INFECTION PREVENTION AND CONTROL
INFECTION PREVENTION AND CONTROL: REDUCING RISK OF COVID-19 TRANSMISSION & OTHER INFECTION CONSENT DOCUMENT FOR PRIVATE HOME VISIT SUPPORT
The Government recently announced their plan for ‘Living with Covid-19’, which sets out their plans to end the legal requirement to self-isolate, even for those who receive a positive Covid test.
Infection Prevention and Control has continued to evolve throughout the pandemic, and Public Health England are now setting out further changes following updates from the UK Health Security Agency (UKHSA).
Coronavirus (COVID-19) is the illness discovered in 2019 caused by a respiratory corona virus which can cause a new continuous cough, fever or loss of, or change of smell or taste.
Local and national prevalence and incidence data will continue to guide services as advised by country specific/public health organisations. Identification of new variants of concern is inevitable and on each new identification evidence for any change in transmissibility, mode of transmission, disease severity and any evidence of vaccine evasion will need to be considered as well as local incidence and prevalence of any new variant concern. It may be necessary to change the Infection Prevention Control measures required on the basis of any new evidence (Public Health England, 2021).
The UK Health Security Agency latest updated IPC in June 2022, stated “As we learn to live safely with coronavirus (COVID-19), there are actions we can all take to help reduce the risk of catching COVID-19 and passing it on to others. These actions will also help to reduce the spread of other respiratory infections such as flu, which can spread easily and may cause serious illness in some people.”
The practitioner will continue to offer a home visit support to clients and ensure to practise safely in reducing the risk transmission of Covid-19 virus and other infection such as seasonal flu during home visit consultation.
INFECTION CONTROL AND PREVENTION MEASURES:
1. HAND HYGIENE & CLEANING THE SURFACE ENVIRONMENT:
- I will be washing my hands upon arrival in my client’s home using my personal chlorhexidine hand wash. I will ensure to practise strict hand washing and hand sanitising techniques at all times as recommended by WHO (5 moments for hand hygiene - before touching a patient, before clean/aseptic procedures, after body fluid exposure/risk, after touching a patient, and after touching patient surroundings. I will use alcohol hand gel whenever necessary and practise decontamination of equipment and environment (ie, baby’s changing matt, table etc) using clinell wipes.
2. WEARING MASK / PPE (Personal Protective Equipment)
- The UKHSA advise for healthcare workers sets out that in health and care settings, non-pharmaceutical interventions (such as mask wearing and enhanced ventilation) may be used, depending on local prevalence and risk assessment with the aim to reduce the spread of SARS-CoV-2.
- For health and care staff:
- Health and care staff should continue to wear facemasks as part of personal protective equipment required for transmission-based precautions when working in COVID-19/respiratory care pathways, and when clinically caring for suspected/confirmed COVID-19 patients. This is likely to include settings where untriaged patients may present such as emergency departments or primary care, depending on local risk assessment. In all other clinical care areas, universal masking should be applied when there is known or suspected cluster transmission of SARS-CoV-2, eg during an outbreak, and/or if new SARS-CoV-2 VOC emerge.
- • Universal masking should also be considered in settings where patients are at high risk of infection due to immunosuppression eg oncology/haematology. This should be guided by local risk assessment.
- Health and care staff are in general not required to wear facemasks in non-clinical areas eg offices, social settings, unless this is their personal preference or there are specific issues raised by a risk assessment. This should also be considered in community settings.
- In the practitioner’s practise, I will ask clients if they prefer me to wear masks around them and will wear Type 2 surgical mask during assessment and procedure of their baby.
3. CLIENTS / FACE COVERING / HAND HYGIENE:
- It is encouraged that parents wear a face covering or mask (if tolerated) during our face-to-face consultation whenever if possible, however face covering is no longer required to well individuals as per recommendation from Public Health England unless it is your personal reference. Clients should also practise hand washing during the visit to protect self, their baby and the practitioner.
4. VACCINE (Covid-19 Vaccine and Seasonal Flu Vaccination)
- The government continues to urge individuals to receive their Covid-19 vaccines and seasonal flu.
- Despite most of us receiving the vaccine against Covid-19 and the seasonal flu vaccines, the government urge us to continue to follow the latest advice on infection prevention and control such as social distancing, respiratory and hand hygiene etc.
- Please note that the practitioner is updated on her seasonal flu vaccine and received 3x doses of Covid-19 vaccine.
5. LATERAL FLOW TESTING
- The practitioner will continue to do twice weekly lateral flow test until further notice from the government
- It is encouraged in my practise, that parents who maybe experiencing Covid symptoms to get tested and cancel the appointment for a positive Covid lateral flow test.
6. ISOLATION IF TESTED POSITIVE FOR COVID-19
- If you have Covid-19, you can pass the virus to other people for up to 10 days from when your infection starts.
- Please self-isolate for 10 days, and the booking will be arranged after 10 days providing the client is well.
- The practitioner will also follow the guidelines of 10-day isolation if tested positive of Covid-19 to avoid transmission of the virus.
- The isolation maybe completed before 10 days if have negative lateral flow test on Day 5 & 6.
