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Board Resolution No. 2020-002

Interim Guidelines on the Practice of Occupational Therapy amidst the Coronavirus Disease (COVID-19) situation in the Philippines

Coronavirus Disease 2019 (COVID-19) is an illness due to a new strain of coronavirus that causes respiratory symptoms, fever, cough, shortness of breath, and breathing difficulties, and in more severe cases, causes pneumonia, severe acute respiratory syndrome, kidney failure, and even death.1 It has affected thousands of people worldwide since December 2019.2 Consequently, on the 8th of March 2020, the World Health Organization declared COVID-19 outbreak as a global pandemic.3,4 In the Philippines, community quarantine and stringent social distancing measures are currently being imposed in many areas across the country5,6,7 in conjunction with the Office of the President declarations on the country being in a state of public health emergency8 and a state of calamity9 throughout the Philippines due to the COVID-19 situation. Furthermore, concerned government agencies such as the Department of Health (DOH), Commission on Higher Education (CHED), Civil Service Commission (CSC), and the Department of Labor and Employment (DOLE) released supplemental guidelines on this matter. Accordingly, the Philippine Academy of Occupational Therapists, Inc. (PAOT, Inc.), formerly known as the Occupational Therapy Association of the Philippines, Inc. (OTAP), acknowledges the risk of occupational therapists (OTs) and all our stakeholders of contracting the coronavirus disease (COVID-19) and the need to comply with said measures in the practice of occupational therapy.

1 World Health Organization. (2020). Coronavirus. Retrieved from https://www.who.int/health-topics/coronavirus 2 World Health Organization. (2020). Coronavirus disease 2019 (COVID-19) Situation Report - 57. Retrieved from https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200317-sitrep-57-covid-19.pdf?sfvrsn=a26922f2_2 3 WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. Retrieved from https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020 4 World Health Organization. (2020). WHO Coronavirus disease 2019 (COVID-19) Situation Report - 51. Retrieved from https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf?sfvrsn=1ba62e57_10 5 Office of the President. (2020). Memorandum from the Executive Secretary on stringent social distancing measures and further guidelines for the management of the coronavirus disease 2019 (COVID-19) situation. Retrieved from https://www.officialgazette.gov.ph/downloads/2020/03mar/20200313-MEMO-RRD-1.pdf 6 Office of the President. (2020). Memorandum from the Executive Secretary on community quarantine over the entire Luzon and further guidelines for the management of the coronavirus disease 2019 (COVID-19) situation. Retrieved from https://www.officialgazette.gov.ph/downloads/2020/03mar/20200316-MEMORANDUM-FROM-ES-RRD.pdf 7 “Visayas, Mindanao LGUs set up community quarantines vs COVID-19”. GMA News Online. March 17, 2020. Retrieved from: https://www.gmanetwork.com/news/news/regions/730098/visayas-mindanao-lgus-set-up-community-quarantines-vs-covid-19/story/ 8 Office of the President. (2020). Proclamation No. 922, S. March 8, 2020. Declaring a State of Public Health Emergency throughout the Philippines due to Coronavirus Disease 2019. Retrieved from https://www.officialgazette.gov.ph/downloads/2020/02feb/20200308-PROC-922-RRD-1.pdf 9 Office of the President. (2020). Proclamation No. 929, S. March 16, 2020. Declaring a State of Calamity throughout the Philippines due to Coronavirus Disease 2019. Retrieved from

https://www.officialgazette.gov.ph/2020/03/16/proclamation-no-929-s-2020/

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Rooted in occupational therapy practice frameworks is the overarching task of ensuring that all our clients are able to participate in life situations through their engagements in valued and meaningful occupations.10,11 This may be hampered by the client’s context and environment in situations such as natural disaster, political unrest, and in our current scenario, public health emergency evident in the continuous increase in the number of confirmed COVID-19 cases. In this situation, the context and environment serve as barriers to occupational performance causing disruption of routines, difficulty in assuming life roles, scarcity of resources, and limitation in participation across the developmental stages, whether one contracted the disease or not. This is further complicated by personal or financial losses as well as various psychological reactions not limited to fear, helplessness, and loss of confidence.12

PAOT, Inc. acknowledges various limitations in our societal context, which cannot be detached from the overall service delivery, such as the absence of clear communication channels to the public, proliferation of fake information, scarcity of resources for the frontliners, and adoption of a culture of individualism during these trying times. While PAOT, Inc. recognizes that occupational therapists (OTs) need to assume various roles in times like this which go beyond the provision of conventional direct client services and of the regular classroom-based education in higher education institutions, it is of utmost importance for Filipino OTs to attend to themselves and their families first and to ensure one’s safety and overall well-being before discharging various functions as a professional. In this way, the overall safety and welfare of all the stakeholders will still be facilitated given this complicated situation Once a sense of stability and control has been regained by us, we strongly urge Filipino OTs, true to our nature as a helping profession, to adopt safe, alternative, and innovative means of occupational therapy service provision in continuing the delivery of services to those that they already serve given the restrictions that everyone is having, in promoting the health and well-being of others, in mediating in the redesign of one’s routines, lifestyle, and role assumption, in addressing the psychosocial and mental health concerns inevitable during crisis situations, and in promoting occupational justice of individuals who might be affected due to quarantine measures, and to come up with alternative teaching-learning strategies for future OTs; provided that such interventions and strategies adhere not only to the Occupational Therapy Standards of Practice13 and Occupational Therapy Code of Ethics14 but also to the social distancing measures and disease prevention protocols as recommended by concerned government agencies.

10 American Occupational Therapy Association (AOTA). (2014). Occupational therapy practice framework: domain and process, 3rd edition. American Journal of Occupational Therapy, 68(1), S1-S48. 11 Republic Act No. 11241. An act regulating the registration, licensure, and practice of occupational therapy, providing funds therefor and for other related purposes. 23 July 2018. Retrieved from https://www.officialgazette.gov.ph/downloads/2019/03mar/20190311-RA-11241-RRD.pdf 12 Scaffa, M., Gerardi, S., Herzberg, G., McColl, M. (2006). The role of occupational therapy in disaster preparedness, response, and recovery. American Journal of Occupational Therapy, 60(6), 642-649. 13 Philippine Academy of Occupational Therapists, Inc. (formerly Occupational Therapy Association of the Philippines, Inc.. (1998). Occupational Therapy Standards of Practice. 14 Philippine Academy of Occupational Therapists, Inc. (formerly Occupational Therapy Association of the Philippines, Inc.). (1998). Occupational Therapy Code of Ethics.

