Covid-19 POLICY - MGP EXPECTED OUTCOME - PowerPoint Presentation

1. Covid-19 POLICY - MGPEXPECTED OUTCOMEAll staff are aware of the procedures to be followed to decrease the risk of COVID-19 spread within the practice

2. Patients with cold/flu symptoms should be advised not to attend the practice and a follow up phone call from a medical officer should be bookedAll patients entering the practice must be screened for potential COVID-19. When indoor mask wearing is mandated under NSW Public Health orders. All patients are required to wear masks within the practiceAny patient who is potentially infected with COVID-19 must be given a surgical mask to wear and isolated in an unused consultation roomAny areas of the practice in which a patient with suspected or confirmed COVID-19 has been requires a complete and enhanced cleaning process that decontaminates the area including all equipment (sometimes referred to as a ‘terminal clean’)

3. backgroundCoronaviruses are a large family of viruses that cause respiratory infections. COVID-19 was first reported in December 2019 in Wuhan City in China. COVID-19 can spread from person to person through:Close contact with an infected person (including in the 48 hours before they had symptoms)Contact with droplets from an infected person’s cough or sneezeTouching objects or surfaces (like doorknobs or tables) that have droplets from an infected person, and then touching your mouth or face

4. Symptoms of COVID-19 can range from mild illness to pneumonia. People with coronavirus may experience symptoms such as:FeverRespiratory symptomsCoughingSore throatShortness of breathOther symptoms can include runny nose, headache, muscle or joint pains, diarrhoea, vomiting, loss of sense of smell, altered sense of taste, loss of appetite and fatigue

5. General principlesIt is the responsibility of all staff to ensure that the general principles known to decrease the risk of spread of COVID-19 are implemented in the practice at all times. This includes:Maintaining safe social distancing principles, including setting up the waiting room to allow for same and ensuring the configuration is not changed/altered by patientsUndertaking regular hand hygiene and encouraging patients to do the same (particularly on arrival to the practice)Removing objects from the waiting room that could aid transmission (for example, toys, magazines)Encouraging patients to use EFPTOS to minimise the handling of cash Ensuring patients with potential COVID-19 symptoms or exposure are provided with a face mask and isolated from other patients/staff immediately (refer to Section 3)Utilising personal protective equipment (PPE) as clinically indicated

6. Screening patients – telephone triageEvery patient wishing to book an appointment should be screened to assess if he/she has any cold or flu like symptomsPatients with cold/flu symptoms should be advised not to attend the practice and a follow up phone call from a medical officer should be bookedPatients who are scheduled for an appointment in the practice should be advised not to attend if he/she develops cold/flu like symptoms in the interim

7. Screening patients on arrival to the practiceAll patients entering the practice must be screened for potential COVID-19. This includes asking the patient if:He/she has any symptoms (fever, cough, sore throat, shortness of breath)He/she has had potential exposure to COVID-19 (including visiting any ‘hot spots’ eg. Melbourne)Any patient who answers positively to any of the screening questions must be given a surgical mask to wear and isolated in an unused consultation room

8. Mandated mask wearingWhen indoor mask wearing is mandated under NSW Public Health orders all patients are required to wear masks within the practiceThis applies regardless of whether or not the patient has proof of exemption for not wearing a maskPatients who are unable or refuse to wear a mask must be refused entry to the practice in order to protect the health and wellbeing of other patients and staffTelehealth appointments must be scheduled for patients who cannot or will not wear a mask

9. Isolation of potentially infected patientsAny patient who is potentially infected with COVID-19 must be given a surgical mask to wear and isolated from other patients/staff in an unused consultation roomThe clinician who is to review the patient must be made aware that the patient is a potential COVID-19 carrier The clinician reviewing the patient MUST:Wear full PPE while reviewing the patientReview the patient in the consultation room in which the patient has been isolated (that is, the patient is not moved to other areas within the practice)

10. Implications for staff if a patient tests positive for covid-19Infection Control Precautions Used During ConsultationIf the recommended infection control precautions, including the use of full PPE were used when consulting a patient with, or who is later confirmed as having COVID-19, this is not considered close contactThe clinician is NOT considered a suspected case and no further action is requiredInfection Control Precautions Not Used During ConsultationIf PPE was not worn during the consultation with a patient who tests positive for COVID-19 and the clinician spent more than 15 minutes face to face with the patient, this is considered close contactRequired ActionThe clinician must self-isolate for 14 days from his/her last interaction with the patientAs there is no requirement for GPs to perform telehealth consultations from the practice premises, he/she can continue to conduct telehealth consultations during the self-isolation periodThe local public health unit must be contacted to seek instruction about managing possible exposure to other staff and patients during this time

11. What to do if a practice team member tests positive for covid-19Staff Member Has Not Been in the Workplace 48 Hours Prior to Developing SymptomsIf the affected staff member has not been in the workplace 48 hours prior to developing symptoms, no further action is required by the practiceThe team member who tests positive must self-isolate – and therefore not return to the practice – until they meet the criteria for release from isolation (see below)

12. Staff Member Has Been in the Workplace 48 Hours Prior to Developing SymptomsIf the staff member has been in the workplace in the 48 hours prior to developing symptoms, the local public health unit must be contacted to seek instruction on managing possible exposure to other staff and patientsThe actions required will depend on a number of variables including when the team member last worked, the nature of the work they performed and the interactions he/she had with othersIf there has been a risk of exposure to other team members or patients, the public health unit will conduct contact tracing and notify those who require testing and self-isolation (including the practice’s patients)If the practice must undergo temporary changes (such as temporary closure or a temporary transition to telehealth consultations only) staff members may communicate this to patients directly as well as via call-holding messages etcThe team member who tests positive must self-isolate – and therefore not return to the practice – until they meet the criteria for release from isolation (see below)

13. Release from Isolation Criteria for Confirmed COVID-19 CasesRelease from isolation can occur when:At least 10 days has passed since the onset of symptoms andThere have been no symptoms of acute illness for the previous 72 hoursIn addition to meeting the above criteria persons who are significantly immunocompromised can be released from isolation when they meet the following additional criteria:PCR negative on at least two consecutive respiratory specimens collected at least 24 hours apart at least 7 days after symptom onset

14. Environmental cleaning for covid-19Frequently touched surfaces should be cleaned and disinfected after each patient (according to normal infection prevention and control practices)This includes items located outside of consultation rooms such as the EFPTOS terminalRegular cleaning of surfaces that patients frequently touch (eg. door handles, front counter) should be undertaken

15. Cleaning of potentially contaminated rooms/areas/equipmentAny areas of the practice in which a patient with suspected or confirmed COVID-19 has been requires a complete and enhanced cleaning process that decontaminates the area including all equipment (sometimes referred to as a ‘terminal clean’)Full PPE must be worn when undertaking a terminal cleanA terminal clean can be undertaken using one of two methods as described below

16. 2-Step CleanThis involves physical cleaning with detergent followed by disinfection with a TGA-listed hospital-grade disinfectant with activity against viruses (according to label/product information) or a chlorine-based product such as sodium hypochlorite2-in-1 CleanThis involves a physical clean using a combined detergent and TGA-listed hospital-grade disinfectant with activity against viruses (according to label/product information) or a chlorine-based product such as sodium hypochlorite, where indicated for use (that is a combined detergent/disinfectant wipe or solution)

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