contact with dromedary camels**** or
consumption of camel products (e.g. raw meat,
unpasteurized milk, urine)
All suspected cases should have samples collected for MERS-CoV testing (nasopharyngeal swabs
or sputum, and when intubated, lower respiratory secretions)
**Chronic renal failure and congestive heart failure patients may exhibit fever and presence of fluid
overload may mask the radiological features of pneumonia
*** Exposure is defined as a contact within 1.5 meters with a confirmed MERS-CoV patient.
****Exposure to camels include:
o Direct physical contact with camels or their surroundings (milking and handling excreta are
especially risky), drinking raw camel milk or other unpasteurized products derived from camel milk,
and handling raw camel meat.
o Indirect contact include casual contact with camel places like visiting camel market or farms without
direct physical contact with camels, living with a household member who had direct contact with
camels.
2.1.2 Confirmed Case:
2.1.2.1 A Confirmed case is defined as a suspected case with laboratory
confirmation of MERS-CoV infection.
VISITA TION PROCEDURE FOR CONFIRMED / SUSPECTED PA TIENTS WITH MERS-Co V

3.0 POLICY:
3.1 King Fahad Hospital, Tabouk (KFH, Tabouk) recognizes the importance and the rights of
patients to have visitors.
3.2 King Fahad Hospital, Tabouk (KFH, Tabouk) identifies and implements visitation policy
for MERS-CoV patient on isolation precautions.
3.3 One visitor should be considered during visitation time to MERS-CoV patient visiting
time is 5 (five) minutes only.
3.3.1 Watchers should not be considered for MERS-CoV patient.
3.3.2 Children should not be considered for MERS-CoV patient.
3.3.3 Staff Nurse should be instructed the visitors the use of appropriate personal
protective equipment (PPE) before entering the room and proper disposal of
medical waste maintained.
3.3.4 Any visitors for MERS-CoV, the staff nurse should document to the log book
(including the name of the visitor, the phone number, time to visit and the
duration of visit).

4.0 MATERIALS:
4.1 Visitor Logbook.

5.0 PROCEDURE:
5.1 Special considerations:
5.1.1 Visiting Rules in Isolation Units:
5.1.1.1 Allowed daily visit period is for ONLY ONE HOUR: from 4:00 p.m.
to 7:00 p.m. Sunday through Thursdays, and from :00 p.m.
to :00 p.m. Friday and Saturday.
5.1.1.2
5.1.1.3 One visitor allowed per day, visiting time is 5 (five) minutes only.
No children under 12 years are allowed.
5.1.1.4 Visitors shall adhere to the use of appropriate PPE and infection
control measures.
5.1.1.5 Visitors shall contact the head nurse for instructions of use and
disposal of PPE and infection control measures.
5.1.1.6 Visitors are not allowed during aerosol-generating procedure.
5.1.1.7 Visitors should be instructed to limit their movement within the
facility.
5.1.1.8 All visitors must depart the hospital at the completion of each
visiting hours. This restriction is to ensure that the patient receives
the required rest for recovery.
5.1.1.9 The number of visitors may be limited by the hospital staff,
according to the medical needs of the patient and/or any other
patients in the same room.
5.1.1.9.1 Children under twelve (12) years of age are not allowed.
5.1.1.9.2 Permission must be obtained prior to visiting hours and a
"Special Visiting Permit" must be completed by Social
Services Department. The visitor must be able to show the
permit at the time.
5.1.1.10 Patients with special social or psychological needs and long term
patients may not be permitted.
5.1.1.11 Patient visitors will need to observe courtesy toward other
hospitalized patients, i.e., limits need to be observed as to

Page 20f4
VISITATION PROCEDURE FOR CONFIRMED / SUSPECTED PATIENTS WITH MERS-CoV

excessive noise, and the no smoking regulation must be followed

in the patient rooms.
5.1.1.12 Smoking is not permitted inside the MERS-CoV patient's room.
5.1.1.13 Visitors not in conformity to these usual courtesies for hospital
patients will be asked to leave the hospital, or to utilize the hospital
main lobby areas on an interim basis.
5.1.2 Hospital security staff may be requested if assistance in visitor control is
needed for compliance with these necessary procedures.
5.1.3 Visitors are not permitted to bring food to the patient unless the patient has
received an authorization for exception. This restriction is for the protection of
the patient on a special diet. However, visitors may bring coffee, tea and fruit.
5.1.4 Watchers are not allowed to MERS-CoV patient, except for the patients below
than 5 years old. For ICU case, watcher is not allowed.
5.1.5 Any violation to the above regulations may result in the visitor being denied
access to the hospital.

6.0 RESPONSIBILITY:
6.1 Shift-In-Charge Nurse of the patient care area.
6.2 Security Head.
6.3 Medical Director.
6.4 Nursing Director.
6.5 Hospital Director

7.0 REFERRENCE:
7.1 MOH Guidelines on MERS-CoV Infection Control in Healthcare Facilities, 2014.

Page 3 of4
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VISITA TION PROCEDURE FOR CONFIRMED / SUSPECTED PATIENTS WITH MERS-Co V

8.0 AUTHORIZED SIGNATURES:

APPROVAL:

Action Name Position Signature Date

Process Owner: Department of Infection Prevention and
Control _,..........,
Reviewed by: MR. WALEED OTTAI Director of IPC u.b"":
»z>: g-. '-t./~

Reviewed by:
DR. MOHAMMAD MOMINUL
ISLAM
MS. HIND MOHAMED ALAIDAI
Acting Consultant" £:::;)
for IPC
Nursing Director
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MR. SALEM AL ATAWI Director of TOM _t;:)_ t::;r_
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DR. SALEM AL BALAWI Medical Director c, '__}.J ~~ f',.~~~
Approved by: DR. TARIQ ALI AL BALAWI Hospital Director \ .J. z-> tDf:_YI /'
v

REVIEW HISTORY
Name Position Signature Date

2
3
4
5

Page 4 of4