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All occupational therapists practicing in the country should abide by all jurisdictional, institutional, and professional regulations and balance the same in their OT service delivery to fulfill their duties, considering that the country is under a public health emergency and has been declared to be under a state of calamity. Further, PAOT, Inc. expects that occupational therapists observe fidelity and safety in the practice of the profession for all their stakeholders. All of these cannot be attained by individual actions alone. An orchestrated effort to look after each other and help one another as one united professional organization, as in the spirit of bayanihan, will facilitate effective and ethical service provisions that will benefit all the stakeholders even with the limitations that we have under this period. NOW, THEREFORE, THE PAOT, Inc. hereby adopts and promulgates the following: Sec. I. Objectives. This document shall provide guidance and recommendations to the members and stakeholders of the Philippine Academy of Occupational Therapists, Inc. in response to the global pandemic COVID-19 and its effects to the nation. Sec. II. Scope. The guidelines shall respond to the need to continue the practice of occupational therapy despite the COVID-19 situation in the country, in consideration of precautionary measures based on directives and protocols from concerned government agencies. The guidelines shall be applied during the duration of Enhanced Community Quarantine (from March 15 - April 13, 2020) and shall be subject to adjustments upon further advisory by the government. Sec. III. Definition of Terms. For the purposes of this document, the following terms shall be defined as follows:

1. Alternative forms of service provision - encompasses methods and processes which are not conventionally utilized by occupational therapists as stand-alone forms in the delivery of services

2. Alternative teaching-learning strategies - encompasses strategies which are not conventionally utilized by occupational therapy educators as stand-alone forms in targeting the set learning outcomes for both classroom and practice placement settings

3. Client - refers to the direct recipient of occupational therapy services and also pertains to the family members/caregivers

4. Client Education - imparting of knowledge and information about occupation, health, well-being, and participation that enables the client to acquire helpful behaviors, habits, and routines that may or may not require application at the time of the intervention session15

5. Client Training - facilitation of the acquisition of concrete skills for meeting specific goals in a real-life, applied situation. In this case, skills refer to measurable components of function that enable mastery. Training is differentiated from education by its goal of enhanced performance as opposed to enhanced understanding, although these goals often go hand in hand.16

15 AOTA, Occupational therapy practice framework: domain and process. 16 AOTA, Occupational therapy practice framework: domain and process.

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6. Clinician - an occupational therapist who is engaged in direct patient evaluation and intervention and urged to explore alternative and innovative forms of service provision during this period

7. Direct client contact hours - refers to the hours spent with clients in the practice placements of occupational therapy students wherein actual screening, assessment, and intervention procedures will be performed by the latter

8. Educator - a qualified occupational therapist, working in higher education institutions and/or practice placements, tasked with teaching, assessing, and mentoring occupational therapy students

9. Home programs - refers to the contextualized designing of a plan of action that may be carried out in the client’s homes which will include the provision of learning resources and aids, which can be written or online, and teaching of strategies and techniques

10. In-person service provision - encompasses all forms of delivery of service wherein the occupational therapist and the client are in the same physical space. In these guidelines, this is applicable to both clinical and educational settings.

11. Manager - an occupational therapist whose functions include but not limited to planning, organizing, directing, and controlling the service delivery of a unit or institution that s/he owns or that s/he is assigned to manage. S/he is also responsible for ensuring the sustainability of his/her unit or institution in providing quality occupational therapy services.

12. Nature of work - roles fulfilled by an occupational therapist as a clinician, educator, manager, etc.

13. Period - duration of Enhanced Community Quarantine from March 15 to April 13, 2020 subject to adjustments upon further advisory by the government

14. Student - a person taking up a degree in occupational therapy 15. Symptomatic - a person who has fever (≥38° Celsius) and/or cough or shortness of

breath or other respiratory symptoms, OR as defined by DOH based on its most updated guidelines/protocols

16. Telehealth - an alternative form of service provision utilized when the occupational therapist and the client are in different physical locations. Interactions through telehealth could either be synchronous (activities and interaction happens in real-time, e.g. video conferencing, video or phone call, messaging), asynchronous (activities and interactions may be recorded or stored for a later time, e.g. instructional videos, photo demonstrations), or a combination of both.17

Sec IV. General Guidelines.

1. An occupational therapist shall first ensure his/her safety and physical and mental well-being before discharging various functions.

2. Whether in the practice of his/her profession or in the course of his/her daily life, an occupational therapist shall adjust and/or redesign, within the context of his family

17 World Federation of Occupational Therapists. (2014). Position statement: Telehealth. Retrieved from https://wfot.org/resources/telehealth

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and/or social environment, his or her habits, roles, and routine. This may aid in the promotion of one’s (and eventually that of the family’s and client’s) health and well-being.

3. Whether in the practice of his/her profession or in the course of his/her daily life, an occupational therapist shall comply with personal protection and hygiene measures as recommended by DOH or the World Health Organization (refer to Annex A for Resources) to ensure his/her own safety and the safety of those s/he shall interact with to subsequently aid in the containment of COVID-19. Specifically, an occupational therapist shall: 3.1. Continuously monitor own health status; 3.2. Responsibly self-impose and follow home quarantine guidelines if s/he

manifests signs/symptoms of COVID-19 infection, has recent travel history, and/or has been in contact with a Person Under Monitoring (PUM) or Patient Under Investigation (PUI), subject to the most updated protocol of DOH with regard to PUM or PUI;

3.3. Practice respiratory etiquette18; 3.3.1. Cough and sneeze into tissue or into shirt sleeve if tissue is not

available. Dispose used tissues properly and disinfect hands immediately after a cough or sneeze;

3.3.2. Avoid touching the eyes, nose, and mouth to help slow the spread of the virus; and

3.3.3. Use face masks, which provides a physical barrier from the 2019-nCoV ARD viruses by blocking large-particle respiratory droplets propelled by coughing or sneezing, only if one (a) is caring for the sick, (b) is attending to clients with respiratory infection/symptoms, or (c) has respiratory infections/symptoms.

3.4. Practice hand hygiene consistently; and 3.4.1. Perform regular and thorough handwashing with soap and water; or 3.4.2. Perform hand rubbing through use of alcohol-based hand sanitizers

containing at least 60% ethanol or isopropanol when soap and water are not available19.

