BHH Policies

Service Areas

The service area for Boquete Health & Hospice includes:

Bajo Boquete – including Los Naranjos, Alto Lino, Palo Alto, Bajo Mono, Alto Boquete – extending south to the northern Dolega line.

Potrerillos – most of the town but cases in outlying areas will be handled on a case-by-case basis.

Caldera - most of the town but cases in outlying areas will also be handled on a case-by-case basis.

Equipment Loan Policy

Hospice Services: Our equipment loan program is free of charge to our Hospice clients. Our Hospice clients will always have priority to our equipment.

Health Services and others in the community:
·  We loan our equipment free of charge for up to 3 months to our Health Services clients and others in the community.  
·  Health services clients and others in the community may be asked to return equipment at any time for use by Hospice clients in need.

Persons borrowing BHH equipment must return the equipment in the same condition in which they received it at the agreed upon time.  It is understood that equipment will be promptly returned as soon as the client no longer needs it or after 3 months whichever is earlier.  Exceptions will be made for Hospice clients.


The equipment must be in good condition.  It will be cleaned and sanitized before loan and after return.  If it is returned in a condition where it can no longer be loaned, the borrower will be asked to pay for a replacement.  If the said equipment:
·  is not returned, OR
·  is returned in a condition in which it can no longer be loaned to other clients, OR
·  the person does not pay the amount it would cost BHH to replace the equipment, then the person will no longer be eligible for future loans of BHH equipment.

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Respiratory Equipment Loan Policy

Respiratory Equipment that is not expected to be returned (CPAP, Nebulizers, etc.) are received as donated and a brief test is performed to make sure they work.  They are loaned out “as is”, machine only.  All consumables (breathing assists and medicines) are the responsibility of the borrower/patient.


Oxygen Concentrators are cleaned prior to loan and upon return.  The concentrators are to be loaned out to residents in our service area and are not to be taken out of our service area without the express approval of the Respiratory Team Leader and the Council.  
If one of our borrowers requires a concentrator to travel for an extended time, the patient/borrower must make alternate arrangements, as our limited equipment inventory prevents us from loaning equipment under these circumstances.


Oxygen Concentrators use regular filters and then a HEPA filter to filter the air coming into the concentrator from the room.  The HEPA filter will trap any virus from the air.  The air is then sent through the machine and to the patient.  The patient will use a new, sterile nasal cannula that will be disposed of prior to return of the unit to the locker.  The HEPA filter will be replaced before the unit is loaned out again.  The exterior of the concentrator will be sanitized with a bleach/water solution on return to the locker and again before it is loaned out.

Hospice Services Clients:  Our oxygen concentrator loan program is free of charge to our Hospice clients as long as required.  Our Hospice clients will always have priority to our equipment. ·  The concentrator will be promptly returned as soon as the client no longer needs it.  The concentrator must be returned in the same condition in which it was originally received during checkout.·  Once in the client’s home, the concentrator must be connected at all times to an electrical surge protector.·  Barring communication from the patient that the concentrator is not working properly, Boquete Health and Hospice may send a trained volunteer to inspect the unit and perform any required maintenance.      

 

Health Services Clients:  We loan our oxygen concentrators free of charge for up to 3 months to our Health Services clients.  Prior to the end of the 3-month period it is the client’s responsibility to obtain his/her own oxygen concentrator.·  The concentrator must be returned on or before the agreed return date and in the same condition in which it was originally received during checkout.·  Once in the client’s home, the concentrator must be connected at all times to an electrical surge protector.·  Barring communication from the patient that the concentrator is not working properly, Boquete Health and Hospice may send a trained volunteer to inspect the unit and perform any required maintenance.·  Health services clients may be asked to return equipment at any time for use by Hospice clients in need.

Respiratory Maintenance Policy

All Oxygen Concentrators will be checked for damage and wear-and-tear on return of the unit to the locker.


Quarterly, all units must be checked to verify the oxygen saturation produced. Once a quarter, a replacement unit will be delivered to our patients so that their current unit can be returned to the locker for maintenance and inspection.

Oxygen Concentrators Loan Policy

Oxygen concentrators are loaned out for a short-term loan.  If it becomes apparent that the need will be on-going, arrangements will need to be made to either:

  • Purchase a concentrator outright

  • Make arrangements with BHH to purchase the concentrator over a one-year time period making payments quarterly.  Payments would be collected quarterly ($40/month, $120/quarter) and these funds would allow for the purchase by BHH of another concentrator.

 

Quarterly maintenance and follow-up by a BHH volunteer would still occur.

BHH POLICIES DURING A HEALTH CRISIS

Volunteer's Health is First

 

Regardless of anything else, our volunteer’s health and safety must come first.  Under no circumstances should a volunteer be placed in a situation that endangers their welfare.

 

In a health crisis regarding a communicable illness

Volunteers may deliver meals or music to a patient’s home, but may not enter the building or have any physical contact with a member of the household.  Social distancing must be observed and masks must be worn.

If equipment is needed, it is preferred for the borrower/patient come to the locker. The volunteer can them demonstrate how to use the needed equipment.

If this is not possible, the volunteer may enter the house and set up the equipment after the following steps are taken:

 

The Administrator should find out who the patient’s primary doctor is, contact them and try to determine “WHY” they need the equipment.  If it is due to a communicable disease, our volunteer(s) should not enter the house.  

 

If the cause of the respiratory problem is other than a communicable disease, the volunteer may enter the house, set up the unit, and get the signature.