7. PHYSICAL DISTANCING:
- In health and care settings, physical distancing is the recommended distance that should be maintained between the staff and the patients unless mitigations are in place such as the use of PPE. WHO continuous to advise that physical distance of at least 1 metre should be maintained between among people in health care. This distance should be increased wherever feasible, especially indoor settings. Physical distancing is recommended to remain at 2 metres where infectious respiratory patients are cared for.
- Clients and practitioner will maintain at least 1-metre or more apart from each other during face-to-face conversation. As the practitioner may need to support parents on infant feeding (breastfeeding support or bottle feeding) and unable to maintain the distance- mask, apron and gloves and appropriate PPE should be worn at all times.
8. VENTILATION
- Ventilation is the process of introducing fresh air into indoor spaces while removing stale air. Letting fresh air into indoor spaces can help remove air that contains virus particles and prevent the spread of coronavirus (Covid-19)
- Opening windows and doors at home is the simplest way of improving ventilation during indoor meetings.
9. RISK ASSESSMENT:
If the family hope to limit the contact during the visit, telephone conversation will be booked before the consultation, to give as much information, informed consent, support and address the families concern beforehand to limit long contact during the visit.
The practitioner will ask questions to clients prior to visit and clients should inform the practitioner in an event of anyone in the household presenting COVID-19 symptoms (new cough, fever, shortness of breath, loss of taste and smell, fatigue, headache). In this event, the appointment should be cancelled to prevent the spread of infection and to protect the vulnerable individuals such as the babies.
SCREENING QUESTIONS FOR PARENTS BEFORE APPOINTMENT:
Are you experiencing symptoms of Covid-19? Please Answer YES or NO
1. Temperature (>37.7)?
- If you haven’t measured your temperature, NHS 111 guidance is “this means you feel hot to touch on your chest or back
2. New Continuous Cough?
- Coughing a lot for more than an hour?
- 3 or more coughing episodes in 24 hours?
- If you usually have a cough, it maybe worse than usual?
3. New Onset of altered or loss of smell?
4. Shortness of breath / acute respiratory disease?
5. Are you currently in self-isolation due to household member having symptoms of Covid-19?
6. Have you been contacted by track and trace to self-isolate?
7. Have you been in contact with anyone confirmed with Covid-19 or experiencing symptoms of Covid-19 within the last 14 days?
8. Have you travelled outside the UK in the last 7 days?
9. Are you in a high-risk category group of individuals identified by the government (ie, receiving chemotherapy, has medical condition such as COPD, cystic fibrosis etc.?)
10. Are you and your partner are happy to practise hand hygiene and wear face covering during my visit? (Please note; the current guidelines do not expect healthy individuals to wear mask unless its their own preference).
11. Do you wish the practitioner to wear masks throughout her visit?
12. Did you and your partner receive Covid-19 vaccine?
SUMMARY:
- Get Vaccinated
- Hand wash regularly, cleaning environment
- Wear face covering, social distance if possible
- Open windows within indoors meeting
- Stay Home/Cancel appointment if unwell
- Get tested and self-isolate if need to as per new guidelines
- Download NHS Covid-19 app for more information
COVID-19:
While it is currently thought that people are most contagious when they are most symptomatic, it is possible that some spread might be possible before people show any symptom.
Ultimately, we are doing all that we reasonably can to minimise risk whilst remaining open such as discussed above (risk assessment, hand hygiene, physical distancing, ppe, vaccine, lateral flow tests, isolation etc.). However, the practitioner cannot eliminate risk, especially as COVID-19 can be spread by person-to-person contact. Should you have any question, please do not hesitate to let the practitioner knows.
CONSENT: By booking the practitioner, you are agreeing that you understand that the practitioner has given you all the information regarding Covid-19 and is aware that there is a risk of transmission of the virus as a result of the home visit face to face contact support and you are agreeing that JULIENNE ESPINELI cannot accept responsibility for transmission of COVID-19 or other seasonal flu, should you or your family become infected and vice versa.
REFERENCES:
HM Government. (2022). Covid-19 Response: Living with Covid-19. Retrieved March 02, 2022, from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1056229/COVID-19_Response_-_Living_with_COVID-19.pdf
NHS UK Health Security Agency. (2021). A guide to Covid-19 vaccination: Information on pregnancy and breastfeeding. Retrieved December 01, 2021, from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1027193/UKHSA_12073_COVID-19_vaccination_info_pregnancy_breastfeeding_v5.pdf
NHS UK Health Security Agency. (2021). Guidance: Infection Prevention and Control for seasonal respiratory infections in health and care settings (including SARS-CoV-2) for winter 2021 to 2022. Retrieved December 06, 2021, from https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/covid-19-guidance-for-maintaining-services-within-health-and-care-settings-infection-prevention-and-control-recommendations
NHS England and NHS Improvement. (2022). Next steps on infection prevention and control (IPC). Retrieved June 26, 2022, from https://www.england.nhs.uk/wp-content/uploads/2022/04/C1657_next-steps-on-infection-prevention-and-control-letter_010622.pdf
UK Health Security Agency. (2022). Living safely with respiratory infections, including Covid-19. Retrieved June 26, 2022 from https://www.gov.uk/guidance/living-safely-with-respiratory-infections-including-covid-19
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