3.5. Comply with social distancing measures20 as much as possible, specifically: 3.5.1. Keep a distance of at least 3 feet or 1 meter away from other people to

reduce the possibility of person-to-person transmission; 3.5.2. Offer telecommuting and replace in-person meetings in the workplace

with video or telephone conferences; and 3.5.3. Postpone or cancel mass gatherings until further advice by DOH.

18 Department of Health. (2020). Department Circular No. 2020-0039. Reiteration of the Interim Guidelines for 2019 Novel Coronavirus Acute Respiratory Disease (2019-nCoV ARD) Response in the Workplace. Retrieved from: https://www.doh.gov.ph/sites/default/files/health-update/DC2020-0039-Reiteration-of-DM2020-056-Interim-Guidelines-on-2019-nCoV-ARD-Response-in-the-Workplace.pdf 19 DOH, Interim Guidelines in the Workplace. 20 DOH, Interim Guidelines in the Workplace.

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4. In the practice of the profession during this period, an occupational therapist shall: 4.1. First and foremost ensure the safety of his/her clients, students, fellow

occupational therapists, and/or other stakeholders to aid in the containment of COVID-19;

4.2. Promote mental health of clients and/or students through developmentally appropriate therapeutic use of self, empathy, basic counseling principles and psychological first aid;

4.3. Adhere to the Occupational Therapy Standards of Practice21 and Occupational Therapy Code of Ethics22. Specifically, an occupational therapist shall: 4.3.1. Demonstrate concern for and promote the welfare of clients through the

provision of safe, competent, evidence-based, client-centered, and accessible occupational therapy services;

4.3.2. Refrain from inflicting harm or risk of harm––whether intentional or not, and whether it be physical, sexual, financial, emotional, or psychological in nature––towards clients, colleagues, students, as well as research participants;

4.3.3. Uphold the truth at all times by reporting only factual information, including but not limited to those about the profession, occupational therapists, and stakeholders, without compromising confidentiality. This principle also compels occupational therapists to disclose not only the beneficial outcomes but also the possible risks and harms of all possible occupational therapy services to recipients;

4.3.4. Respect the right of the recipients to make informed decisions and promote collaboration with clients and stakeholders throughout the occupational therapy process;

4.3.5. Maintain to inviolate the privacy of clients and safeguard any personal information which has been disclosed before, during, and after service delivery;

4.3.6. Provide competent occupational therapy services by possessing knowledge, skills and qualifications required to practice, abiding by the Standards of Practice set by PAOT, Inc., participating in continuing professional development and educational activities, providing services that correspond to their qualifications and experience, providing appropriate supervision to individuals under his or her supervisory responsibility, and referring clients to other services when necessary;

4.3.7. Treat their colleagues and other professionals fairly, respectfully, and judiciously by keeping information about colleagues and staff confidential, representing the qualifications, views, and contributions, and finds of colleagues accurately, and reporting breach of the Code of Ethics to appropriate authority; and

21 PAOT, Inc., Occupational Therapy Standards of Practice. 22 PAOT, Inc., Occupational Therapy Code of Ethics.

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4.3.8. Uphold justice, fairness, and objectivity by obeying to laws and maintaining the code of standard of practice in the provision of services;

4.4. Assist the integrated professional organization in its efforts to respond to the current situation, such as but not limited to program and policy development and implementation (e.g. following the recommended guidelines set forth herein, answering monitoring forms to be released by the organization that will look into the practice patterns during this period, etc.); and

4.5. Consider provision of services beyond his/her regular area of practice and assume various roles which may be called upon by the current public health emergency. Specifically, an occupational therapist may opt to perform the following with due consideration of the herein stated guidelines: 4.5.1. Promote the health and well-being of others; 4.5.2. Minimize activity limitations and participation restrictions by mediating in

the redesign of one’s routines, lifestyle, and role assumption; 4.5.3. Address the psychosocial and mental health concerns inevitable during

public health emergency situations; 4.5.4. Promote occupational justice of individuals who might be affected due to

quarantine measures; and 4.5.5. Mediate, if the manager is not an occupational therapist, in the

formulation of institution-specific policies in the delivery of services adherent to state-mandated regulations and restrictions and professional organization’s guidelines.

Sec. V. Specific Guidelines for the Practice of the Profession.

1. An occupational therapist working as a manager shall lead the development and implementation of policies in response to the current situation to balance the need to continue service delivery if so required or allowed, the need to follow measures to aid in the containment of COVID-19 and the need to ensure the welfare of his/her team of occupational therapists and students (if any), guided by the provisions set forth in Annex B.

2. An occupational therapist working as a clinician shall determine the course of service delivery for his/her clients during this period, keeping in mind the need to ensure the safety of everyone involved and the need to comply with state-mandated regulations and restrictions or relevant local government directives, as well as institutional policies where s/he is affiliated, while adhering to professional standards and code, guided by the guidelines outlined in Annex C.

3. An occupational therapist working as an educator, whether in a higher education institution or practice placement, shall be flexible in facilitating the learning of the students23,24,25 to meet set learning outcomes within the bounds of state-mandated regulations and

23 Commission on Higher Education. (2020). Guidelines on the Prevention, Control, and Mitigation of the Spread of Coronavirus Disease 2019 (COVID-19) in Higher Education Institutions (HEIs), CHED Advisory No.2 24 Commission on Higher Education. (2020). Guidelines on the Prevention, Control, and Mitigation of the Spread of Coronavirus Disease 2019 (COVID-19) in Higher Education Institutions (HEIs), CHED Advisory No.3 25 Commission on Higher Education. (2020). Guidelines on the Prevention, Control, and Mitigation of the Spread of Coronavirus Disease 2019 (COVID-19) in Higher Education Institutions (HEIs), CHED Advisory No.4

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restrictions and directives from the local government and/or his/her respective Higher Education Institution (HEI), following the provisions outlined in Annex D.

Sec. VI. Research and Development. For the purposes of evidence-based policy-making, the practice patterns employed by occupational therapists, and the experience of students taking up a degree in occupational therapy in response to the COVID-19 situation in the Philippines shall be explored. In addition, exchange of ideas and practices may be facilitated for the benefit of all occupational therapists.