If possible, the volunteer’s hands must be washed before the volunteer leaves the premises and gets in their car.  Once out of the house, the volunteer should use hand sanitizer to help prevent contamination of their car.

Suggestion – when the volunteer gets home, shower and wash the clothes that were worn.

DURING HEALTH CRISIS, NO BHH VISITS WILL BE MADE, TO PROTECT OUR VOLUNTEERS & OUR PATIENTS

All volunteers that interact with patients and/or equipment must take precautions: Wear latex/nitrile gloves and wash their hands before they leave the patient’s house to avoid contaminating their vehicle.

A patient or their family may pick up equipment at the locker (have the patient or their family pick up outside the locker building to avoid contaminating any equipment inside. Equipment should be sprayed with bleach water and wiped dry before giving it to the patient/family just to make sure we don’t pass on any virus. When equipment is returned, it needs to be sprayed with bleach solution, let it sit for ten (10) minutes then wipe it off.  Spray bottles of bleach and water, along with paper towels are in each locker. Please use to clean the equipment.

After distributing equipment, wash hands with soap and water or sanitizer.

No meetings, classes, training, or other gatherings will be held.  Use WhatsApp, Facebook or Skype (or other communication tool) to contact people.

INFORMATION FROM DRA. DIGNA DIAZ REGARDING COVID-19

The patients that have mild symptoms will stay at home on quarantine and will be checked only by phone.  No health personnel will visit. They should have something at home to check their blood pressure and take their temperature so they can give feed back to the head physician.  The treatment is symptomatic only.  If they have a fever, they should take something for the fever. If they are wheezing, then they should take a nebulizer treatment or get a doctor’s orders for a nebulizer machine and medicine.  If they are coughing, they should take something for the cough.  If the case is so severe that they are using accessory muscles (chest muscles) to breathe and have de-saturation (change in mental status or finger tips/lips turning blue), they are the only ones who should go to the hospital. They should go by ambulance.  They can go by themselves but must notify the hospital that it is a suspicious case for Corona Virus, especially if they have airway symptoms and have had either contact with someone who has had it or have been travelling and just recently arrived in the country.

Per Dra. Diaz, anyone who suspects they may have the virus must report it to Seguro (Minsa) at +507-720-2480.

GENERAL INFORMATION

Information taken from the New York State Department of Health on how to protect yourself:

  • Wash hands for at least 20 seconds (sing Happy Birthday twice) 

  • Before and after eating

  • After sneezing, coughing or nose-blowing

  • Using the restroom (wash hands, use paper towels to dry, and use the paper towel to open door handle)

  • Before handling food

  • After touching or cleaning surfaces that may be contaminated

  • After using electronic equipment

 

In addition – it is recommended to use soap and water to clean non-porous surfaces to remove dirt, dust, grease, etc. before using a disinfectant.

 

Frequently-touched surfaces that should be cleaned and disinfected daily:

  • Desks and chairs

  • Counters, tables and chairs

  • Door handles and push plates

  • Handrails

  • Light Switches

  • Kitchen and bathroom faucets and toilet handles

  • Handles on equipment (example – grocery carts)

  • Remote controls

  • Telephones

  • Electronic devices

 

Information from the CDC regarding cleaning objects:

  • If possible, clean objects with soap and water, then disinfect.

  • At the locker building in each locker, there will be a spray bottle with a solution of) 8 ounces of bleach to 20 ounces of water.  Spray items with the solution, wait ten (10) minutes and wipe off.  This should be done outside if at all possible.  

  • Rotate returned items – give out items that have been in the locker the longest before giving out the most recently returned items.  

  • To disinfect:
 Most common EPA-registered household disinfectants will work. Use disinfectants appropriate for the surface.

  • Options include: 

  • Diluting your household bleach.
To make a bleach solution, mix: 

  • 5 tablespoons (1/3rd cup) bleach per gallon of water
OR

  • 4 teaspoons bleach per quart of water

  • Follow manufacturer’s instructions for application and proper ventilation. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against coronaviruses when properly diluted. 

  • Alcohol solutions.
Ensure solution has at least 70% alcohol.

Health is First - New Community Interaction Policy

To all our BHH members and our community friends: In response to the continued spread of the Covid 19 virus and its emerging variants in Panama, Boquete Health and Hospice has established a policy requiring that member volunteers who interact with the community, other team members or patients to be fully vaccinated or have started the vaccination process by having completed the first dose of a two dose regimen against the Covid-19 virus.  On August 7, 2021, the BHH Council passed the following policies with the intention of further protecting our members and our community.  

Mask Policy

Effective immediately – all Boquete Health and Hospice personnel MUST wear masks continuously when representing BHH.   A BHH volunteer will be appointed at every in-person meeting/event to ensure that all safety precautions are followed.  If anyone notices that masks are not being worn or are being worn incorrectly, please ask the person not complying to adjust their mask.

Vaccination Policy

Any volunteer of Boquete Health and Hospice representing and interacting with members of the community must be vaccinated.  This applies to the Patient Care Coordinators, Equipment Team, Ambassadors, CPR Instructors, anyone leading a meeting or a class, the people representing BHH at the Tuesday Market.  (These are just examples). Starting with the September 2021 New Member Training Class – all new members must be vaccinated. A dispensation can be granted by the Council upon receipt of a negative antigen test performed within the prior 48 hours of the event and written test results provided prior to the event.  Prior to the event, the unvaccinated person must disclose to the audience that they are unvaccinated but have tested negative for the virus.