Infection Prevention & Control Information

European Centre for Disease Prevention and Control ECDC 13th May  ‘Infection prevention and control for COVID-19 in healthcare settings’ update of the ECDC guidance dated 31st March

This third update contains the following additions:

  1. The recommendation that all healthcare staff providing care to patients in areas with community transmission should consider wearing surgical masks or FFP2 respirators, if available, in addition to practising meticulous hand hygiene.
  2. The clarification that the recommendation for long-term care facility (LTCF) staff not to come to work if they have symptoms compatible with COVID-19 also includes those with mild symptoms.
  3. The recommendation that in areas with community transmission all LTCF staff who provide care for residents or have contact with residents or communal areas of the LTCF should consider wearing surgical masks or FFP2 respirators, in addition to practising meticulous hand hygiene.
  4. Additional references to current ECDC surveillance guidance for long-term care facilities recommending laboratory testing as soon as possible after the detection of a case, to guide infection prevention and control measures. If a suspected case is detected, samples should be tested from all suspected cases in residents and staff as a minimum, but preferably from all staff. If a laboratory-confirmed case is detected, all residents and staff should be tested, preferably with staff being tested weekly as a follow-up [1a]. Click Here:

HSE Updated Advice on Mask Wear 16th May

Wearing a cloth face covering is recommended in situations where it’s difficult to practice social distancing. For example, in shops and on public transport. They may help prevent people who do not know they have the virus from spreading it to others.
If you wear one, you should still do the important things necessary to prevent the spread of the virus. Click on the link for more information Click here:

Who should wear a face mask?

This is an interesting article debating whether or not one should wear a place if asymptomatic in public places such as supermarkets .Opinion is divided and advice on this varies greatly and can change. Current advice from the World Health Organisation is that you should wear a mask if you are coughing or sneezing. Click Here:

BIR Article

Survey reveals Radiographers concerns about COVID-19 protection  Click Here:

RSCI Conversations that Matter

PPE Impacting how we communicate with patients  Dr Miriam Colleran St Brigid’s Hospice

PPE is another layer over health care workers and its uncomfortable for the wearer . Discussed the way healthcare workers have changed the way with communicate with patients .All healthcare workers have to stand when  communicating with patients as they can’t sit down to avoid contamination . Healthcare workers have to decrease their time with patients to rinse the risks. It’s difficult to make eye contact and non-verbal cues due to PPE .There are staffing and resources implications dealing with covid-19 we are working in different ways.

https://www.rcsi.com/dublin/coronavirus/healthcare-professionals/conversations-that-matter

Center for Disease Control CDC Optimising PPE Webinar

The presenters will provide a COVID-19 update and discuss strategies for healthcare facilities to optimize personal protective equipment (PPE) supplies such as eye protection, isolation gowns, facemasks, and N95 respirators. Click Here:

Centre for disease control CDC  and prevention  Webinar Infection Prevention and Control Recommendations

Learn how to implement infection prevention and control measures for COVID-19, assess risks for exposures, and optimize the use of personal protective equipment supplies Click Here:

ISRRT. What personal protective equipment (PPE) should I wear?

Patients case definitions

ISRRT E-learning Book

PPE Poster Safety Tip of the Week brought to you by Declan Morey, DGSA Consultant Eco Online

‘Be aware of your limitations when wearing PPE, the protective equipment is your last line of defence and a precautionary measure, but it does not eliminate health or physical hazards. Ensure PPE fits you correctly and that any defects are reported and replaced.’

Sample poster on PPE procedures for COVID-19 safety measures Click Here:

ISRRT How to sanitize portable X-ray equipment

When chest X-rays are performed on bed-ridden patients, some important considerations to reduce mobile X-ray machine contamination are: Click Here:

Printable Infographics on Cleaning Guidelines Varian machines Click Here:

Aunt Minnie

Radiographers speak on PPE and COVID-19 infection control

Radiographers have found themselves on the front lines during the COVID-19 pandemic, and there’s a growing awareness that radiology departments must develop and implement a strategy to keep radiographers and patients safe. But how can this be done?

Click Here:

ISRRT .Experiences of wearing Personal Protective Equipment (PPE) when examining patients

The routine working life of a radiographer has changed dramatically in a few short weeks due to the current Coronavirus pandemic. One of the main aspects of this change is the mandatory requirement to wear various levels of PPE, in order to minimise the potential for transmission of the virus from a patient to staff; staff to patient and staff to staff etc, thereby facilitating the (uncontrolled) spread of disease

Click Here:

COVID-19  ISRRT Response Document – Appropriate and safe use of Medical Imaging and Radiation Therapy with infection control measures considered in addition to standard radiation protection procedures

Click Here:

Extended Mask Wear

I have included some articles on extended mask wear and associated side effects .