1. An occupational therapist shall document all alternative forms of service provision or alternative teaching-learning strategies, as the case may be, employed within said period, with due consideration of the Initial Data List (Annex E) to be collected for research and development with the end goal of describing the practice of occupational therapy in the country amidst the COVID-19 situation as essential in evidence-based policy-making.

2. An occupational therapist working as a manager shall likewise document all efforts to respond to COVID-19 which include policies, protocols, or measures developed and implemented and alternative forms of service provision employed during the said period as outlined in Annex E.

3. Experiences of both the educators and students on the teaching-learning strategies adopted during the said period shall also be explored. Educators shall remind students to reflect on their engagement in said strategies, noting features and effectiveness of the strategies in relation to learning outcomes given the resources available, as well as the issues and challenges encountered, among others. Annex E outlines the variables to be explored.

4. The Chairs of the Committee on Standards and Ethics, the Committee on Education and Research, and the Sub-Committee on Student Affairs shall be responsible for the implementation of this section. Any member of PAOT, Inc. who intends to be part of this initiative shall notify the said team. PAOT, Inc. may likewise request and urge the participation of specific members with appropriate competency and background.

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Sec VII. Reiteration of the Enforcement of the Occupational Therapy Code of Ethics. Should an occupational therapist be aware of violations of the code of ethics, s/he shall report the concerned party/parties to the Committee on Standards and Ethics following Board Resolution No. 2018-00126 or to the Professional Regulation Commission following their procedure in filing a complaint27, whichever is applicable.

Sec. VIII. Effectivity. The guidelines set forth herein shall be for immediate compliance upon release to the public, and shall be effective within the duration of Enhanced Community Quarantine, subject to adjustments upon further advisory by the government.

Prepared by: Kristine Ann M. Carandang, Committee on Programs Kim Gerald G. Medallon, Committee on Professional Standards and Ethics John Paul O. Mallari, Committee on Professional Standards and Ethics Vanessa Guenever B. Tan-Ibanes, Committee on Professional Standards and Ethics Kristel Faye M. Roderos, Committee on Community Affairs Diana Jane A. Luib, Committee on Professional Standards and Ethics Arden A. Panotes, Sub-Committee on Student Affairs Layout and design by: Lemuel Asuncion, Committee on Public Relations

Promulgated by the Board of Directors of the Philippine Academy of Occupational Therapists, Inc. on 18 March 2020 in the City of Makati, Philippines

26 Philippine Academy of Occupational Therapist, Inc. (2018). Board Resolution No. 2018-001. 2018 Revised Enforcement Procedures of the Occupational Therapy Code of Ethics. 27 Professional Regulation Commission. Filing a Complaint against Professionals. Retrieved from: https://www.prc.gov.ph/sites/default/files/LEGAL-FILINGOFCOMPLAINT-%289-20-16%29-REV%20%28size%2020%27%27x30%27%27%29.pdf

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Annex A

Resources

Please note that this list is not all-inclusive. 1. Home Quarantine Guidelines

Department Memorandum No. 2020-0090: Interim Guidelines on the Management of Persons Under Monitoring (PUMs) suspected with Coronavirus Disease 2019 (COVID-19) for Home Quarantine https://www.doh.gov.ph/sites/default/files/health-update/DM-Interim%20Guidelines%20for%20Home%20Quarantine.pdf

2. Personal Protection and Hygiene Measures

2.1. Hand hygiene

2.1.1. Annex C of Department Circular No. 2020-0039: Reiteration of the Interim Guidelines for 2019 Novel Coronavirus Acute Respiratory Disease (2019-nCoV ARD) Response in the Workplace. https://www.doh.gov.ph/sites/default/files/health-update/DC2020-0039-Reiteration-of-DM2020-056-Interim-Guidelines-on-2019-nCoV-ARD-Response-in-the-Workplace.pdf

2.1.2. Annex A.1 of Department Circular No. 2020-0049: Reiteration of the Interim Guidelines for 2019 Novel Coronavirus Acute Respiratory Disease (2019-nCoV ARD) Response in Hospitals and Other Health Facilities https://www.doh.gov.ph/sites/default/files/health-update/DC2020-0049-Reiteration-of-DM2020-0072-Interim-Guidelines-for-2019-nCoV-ARD-Response-in-Hospitals-and-Other-Health-Facilities.pdf

2.1.3. Pages 13, 14 and 27 of WHO Guidelines on Hand Hygiene in Health Care: A Summary https://www.who.int/gpsc/5may/tools/who_guidelines-handhygiene_summary.pdf

2.2. Respiratory Etiquette

2.2.1. Annex A of Department Circular No. 2020-0039: Reiteration of the Interim Guidelines for 2019 Novel Coronavirus Acute Respiratory Disease (2019-nCoV ARD) Response in the Workplace. https://www.doh.gov.ph/sites/default/files/health-update/DC2020-0039-Reiteration-of-DM2020-056-Interim-Guidelines-on-2019-nCoV-ARD-Response-in-the-Workplace.pdfs

2.3. Social Distancing Measures

2.3.1. Page 2 of Department Circular No. 2020-0039. Reiteration of the Interim Guidelines for 2019 Novel Coronavirus Acute Respiratory Disease (2019-nCoV ARD) Response in the Workplace. Retrieved from: https://www.doh.gov.ph/sites/default/files/health-update/DC2020-0039-Reiteration-of-DM2020-056-Interim-Guidelines-on-2019-nCoV-ARD-Response-in-the-Workplace.pdf

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2.3.2. Page 2 of Department Circular No. 2020-0049: Reiteration of the Interim Guidelines for 2019 Novel Coronavirus Acute Respiratory Disease (2019-nCoV ARD) Response in Hospitals and Other Health Facilities https://www.doh.gov.ph/sites/default/files/health-update/DC2020-0049-Reiteration-of-DM2020-0072-Interim-Guidelines-for-2019-nCoV-ARD-Response-in-Hospitals-and-Other-Health-Facilities.pdf

3. Cleaning and Disinfection Measures

3.1.1. Page 2 of Department Circular No. 2020-0049: Reiteration of the Interim Guidelines for 2019 Novel Coronavirus Acute Respiratory Disease (2019-nCoV ARD) Response in Hospitals and Other Health Facilities https://www.doh.gov.ph/sites/default/files/health-update/DC2020-0049-Reiteration-of-DM2020-0072-Interim-Guidelines-for-2019-nCoV-ARD-Response-in-Hospitals-and-Other-Health-Facilities.pdf

