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COVID-19 Practice and Policy Survey
DEADLINE APRIL 11, 2020
In an effort to share as much information as possible, SMFM is collecting information about how institutions and practices are handling obstetric patients in light of COVID-19.
1.
Name
2.
Workplace Location
Institution Name
City
State
Zip Code
3.
Practice Type
Academic
Community - teaching
Community - non-teaching
4.
How many COVID+ pregnant patients have you had at your institution?
5.
How many COVID+ pregnant patients on average do you see a week?
6.
Is your institution currently performing Universal COVID-19 Testing in women who are admitted to L&D or your Obstetric Inpatient services?
Yes
No
Currently considering universal testing, but not decided yet
7.
Are you testing women prior to planned admission or upon arrival to L&D?
Prior to admission
Upon arrival
Currently considering whether to test women prior to planned admission or upon arrival, but not decided yet
Not testing
8.
If you are performing universal testing, what platform are you using?
9.
Are you performing testing for outpatient services for pregnant women?
Yes
No
Currently considering universal testing, but not decided yet
10.
If yes, what are the testing location parameters (e.g. do pregnant patients need to be tested at the hospital or in a location other than their PCP's office?
11.
Does your unit have a "surge plan" in place? (A surge is defined as an anticipated increase in maternal and neonatal patient volume due to mass casualty events, including increased transfer of high-acuity patients.)
Yes
No
Working on it, but not yet in place
12.
Are you using GYN or other staff to cover labor and delivery?
Yes
No
13.
If yes, please check all that apply:
Gynecology
REI
GYN-Oncology
Family Medicine
Midwives
Other Physicians
14.
If "other", what other staff is covering labor and delivery?
15.
Do you have a protocol in place for pregnant healthcare workers?
Yes
No
Considering a policy for pregnant healthcare workers
16.
If yes, what does your protocol for pregnant healthcare workers entail?
17.
What type of personal protective equipment (PPE) is available to you? Check all that apply
Surgical masks
N95s
Face Shields
18.
My institution is using the following during deliveries (Please check all that apply):
N95 masks for vaginal delivery for PUI or Covid +
N95 masks for vaginal delivery for all patients
N95 masks for cesarean for PUI or Covid +
N95 masks for cesarean delivery for all patients
19.
Is there anything else you would like to add?