Increased Face Mask Wear Can Lead to Skin Irritation and Infection—Here’s How to Reduce Risk

https://www.realsimple.com/beauty-fashion/skincare/face-mask-skin-irritation

https://www.magonlinelibrary.com/doi/full/10.12968/jowc.2020.29.Sup2a.S1

https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html

Faces of the future: inventive Cork students fix faulty masks Kinsale Community School

MAEVE SHEEHAN IRISH INDEPENDENT Sunday Independent 26th April

I read this article on Sunday and had to include and commend the wonderful work being done by Kinsale Community school making PPE and  also fixing a consignment of faulty PPE from China . Fergal McCarty , school principal opened the school to a small group of pupils including Oisin Coyle (17) and Shane Collins (16 and teachers and production has not stopped since. They have produced more than 5,000 protective face shields for frontline health care staff in big hospitals   — Cork University Hospital, the Mercy and the Mater Private — and for care centres, nursing homes, local GPs, pharmacists and even the local convent Read More:

Guidance on the use of Surgical Masks in the Healthcare Setting in the Context of the COVID-19 Pandemic

Introduction
This guidance replaces previous guidance on the use of surgical masks in healthcare settings in the context of the COVID-19 pandemic. This guidance is for immediate implementation. The content will be incorporated into other Infection Prevention and Control guidance documents as they are updated.

Use of surgical masks by healthcare workers in the context of viral respiratory tract infection has two objectives:

  1. To reduce the risk of droplet transmission of infection to the wearer.
  2. To reduce the risk of droplet transmission of infection to others.

Use of surgical masks for these purposes is in addition to and not as a replacement for other measures to reduce the risk of transmission of infection. These measures include hand hygiene and maintaining a distance of 2m between people whenever possible. Surgical masks must be donned correctly and should remain in place covering the nose and mouth throughout the period of use. Masks should not be moved up and down over the nose and mouth. When a mask is no longer required or if a fresh mask is needed the mask must be removed and disposed of safely as healthcare risk waste.

Guidance

  • Surgical masks should be worn by healthcare workers when providing care to patients within 2m of a patient, regardless of the COVID-19 status of the patient.
  • Surgical masks should be worn by all healthcare workers for all encounters, of 15 minutes or more, with other healthcare workers in the workplace where a distance of 2m cannot be maintained Click Here:

Health Protection Surveillance Centre HPSC

Risk Assessment of Healthcare Workers with Potential Workplace Exposure to Covid-19 Case V8.1

This is a useful poster to guide HSCP;s carrying out risk assessments. Click Here:

Cochrane

This Special Collection has been created in response to the COVID-19 pandemic and is regularly updated. It aims to ensure immediate access to systematic reviews most directly relevant to the prevention of infection. It includes reviews that are relevant to the WHO interim guidance, as well as other potentially relevant reviews from three Cochrane Networks: Cochrane Public Health and Health Systems; Cochrane Musculoskeletal, Oral, Skin and Sensory; and Cochrane Acute and Emergency Care, and also draws on the knowledge of Cochrane groups in affected regions. Many reviews in this collection have associated Cochrane Clinical Answers (CCAs), with links provided.

https://www.cochranelibrary.com/collections/doi/SC000040/full

The Role of Vaccines in Preventing Infectious Diseases and Antimicrobial Resistance

Learn how vaccines work and can be used for infectious disease control with this online course for healthcare professionals. You need to register but this link is free after that. Click Here:

NICE

NICE scientific advice Guide for COVID-19 evidence collection. We have produced a draft guide on clinical evidence generation for developers of medicinal products for COVID-19. The guide provides advice on considerations including clinical trial design, the trial population, the length of the trial and real-world evidence collection. Click Here

Health  Protection Surveillance Centre HPSC

How to put on and take off PPE full coveralls, face shields and masks (new PPE regulations ) 15/04/2020 Click Here:

College of Radiographers /RCR PPE poster’s

The posters, Personal protective equipment advice for imaging and oncology departments and teams, offer advice for aerosol generating procedures or high-risk areas and general contact with confirmed or possible Covid-19 cases