3.1.2. WHO Technical Brief on Water, sanitation, hygiene and waste management for the COVID-19 virus https://apps.who.int/iris/rest/bitstreams/1271257/retrieve

4. Personal Protective Equipment

Annex A.3 of Department Circular No. 2020-0049: Reiteration of the Interim Guidelines for 2019 Novel Coronavirus Acute Respiratory Disease (2019-nCoV ARD) Response in Hospitals and Other Health Facilities https://www.doh.gov.ph/sites/default/files/health-update/DC2020-0049-Reiteration-of-DM2020-0072-Interim-Guidelines-for-2019-nCoV-ARD-Response-in-Hospitals-and-Other-Health-Facilities.pdf

5. The Department of Health also has Infographics, Gabay sa Publiko and Public Advisories written in both Filipino and English in relation to COVID-19 situation which can be sourced at: 5.1. https://www.doh.gov.ph/2019-nCov/infographics 5.2. https://www.doh.gov.ph/COVID-19/Gabay-sa-Publiko 5.3. https://www.doh.gov.ph/2019-nCov/advisories 5.4. Official Facebook Page: https://www.facebook.com/OfficialDOHgov/ 5.5. Twitter: https://twitter.com/DOHgov

6. For other useful information and advisories on the 2019-nCoV, you may join DOH PH

COVID-19 Viber group or refer to: 6.1. bit.ly/COVIDPH 6.2. https://www.doh.gov.ph/2019-nCoV 6.3. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

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Annex B

Specific Interim Guidelines on the Practice of Occupational Therapy amidst the Coronavirus Disease (COVID-19) Situation in the Philippines

for MANAGERS

An occupational therapist working as a manager shall lead the development and implementation of policies in response to the current situation to balance the need to continue service delivery if so required or allowed, the need to follow measures to aid in the containment of COVID-19 and the need to ensure the welfare of his/her team of occupational therapists and students.

1. A manager shall at all times comply with Section IV (General Guidelines). 2. A manager shall likewise ensure the safety and physical and mental well-being of his/her

team of occupational therapists and students before discharging various functions. 3. A manager shall ensure the welfare of its team (e.g. work arrangements, compensation,

emergency assistance, etc.) with regard to DOLE and CSC guidelines in response to COVID-19 situation, whichever is applicable.

4. A manager shall ensure compliance with Section IV (General Guidelines) of all occupational therapists and students, if any, under his/her scope of responsibility.

5. After a thorough discussion with his team including the support staff members, a manager shall decide the course of service provision considering context-specific factors, which may be any of, but not limited to, the following: (a) temporary suspension of service delivery, (b) adoption of alternative forms of service provision, or (c) continuance of regular operations.

6. Should adoption of alternative forms of service provision be considered, a manager shall: 6.1. Facilitate the exploration of all the possible alternative forms of service provision

which may be utilized by the occupational therapists under his/her facility for the time being considering context-specific factors;

6.2. Assess the feasibility of utilizing these alternative forms in meeting the set outcomes for all the clients who will be availing of such services context-specific factors. Factors to be assessed may include but not limited to the resources to be used, preparedness and competencies of the occupational therapists in using these forms, and perceptions and resources of the clients and the family members in using these forms;

6.3. Create facility-specific policies as to how these alternative forms will be delivered with utmost consideration of the Occupational Therapy Standards of Practice, Code of Ethics, and other pertinent guidelines released by PAOT, Inc. and with due regard to context-specific factors;

6.4. Monitor and document the implementation of the said alternative forms and adherence of the occupational therapists to the approved facility-specific policies;

6.5. Provide, if possible, additional resources and training to further augment the competencies of the occupational therapists in using these alternative forms;

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6.6. Facilitate, if possible, the purchase of tools, materials, and equipment which may be needed by the occupational therapists to deliver these alternative forms effectively; and

6.7. Facilitate the discussion among all the stakeholders involved in the determination of rates per type of service provided which should be reasonable given the current situation.

7. Should continuance of in-person service provision still be required as in hospitals or allowed based on policy directives of respective authorities, the manager shall ensure observance of the general preventive measures compliant with protocols promulgated by DOH. Specifically: 7.1. The manager shall ensure that health workers, support staff members, and clients

practice personal protection and hygiene measures as outlined in Section IV.3 through education and provision of supplies.

7.2. The manager shall ensure compliance to cleaning and disinfection measures28 through development and implementation of policies, education, and provision of supplies; specifically, s/he shall: 7.2.1. Facilitate cleaning and disinfection of frequently-touched surfaces and

objects, including toys, therapy tools and equipment, tables, doorknobs, desks, and computer keyboards using diluted water solution with Sodium Hypochlorite (1 part bleach and 99 parts water or ¼ cup bleach and 1 gallon of clean water)29 or using alcohol with 70% ethanol or isopropanol;

7.2.2. Facilitate the maintenance of a clean environment, especially common-use areas and those with touchpoints such as railings, light switches and the like; and

7.2.3. Make dispensers with alcohol-based hand sanitizers with at least 60% ethanol or isopropanol available at point-of-care and in public areas.

7.3. The manager shall enforce strict social distancing measures. Specifically, s/he shall: 7.3.1. Allow only the conduct of one-on-one sessions and prohibit the conduct

of group sessions; 7.3.2. Arrange the unit in such a way that health workers, support staff

members, and clients can maintain a distance of at least 3 feet or 1 meter away as much as possible in the therapy, reception or waiting areas; and

7.3.3. Ensure use of appropriate personal protective equipment as detailed in Annex A3 of Department Memorandum No. 2020-007230, as may be necessary especially when social distancing measures cannot be followed.

28 DOH, Interim Guidelines in the Workplace. 29 Department of Health. (2020). Health Advisory: Paano gagawin ang pagdidisinfect ng mga bagay-bagay upang maiwasan ang COVID-19? Retrieved from: https://drive.google.com/drive/folders/1xswd0Fpg0qTiKWpntivHzqO7-VxFhVr0 30 Department of Health. (2020). Department Circular No. 2020-0049. Reiteration of the Interim Guidelines for 2019 Novel Coronavirus Acute Respiratory Disease (2019-nCoV ARD) Response in Hospitals and Other Health Facilities. Retrieved from: https://www.doh.gov.ph/sites/default/files/health-update/DC2020-0049-Reiteration-of-DM2020-0072-Interim-Guidelines-for-2019-nCoV-ARD-Response-in-Hospitals-and-Other-Health-Facilities.pdf

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7.4. The manager shall perform measures to not allow individuals who are over 60 years old, who have preexisting medical conditions, and who are pregnant from accompanying the direct recipients of occupational therapy services.

