Local Induction to PPEUpdated focus - COVID 19

Developed by the

Infection Prevention and Control Team

April 2020

Rational use of personal protective equipment for

coronavirus disease (COVID-19) – WHO

COVID-19 is a respiratory disease that is different from Ebola virus disease,

which is transmitted through infected bodily fluids.

Due to these differences in transmission, the PPE requirements for COVID-19

are different from those required for Ebola virus disease. Specifically, coveralls

(sometimes called Ebola PPE) are not required when managing COVID-19

patients.https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-2019-nCov-IPCPPE_use-2020.1-eng.pdf

Mark Rudd – Chief ID Medical Director at University of Nebraska

“ the biggest challenge is getting people to pay attention and take the necessary

precautions to protect themselves. There is no medications, no vaccines yet, so

we will have to depend on basic infection control practices”.

Mitigating Risk

Work Health and Safety Regulation 2011 – NSW Legislation The employer has a legal obligation to provide a safe workplace, without risks &

The Work Health Safety Regulations 2001 obligations of the employer –

to identify, assess, eliminate/reduce risks.

The SafeWork NSW stipulates that an employee is to:

Provide employees with information, education, equipment and training for staff to protect

them and others.

The WH&S regulations also state that it’s the employee’s responsibility to

adhere to the recommendations of wearing PPE to protect self and others.

By implementing a consistent approach across the Network

ensures confidence and safety for Staff.

5 Moments for Hand Hygiene

Remember when entering a room, perform hand

hygiene before touching a patient (i.e. after touching

the door handle or positioning equipment).

Infection Prevention & Control Precautions

+

Transmission Based

Precautions: Contact

Droplet

Airborne

WHAT THIS MEANS

Aim: To prevent transmission of infection

(HCW and Patients)

ALL bodily fluids are regarded as

potentially infectious

o e.g. respiratory secretions, excretions

(except sweat), blood – whether or not

visible

HAND HYGIENE (“5 Moments”)

PERSONAL PROTECTIVE EQUIPMENT

(PPE)

o Use if contact with bodily fluids expected

Appropriate handling and disposal of sharps and

clinical wastes

Aseptic techniques

Environmental cleaning

ISOLATION REQUIREMENTS - None

General Principles of Infection Prevention and Control to Prevent

or Limit Transmission Of nCoV – from the CEC

1. Early recognition and source control

2. Application of Standard Precautions for all patients

3. Cough etiquette and respiratory hygiene

4. Implement Transmission Based Precautions

• Contact and Droplet Precautions (except for aerosol generating procedures

or critically ill patients with high volume/high frequency, prolonged care)

• Airborne Precautions for aerosol generating procedures (critically ill patients

with high volume/high frequency, prolonged care)

5. Hand Hygiene (5 moments)

6. Environmental Cleaning

http://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0006/567987/Infection-

control-nCoV-2019-Hospital-Setting-V2-.pdf

WHAT THIS MEANS

Aim: To prevent spread of infectious

agents transmitted via direct and

indirect contact

Perform hand hygiene

(PPE)

o Use if contact with bodily fluids expected

WHAT THIS MEANS

Aim: To prevent spread of infectious

agents transmitted in droplets from

respiratory secretions (1 m)

HAND HYGIENE

PERSONAL PROTECTIVE EQUIPMENT

(PPE)

o Use within 1 m of patient

o Protect mucosa (eyes/nasal) –

Mask and eye protection

ISOLATION REQUIREMENTS

o Single room or cohort

WHAT THIS MEANS

Aim: To prevent spread of infectious agents

small enough to be transmitted in air space

Examples

o Varicella

o Measles

o Pulmonary tuberculosis

o Aerosol generating procedures for

suspected or confirmed COVID19

HAND HYGIENE

PERSONAL PROTECTIVE EQUIPMENT (PPE)

o Particulate N95 or P2 mask. Remove

outside room (untie, discard using ties)

ISOLATION REQUIREMENTS

o Negative pressure, single room

Donning & Doffing of PPE –

Let’s talk about Masks -

How to Apply a P2/N95 Mask and Perform a Fit Check

1. Open

mask and

shape

2. Bend nose

piece to

conform to

nose

3. Separate

the two

elastic straps

4. Position lower strap at

base of neck (under ears)

and upper strap on the

crown of head

5. Mould the nose piece to ensure a secure fit

Perform a Fit Check Before Entering Room

Check the negative pressure seal by gently inhaling

Check for air leaks, by exhaling

Readjust mask until the mask fits and there is no air leakageRPA Infection Prevention and Control Unit 2017

How to Apply a P2/N95 Mask and Perform a Fit Check

Another type of P2 mask in use

Sequence of donning and doffing

14

Combined Isolation signs – reflecting SCHN

donning & doffing processes

Remember your equipment

As part of Standard Precautions: Cleaning all shared equipment (including your

own personal equipment before and after use – it protects you & your pts.

Extra Information / resources

IPC Novel Coronavirus 2019 - Infection Prevention and Control Novel Coronavirus 2019

(2019-nCoV) – Hospital setting

Videos

Tasmanian donning and doffing PPE videos - to go on SCHN intranet soon

https://www.dhhs.tas.gov.au/publichealth/tasmanian_infection_prevention_and_control_unit

/healthcare_worker_education/proper_use_of_personal_protective_equipment

National Hand Hygiene Initiative

http://www.cec.health.nsw.gov.au/keep-patients-safe/infection-prevention-and-

control/healthcare-associated-infections/hand-hygiene

HETI/My Heath Learning

• Infection Prevention – Enhance Precautions

• Infection Prevention - Enhance Precautions for

Pandemic Flu

• Infection Prevention – Transmission- based Precautions

• Infection Prevention & Control Practices

Questions

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