why have we developed this guide? key points · see infographic to the right. ppe donning ppe how...
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Why Have We Developed This Guide? x To update IPPF occupational health and safety mechanisms in
response to the risk posed by COVID-19, to ensure we can
protect our staff and clients. This brief refresher has been
compiled to support (not replace) current Infection Prevention
and Control Measures.
Infection Prevention and Control (IPC) is crucial to managing this risk. IPC programmes support the prevention of avoidable infections and save lives. Effective IPC programmes have led to a 30%+ reduction in hospital-acquired infection rates and prevent morbidity and mortality.
KEY POINTS
Coronavirus disease 2019 (COVID-19) is a
respiratory tract infection caused by a newly
emergent coronavirus
The best way to prevent illness is to avoid
being exposed to this virus.
The virus is thought to spread mainly from
person-to-person. Social distancing and
practicing good hand hygiene are key to
stopping the spread of the virus.
BEWARE FAKE NEWS! This guide has been developed using resources from the World Health Organisation, the Centre for Disease
Control and other reputable sources. Before sharing news or information, check the source and make sure it is accurate.
What is Coronavirus? x
Coronavirus disease 2019 (COVID-19) is a respiratory tract
infection caused by a newly emergent coronavirus, SARS-CoV-2,
that was first recognized in Wuhan, China, in December 2019.
What are the Symptoms of Coronavirus?
Fever Cough Shortness of Breath
(less common: weakness, malaise, runny nose, diarrhoea, vomiting)
Early recognition of suspected patients allows for timely
initiation of appropriate IPC measures.
Most people with COVID-19 develop mild or uncomplicated
illness. Approximately 14% develop severe disease requiring
hospitalization and oxygen support and 5% require admission to
an intensive care unit. In severe cases, COVID-19 can be
complicated by acute respiratory disease syndrome (ARDS),
sepsis and septic shock, multiorgan failure, including acute
kidney injury and cardiac injury. Older age and co-morbid
disease have been reported as risk factors for death.
HOW IS COVID-19 SPREAD?
PREVENTATIVE MEASURES
SCREENING
In an SRH outpatient clinic
setting, the simplest
screening tool is to use the
three most common
symptoms:
Fever
Shortness of
breath
Cough
If a client or person
accompanying is
suspected/ displaying any
COVID-19 symptoms, they
must be isolated and
referred to the appropriate
health facility.
IN THIS GUIDE: This guide includes the information you need to keep clinic staff and clients safe during the COVID-19 outbreak.
1) Hand Washing 2) Personal Protective Equipment 3) Triage & Setting Up Your Clinic
This information was compiled using the best available evidence (as of 01/04/2020). For the most up to date information go to www.who.int/emergencies/diseases/novel-coronavirus-2019
Modes of Transmission
Coronavirus is thought to spread mainly from
person-to-person, between people who are in
close contact with one another (within about 6
feet).
Respiratory droplets produced when an
infected person coughs or sneezes can land in
the mouths or noses of people who are nearby
or possibly be inhaled into the lungs. These
droplets can also land on and contaminate
surfaces and equipment. These droplets are
then transferred when someone touches the
infected surface.
There is currently no vaccine to prevent COVID-19.
The best way to prevent illness is to avoid being exposed to
the virus. The most effective preventative measures include:
Performing hand hygiene frequently (with alcohol-based hand rub or soap
and water)
Avoid touching your eyes, mouth and nose
Maintain social distance (1 metre) from individuals (particularly those with
respiratory symptoms)
Practice respiratory hygiene by coughing and sneezing into a tissue or bent
elbow, then immediately disposing of the tissue and washing your hands
Wear a medical mask, if you have respiratory symptoms.
Hand Hygiene
Practicing hand hygiene is the
best way to prevent the
spread of germs in the
healthcare setting and the
community.