7.5. The manager shall post visual guide or infographics of protocols to follow relevant to each area in the facility, specifically on infection control and social distancing measures, written in English, Filipino, and/or local language (refer to Annex A for resources).

7.6. If managing a stand-alone facility, the manager shall: 7.6.1. Allocate a well-ventilated holding area preferably with a handwashing

facility or sink with soap and water, alcohol-based hand sanitizer, tissue paper, no-touch trash can, and mask31.

7.6.2. Adopt a COVID-19 Screening Protocol for Clients, Support Staff and Health Workers entering the facility, which include, but not limited to, the following, subject to the most updated protocols of DOH: 7.6.2.1. Require all persons entering the facility to sign a declaration

form attesting details on travel history within the last 14 days, contact with PUM or PUI, and presence/absence of symptoms;

7.6.2.2. Subject all persons entering the facility to temperature check; and

7.6.2.3. Provide a person identified as symptomatic with a medical grade mask, and subsequently follow protocol on the management of symptomatics as described in Item 7.6.3.

7.6.3. Adopt a protocol for the Management of Symptomatics32,33 which include, but not limited to, the following, subject to the most updated protocols of DOH: 7.6.3.1. Instruct him/her to stay in the designated holding area; 7.6.3.2. Disinfect the area using diluted water solution with Sodium

Hypochlorite (1 part bleach and 99 parts water or ¼ cup bleach and 1 gallon of clean water)34;

7.6.3.3. Instruct him/her or his/her companion about the most updated guidelines for PUM and for those living and caring for PUM;

7.6.3.4. Instruct him/her or his/her companion to notify their Barangay Health Emergency Response Team for proper monitoring;

7.6.3.5. Send him/her home or to the nearest health unit as would be necessary; and

7.6.3.6. Monitor if instructions after leaving the facility are followed.

31 Department of Health, Interim Guidelines in Hospitals and Other Health Facilities. 32 DOH, Interim Guidelines in the Workplace. 33 Department of Health. (2020). Department Circular No. 2020-0042. Reiteration of the Interim Guidelines on 2019 Novel Coronavirus Acute Respiratory Disease (2019-nCoV ARD) Response in Schools and Higher Education Institutions. Retrieved from https://www.doh.gov.ph/sites/default/files/health-update/DC2020-0042-Reiteration-of-DM2020-0055-Interim-Guidelines-on-2019-nCoV-ARD-Response-in-Schools-Higher-Education-Institutions.pdf 34 DOH, Health Advisory: pagdidisinfect ng mga bagay-bagay

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7.7. If managing a facility within a hospital, the manager shall comply with DOH Department Circular No. 2020-0049 and supplemental guidelines on the COVID-19 situation as implemented by the hospital.

8. A manager shall facilitate engagement of occupational therapists and students under his/her scope of responsibility to assist PAOT, Inc. in its research and development initiative as discussed in Section VI (Research and Development), especially if alternative forms of service provision or if in-service provision are adopted or continued, respectively.

9. The manager shall document all efforts to respond to COVID-19 with due consideration given to the data that may be used for quality assurance, research, and development as described in Section VI (Research and Development).

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Annex C

Specific Interim Guidelines on the Practice of Occupational Therapy amidst the Coronavirus Disease (COVID-19) Situation in the Philippines

for CLINICIANS An occupational therapist working as a clinician shall determine the course of service delivery for his/her clients during this period, keeping in mind the need to ensure the safety of everyone involved and the need to comply with state-mandated regulations and restrictions or relevant local government directives while adhering to professional standards and code.

1. A clinician shall at all times comply with Section IV (General Guidelines). 2. Regardless if in-person or alternative forms of service provision would be provided or if

service delivery would temporarily be suspended, a clinician shall communicate with all the clients under one’s care the course of service provision and explain thoroughly all the mandated restrictions and possible changes that may be implemented during this period;

3. Regardless if in-person or alternative forms of service provision would be provided or if service delivery would temporarily be suspended, a clinician shall provide psychological first aid and/or basic counselling to all his/her clients under one’s care to alleviate feelings of uncertainty and distress during this period. Depending on one’s competency and qualification, other strategies such as Grounding Techniques, Cognitive Behavioral Techniques, and relaxation strategies can be used.

4. Clinicians are urged to initiate the learning of relevant techniques and strategies that will maximize his/her practice as a professional during this period.

5. If alternative forms of service provision are to be utilized in place of in-person service provision which may be applicable to those working in stand-alone centers, those accommodating outpatients in hospital settings, those providing home care services, or those engaged in community-based practice, a clinician shall: 5.1. Comply with institution-specific guidelines as to how these alternative forms will be

delivered, if applicable. 5.2. Explore all the available alternative forms of service provision in line with the call

for social distancing such as but not limited to telehealth, provision of home programs, and family training and education;

5.3. Exercise prudence in selecting appropriate alternative service provision considering one’s overall capacity to deliver it and the preparedness and perception of the clients on the proposed measures;

5.4. Evaluate his/her competence in using alternative forms of service provision, and reject utilization of alternative forms that s/he deems himself/herself incompetent in using;

5.5. Inform the clients and family members that in-person service delivery always supersedes all other forms of service delivery given the client-centered nature of the profession, and conventional forms of service provision may be utilized again

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once the overall situation is already favorable and state-mandated regulations and restriction have been lifted;

5.6. Inform the clients and family members that they may refuse to receive services through alternative forms;

5.7. Ensure the understanding of clients and caregivers with the introduced techniques and strategies and the eventual carryover of these in their homes with utmost emphasis on consistency and safety;

5.8. Provide resources and aids to the clients and caregivers to augment the services delivered through these alternative forms;

5.9. Monitor the effectiveness and efficiency of these alternative forms to meet the set outcomes and make appropriate modifications in the delivery of services as deemed necessary; and

5.10. Document completely the services provided through these alternative forms and provide copies to other stakeholders through the agreed upon medium. Sample documents to be accomplished include, but not limited to, the following: 5.10.1. Informed consent form stipulating in full the details of the services

provided, 5.10.2. Therapy notes per session, and 5.10.3. Monitoring form which may provide data that may be used for research,

quality assurance, and development as described in Section VI (Research and Development);

6. If in-person service provision is warranted such as in hospitals or is still allowed based on the policy directives of respective authorities, a clinician shall: 6.1. Comply with COVID-19 Screening Protocol for Clients, Support Staff and Health

Workers implemented by the facility; 6.2. Strictly adhere to the personal protection and hygiene measures as outlined in

Section IV.3, cleaning and disinfection measures as noted in Item 7.2 of Annex B, and other supplemental institution-specific policies;

6.3. Prepare personal emergency preparedness plans; and 6.4. During service provision:

6.4.1. Adopt innovative means of service provision in keeping with the provisions outlined in Item 5;

6.4.2. Maintain a distance of at least 3 feet or 1 meter during service provision as much as possible;

6.4.3. Should a distance of at least 3 feet or 1 meter is not possible: 6.4.3.1. Use appropriate personal protective equipment, i.e masks,

gloves and gowns, as deemed necessary or based on the precautions applied to the patient, guided by Annex A3 of Department Memorandum No. 2020-007235;

6.4.3.2. Perform hand hygiene and disinfection procedures before and after each session; and

35 DOH, Interim Guidelines in Hospitals and Other Health Facilities.

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6.4.3.3. Instruct clients to observe personal protection and hygiene measures as outlined in Section IV.3; and

6.4.4. Document completely the services provided through these alternative forms and provide copies to other stakeholders through the agreed upon medium. Sample documents to be accomplished include, but not limited to, the following: 6.4.4.1. Informed consent form stipulating in full the details of the

services provided, 6.4.4.2. Therapy notes per session, and 6.4.4.3. Monitoring form which may provide data that may be used for

research, quality assurance, and development as described in Section VI (Research and Development).

7. Should a clinician opt to accommodate new clients in response to the current situation, s/he shall: 7.1. Ensure first that all clients under his/her care prior to the current situation

have been communicated to and informed of the course of service provision during this period;

7.2. Explain to the new clients the restrictions that may influence the delivery of occupational therapy services;

7.3. If alternative forms of service provision are to be utilized, inform the clients of all the available options, along with their respective benefits, risks, duration, and rates in receiving these services. Specific guidelines previously discussed in Item 5 applies to new clients;

7.4. If in-person service provision is warranted, strictly adhere to the personal protection and hygiene measures as well as to cleaning and disinfection measures. Specific guidelines previously discussed in Item 6 applies to new clients; and

7.5. Facilitate in the transition towards the utilization of conventional forms of service provision once the situation becomes favorable.

8. Mediate and collaborate in the formulation of institution-specific guidelines in the provision of occupational therapy services adherent to state-mandated regulations and restriction and professional organization’s guidelines. Compliance of the occupational therapist to these approved guidelines is expected.

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Annex D

Specific Interim Guidelines on the Practice of Occupational Therapy amidst the Coronavirus Disease (COVID-19) Situation in the Philippines

for EDUCATORS

An occupational therapist working as an educator, whether in a higher educational institution or practice placement, shall facilitate the learning of the students to meet set learning outcomes within the bounds of state-mandated regulations and restrictions and directives from the local government and/or his/her respective Higher Education Institution (HEI).

1. An educator shall at all times comply with Section IV (General Guidelines). 2. An educator shall likewise ensure the safety and physical and mental well-being of his/her

students. 3. If an educator works for a Higher Education Institution in which alternative teaching-

learning strategies are being implemented during this period as allowed by the management and if the regulations are in line with the most updated directives by CHED36 and local directives as may be applicable to the institution, s/he shall consider the following in the exercise of his/her functions: 3.1. Exercise flexibility, understanding, and leniency in the implementation of the

course plan/syllabus specifically in courses having lecture and laboratory components;

3.2. Assess one’s preparedness and resources, along with that of the institution’s and of the students’, in the utilization of alternative and innovative teaching-learning strategies. Factors to be assessed may include the following but not limited to equipment, internet connection, and online library access;

3.3. Design and implement alternative and innovative teaching-learning strategies that will still meet the set learning outcomes and are compliant with released institutional guidelines;

3.4. Attend to students who are having difficulties in adjusting with the current platform in delivering instruction, and refer for counselling services if necessary;

3.5. Monitor the effectiveness and efficiency of these alternative and innovative teaching-learning strategies in meeting the set learning outcomes for the students and modify them as deemed necessary;

3.6. Provide assessments aligned with the set learning outcomes, content covered, and the utilized teaching-learning strategies. Feedback sessions should be ample given the restrictions in the current situation;

3.7. Revise the grading rubrics to be used, subject to the approval of the management, in conjunction with the changes in the teaching-learning strategies provided that constructive alignment is ensured and that the students are properly oriented with these revisions;

36 Commission on Higher Education. (2020). Guidelines on the Prevention, Control, and Mitigation of the Spread of Coronavirus Disease 2019 (COVID-19) in Higher Education Institutions (HEIs), CHED Advisory No.5

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3.8. Coordinate with the students regarding the possible changes in weight allocation of the gradable components to come up with the final grade;

3.9. Continuously coordinate with the department chairpersons regarding the plans to be carried out in line with the call for alternative and innovative teaching-learning strategies, along with reporting to them problems and challenges encountered by all parties involved in the overall implementation so that appropriate solutions may be generated;

3.10. Adhere to institutional guidelines regarding the reporting of students who are identified as PUM or PUI; and

3.11. Document all changes employed during this period, guided by the data needed in Section VI (Research and Development).