Our hands are our main tool
for work as healthcare workers
– and they are the key link in
the chain of transmission
SUGGESTION: Set up a handwashing station at the entrance to your clinic (before the triage area). Check out an idea
for a low cost & quick assembly handwashing station from the WHO Africa Regional Office
When to Wash Your Hands
WATCH THE VIDEO AT https://www.youtube.com/watch?v=y7e8nM0JAz0
What is Personal Protective
Equipment (PPE)?
Personal Protective Equipment (PPE)
is specialized clothing or equipment
worn by an employee for protection
against infectious materials.
When to use PPE
The use of masks across contexts
varies, the WHO guidance is:
For healthy people, wear a mask
only if you are taking care of a
person with suspected COVID-19
infection
Wear a mask if you are coughing
or sneezing
Masks are effective only when
used in combination with
frequent hand-cleaning with
alcohol-based hand rub or soap
and water
If you wear a mask, you must
know how to use it and dispose of
it properly. Most masks are single
use only.
IPPF recommends masks are available for all clinicians.
Always assess PPE according to the procedure. For PPE in the SRH setting, see infographic to the right.
DONNING PPE How to Apply PPE
Key Points
PPE should be
available (in the
right condition and
size) when and
where indicated
Always put PPE on
before contact with
the patient
NEVER touch your
face while wearing
PPE https://photos.google.com/share/AF1QipNdOp0UbDcpS-D5AHxbsvGlmlvKMma6KKJRkeyqEjnYVjXs2u8LdbjTWTUCh_5C8g/photo/AF1QipPTdLOgDCZktBafwlpJsWMxVep18P_zuUIiHZjX?key=dGdiekRaUWlTMGtOaExUZllqNFlrbUZZVVh2NzdR
SUGGESTION: Triage is used to screen and refer all patients with COVID- 19 symptoms. PPE should be used according to
the risk of exposure to bodily fluids. PPE is not required in areas of client transit (e.g. corridors, waiting areas).
DOFFING PPE How to Remove PPE
Key Points
Proper removal of PPE is
key to ensuring that you
do not contaminate
yourself
Always remove from
dirtiest to cleanest.
1. Gloves
2. (if wearing a
gown) Wash your
hands before
touching you face
3. (if wearing goggles
remove)
4. Remove the mask
from behind your
head.
5. Hand hygiene
REMEMBER:
The most effective preventative measures against COVID-19 (both in the community and healthcare settings) include:
Performing hand hygiene frequently (with
alcohol-based hand rub or soap and water)
Avoid touching your eyes, mouth and nose
Maintain social distance (1 metre) from
individuals (particularly those with
respiratory symptoms)
Practice respiratory hygiene by coughing and
sneezing into a tissue or bent elbow, then
immediately disposing of the tissue and
washing your hands
Wear a medical mask, if you have respiratory
symptoms.
All health care settings operating in this environment must:
Establish a handwashing station and triage area at the
entrance of the facility. All people entering must wash their
hands.
In the triage area, assess every person entering the facility for
COVID-19 symptoms using a screening questionnaire. It can be
as simple as the three symptoms in graphic to the right.
Post signs around the clinic reminding clients of COVID-19
symptoms and the importance of hand hygiene.
How do I set up the clinic?
In the triage area:
DISTANCE: Ensure that there is at least 1-metre (3- 6 feet) between the triage worker and the client and anyone accompanying. An easy way to do this: rotate your desk so there is maximum distance between the triage worker and the client. Do not share pens or other items with clients.
PPE & HAND HYGIENE: The triage worker should have access to gloves and a mask and hand hygiene (extra PPE may be required based on the risk). Ensure that the clients have access to handwashing and tissues.
ISOLATION & REFERRAL: If a client or person accompanying is suspected/ displaying any COVID-19 symptoms, they must be isolated and referred to the appropriate health facility. Plan an isolation area, where people who are displaying symptoms can wait (for transfer to COVID-19 facility). It must be away from the other clients.
What is a Triage?
Clinical triage includes a system for assessing all clients at the entrance of the facility. This allows
early recognition of possible COVID-19 cases and immediate isolation from others..
SETTING UP YOUR CLINIC
In the Waiting Room
Ensure all chairs are at least 1
metre apart.