4. If an educator works in practice placements – be it in stand-alone facilities, in hospitals, in the community, in academe, or with the professional organization – in which the management allows the training of students through alternative forms and if the regulations are in line with the most updated directives by CHED37 and local directives as may be applicable to the institution, s/he shall consider the following in the exercise of his/her functions: 4.1. Exercise flexibility, understanding, and leniency in the implementation of training

program and overall policies, specifically related to the counting of direct client contact hours;

4.2. Assess one’s preparedness and resources, along with that of the institutions’ and of the students’, in the utilization of alternative and innovative teaching-learning strategies;

4.3. Design and implement alternative and innovative teaching-learning strategies that will compensate for the lost direct client contact hours and for the meeting of set learning outcomes. In this light, makeups are no longer warranted on the part of the students, along with possible grade sanctions, to compensate for the lost direct client contact hours;

4.4. Monitor the effectiveness and efficiency of these alternative and innovative teaching-learning strategies in meeting the set learning outcomes for the students and modify them as deemed necessary;

4.5. Provide assessments aligned with the set learning outcomes, content covered, and the utilized teaching-learning strategies. Feedback sessions should be ample given the restrictions in the current situation;

4.6. Revise the grading rubrics to be used, subject to the approval of the management, in conjunction with the changes in the teaching-learning strategies provided that constructive alignment is ensured and that the internship coordinator/supervisor and students are properly oriented with these revisions;

4.7. Coordinate with the students regarding the possible changes in weight allocation of the gradable components to come up with the final grade;

4.8. Continuously coordinate with the internship coordinator/supervisor of the affiliate HEI regarding the plans to be carried out in line with the call for alternative and

37 Commission on Higher Education. (2020). Guidelines on the Prevention, Control, and Mitigation of the Spread of Coronavirus Disease 2019 (COVID-19) in Higher Education Institutions (HEIs), CHED Advisory No.5

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innovative teaching-learning strategies, along with reporting to them problems and challenges encountered by all parties involved in the overall implementation; and

4.9. Document all changes employed during this period, guided by the data needed in Section VI (Research and Development).

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Annex E

Initial List of Data to be collected for Research and Development

1. Initial list of data to be collected in relation to the practice patterns employed by occupational therapists in response to COVID-19 situation in the Philippines include: 1.1. General response to COVID-19 situation

1.1.1. Location of residence from March 15, 2020 to April 13, 2020 1.1.2. Level of community quarantine imposed, if applicable 1.1.3. Compliance to personal prevention and protection measures 1.1.4. Compliance to social distancing measures 1.1.5. Compliance to cleaning and disinfection measures 1.1.6. Option to work or not to work made voluntarily or involuntarily (specify

reason) 1.2. Practice profile prior to March 15, 2020

1.2.1. Nature of work - clinician, clinical supervisor, instructor/professor, manager, other

1.2.2. Practice setting/s - hospital, private clinic, university/college, school, home healthcare, community, other

1.2.3. Area/s of practice - academe, adolescence, community-based practice, disaster risk reduction and response, geriatrics, mental health/psychosocial dysfunction, pediatrics, physical dysfunction, other

1.2.4. Number of clients on deck 1.3. Practice profile from March 15, 2020 to April 13, 2020 unless otherwise specified

1.3.1. Nature of work - clinician, clinical supervisor, instructor/professor, manager, other

1.3.2. If clinician 1.3.2.1. Practice setting/s - hospital, private clinic, university/college,

school, home healthcare, community, other 1.3.2.2. Area/s of practice - academe, adolescence, community-

based practice, disaster risk reduction and response, geriatrics, mental health/psychosocial dysfunction, pediatrics, physical dysfunction, other

1.3.2.3. Number of old clients (those already on deck prior to March 15) accommodated

1.3.2.4. Number of new clients accommodated 1.3.2.5. cases handled (diagnosis) 1.3.2.6. Type/s of service provided (direct in-service or not) 1.3.2.7. Details of alternative forms of service provision employed

during direct in-service provision and/or to replace direct in-service provision

1.3.2.7.1. Type of method/process used 1.3.2.7.2. Brief description (features, parameters)

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1.3.2.7.3. Goal/s targeted: specific areas of occupation, performance skills, performance patterns, client factors

1.3.2.7.4. Perception of competence/confidence of the therapist and overall experience

1.3.2.7.5. Level of compliance of client 1.3.2.7.6. Effectivity of alternative form of service

provision employed (note factors which affect effectivity)

1.3.2.7.7. Cost of service 1.3.2.7.8. Monitoring process employed 1.3.2.7.9. Evaluation process employed

1.3.2.7.10. Issues and challenges encountered 1.3.2.7.11. Proposed solutions

1.3.3. If manager

1.3.3.1. List of policies, protocols or measures developed and implemented in terms of:

1.3.3.1.1. Service provision 1.3.3.1.2. Welfare of occupational therapists 1.3.3.1.3. Welfare of clients

1.3.3.2. List of alternative forms of service provision employed including those done during in-person service provision if any

1.3.3.3. Issues and challenges encountered 1.3.3.4. Proposed solutions

1.3.4. If educator in an HEI

1.3.4.1. Changes in the course plan/syllabus and overall delivery of instruction

1.3.4.2. On alternative and innovative teaching-learning strategies and assessment measures employed

1.3.4.2.1. Brief description of teaching-learning strategies employed

1.3.4.2.2. Availability of resources (e.g. equipment, internet connection, online library access) of the educator and the students

1.3.4.2.3. Overall experience of educators 1.3.4.2.4. Perception on effectiveness of strategies 1.3.4.2.5. Brief description of assessment measures

employed 1.3.4.2.5.1. Feedback mechanisms to

students 1.3.4.2.5.2. Changes in grading rubrics

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1.3.4.3. Presence of support services (e.g. counseling, ICT services, library)

1.3.4.4. Level of support from the administration 1.3.4.5. Issues and challenges encountered 1.3.4.6. Proposed solutions

1.3.5. If educator in practice placement

1.3.5.1. Changes in the clinical training program 1.3.5.2. Policies on makeup days 1.3.5.3. On alternative and innovative teaching-learning strategies

and assessment measures employed 1.3.5.3.1. Brief description of teaching-learning

strategies employed 1.3.5.3.2. Availability of resources (e.g. equipment,

internet connection, online library access) of the practice placement supervisor and the students

1.3.5.3.3. Overall experience of educators 1.3.5.3.4. Educator’s perspectives on effectiveness of

strategies 1.3.5.3.5. Brief description of assessment measures

employed 1.3.5.3.5.1. Feedback mechanisms to

students 1.3.5.3.5.2. Changes in grading rubrics 1.3.5.3.5.3. Presence of debriefing session

1.3.5.4. Level of support from the management 1.3.5.5. Level of support from the HEI of affiliation 1.3.5.6. Issues and challenges encountered 1.3.5.7. Proposed solutions

1.3.6. Policy recommendations for occupational therapy practice during public health emergency situations

2. Initial list of data to be collected in relation to the perception and experience of the students on the teaching-learning processes shall be similar to those outlined on the factors under Item 1.3.4 and Item 1.3.5.