Display posters with symptoms
and directions.
Have tissues available.
If a patient develops
symptoms, ask them to wear a
medical mask and refer to
COVID-19 health care facility.
Increase environmental
cleaning and disinfection
procedures.
Thoroughly cleaning
environmental surfaces with
water and detergent and
applying commonly used
hospital level disinfectants
(such as sodium hypochlorite)
are effective and sufficient
procedures.
HAND WASHING STATIONS
If alcohol-based hand gel is not available in your context, consider other hand washing opportunities. See low cost alternatives below
More information on
how to set up your
Tippy Tap available
from the WHO
RESOURCES:
Introduction
1. CDC. COVID-19 Symptoms. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html https://www.cdc.gov/coronavirus/2019-ncov/downloads/COVID19-symptoms.pdf
2. WHO Global surveillance for COVID-19 disease caused by human infection with the 2019 novel coronavirus https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected
Hand Washing
1. World Health Organisation. Responding to COVID- 19. This can be accessed at https://openwho.org/channels/covid-19 2. World Health Organisation. When to Wash Your Hands. This can be accessed at
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public 3. World Health Organisation. The five moments of hand hygiene. This can be accessed at
https://www.who.int/gpsc/5may/background/5moments/en/ 4. World Health Organisation. How to Wash Your Hands. This can be accessed at
https://www.who.int/gpsc/5may/How_To_HandWash_Poster.pdf?ua=1 5. World Health Organisation. Hand Hygiene in Healthcare Guidelines. This can be accessed at
https://apps.who.int/iris/bitstream/handle/10665/44102/9789241597906_eng.pdf?sequence=1&isAllowed=y 6. Centre for Disease Control. Handwashing. This can be accessed at https://www.cdc.gov/handwashing/ 7. Centre for Disease Control. Answering Your Handwashing Questions. This can be accessed at
https://youtu.be/d914EnpU4Fo
PPE
1. The United States of America, Department of Labour. Occupational Health and Safety Administration. This This can be accessed at https://www.osha.gov
2. World Health Organisation. Rationale use of personal protective equipment for coronavirus (COVID-19) Interim guidance 27/o2/2020. This can be accessed at https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-2019-nCov-IPCPPE_use-2020.1-eng.pdf
3. World Health Organisation. Responding to COVID- 19 This can be accessed at https://openwho.org/channels/covid-19 4. Modified based on recommendations made in: World Health Organisation. Rationale use of personal protective
equipment for coronavirus (COVID-19) Interim guidance 27/o2/2020. This can be accessed at https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-2019-nCov-IPCPPE_use-2020.1-eng.pdf
5. The World Health Organisation. The COVID-19 Risk Communication Package for Health Care Facilities. 10/03/2020 This can be accessed at https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-2019-nCov-IPCPPE_use-2020.1-eng.pdf
6. World Health Organisation. When to use a mask. This can be accessed at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks
7. Centre for Disease Control. PPE Sequence. This can be accessed at https://www.cdc.gov/hai/pdfs/ppe/ppe-sequence.pdf 8. World Health Organisation. How to remove PPE. This can be accessed at
https://www.who.int/csr/resources/publications/ebola/ppe-steps/en/
Triage
1. Handwashing stations. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0126916 2. CDC. Get Your Clinic Ready for Coronavirus. https://www.cdc.gov/coronavirus/2019-ncov/downloads/Clinic.pdf 3. http://www.washplus.org/sites/default/files/How%20to%20Make%20Other%20Types%20of%20Tippy%20Taps.pdf 4. WHO. Tippy Tap. https://www.afro.who.int/node/12469 5. WHO. The COVID-19 risk communication package for healthcare facilities.
https://iris.wpro.who.int/handle/10665.1/14482
6. WHO. Infection Prevention & Control When Coronavirus Infection is Suspected. https://www.who.int/publications-detail/infection-prevention-and-control-during-health-care-when-novel-coronavirus-(ncov)-infection-is-suspected-20200125
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