PPE Poster for Diagnostic Imaging Department and teams Click Here:

PPE Poster for Radiation Oncology Department & teams Click Here:

EFRS

A statement reminding political leaders across Europe of the importance of medical imaging in diagnosing Covid-19 patients has been supported by the European Federation of Radiographer Societies

The document “emphasises that governments bear the responsibility to ensure healthcare professionals are sufficiently equipped with personal protective equipment (PPE) and other resources necessary in the battle to save lives.” Read More:

BMJ

A cluster randomised trial of cloth masks compared with medical masks in healthcare workers

The aim of this study was to compare the efficacy of cloth masks to medical masks in hospital healthcare workers (HCWs). This study is the first RCT of cloth masks, and the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally. Click Here:

HPSC

Daily COVID-19 surveillance reports Click Here:

 Reproduction Rate of Covid-19 National Public Health Emergency Team (NPHET)

The National Public Health Emergency Team’s modelling data has revealed that Ireland’s effort to date has greatly reduced the transmission of the virus: Professor Philip Nolan, Chair of the NPHET Irish Epidemiological Modelling Advisory Group (IEMAG) said: “When an R number increases by even a fraction above 1, the number of new cases per day will rise, slowly but inexorably. The number of people, on average, that someone with COVID 19 is likely to infect was high at the beginning of the outbreak at 4.5. We now see this ‘R’ (reproduction) number reduced very significantly. The growth rate has reduced from 33% daily in the early weeks of this outbreak to  below 1 at .7 which is very positive news

RTE news 16.04.20 / NPHET

PPE Usage

This spreadsheet is designed to help you track how quickly PPE is being used at your facility.  Click Here     

UK SoR PPE guidelines  now consistent with WHO guidelines Click Here

Covid19 & Decontamination of medical devices

Dr Colleran’s Lecture on Covid 19

Dr . Gerard Colleran  BSc PhD. School of Science Institute of Technology Tallaght Dublin  24,

The recommendations below are a guide and will not supersede local or national policy.

Be prepared by being informed and keeping up to date with the latest Covid-19 information .

Remember this virus is spread by droplets and the only way it can transfer to you is via the nose, mouth or eyes. Keep your hands clean and you have to learn NOT to touch your face

Hand Hygiene Procedure

  • clean your hand soap & water or alcohol gel for 20-30 seconds (cover all areas of hands and do not forget tops of the finger, nail beds, in-between fingers and thumbs).
  • Remember hand hygiene after touching any surfaces especially door handles and do not forget about your 5 moments for hand hygiene
  • Bare below the elbow – clinical and non-clinical staff. This will make it easier for you to clean your hands properly. NO hand/wrist jewellery and NO nail varnish. NO fit bits or watches.

Cough etiquette

  • Cough/sneeze into you sleeve or use a tissue (remember to dispose the tissue into a bin and clean your hands)
  • Teach your patient to also use tissues and give them a bag to dispose of themselves. Remember they also have to clean their hands and if they are unable to do this, assist them.

Workwear/uniforms

  • Machine wash at 60 degrees (separate from another household laundry).
  • Please ensure that you do not wear your work uniform outside the hospital campus.
  • Clean your ID badge/swipe card/bleep and lanyard Clean them all regularly during the day and the lanyard can be put in the washing machine.
  • Mobile phones need to be cleaned regularly
  • Come into work and leave work in your day clothes and remember to clean your hands as you leave the building
  • Have hair tied back with clips and away from your neckline  – helps you stop touching your hair especially when wearing PPE
  • Facial hair – clean shaven

There is a lot of inaccurate information out there so please read the following:

  • Staff looking after COVID patients (suspected or confirmed) – can use the canteen and staff toilets
  • Surgical masks can remain in situ provided they do not become wet or heavily contaminated – no need to change your mask every 10 minutes
  • FFP respirator masks can remain in situ up to 4 hours (European norm) – no need to change every 20 minutes
  • With the necessary PPE on, an HCW can remain in a COVID room/bay as long as needed for a procedure or task (including multiple tasks).
  • Regardless of any patient’s infectious status (COVID/MRSA/CPE), treatments or procedures should be undertaken as deemed necessary whilst complying with the necessary IPC precautions.

Aerosol generating procedures (AGPs)– know the list! Nebulisation is not an AGP. Refer to national guidelines – link is below

  • AGPs in room or bay without ventilation – airborne precautions is required during the procedure and up to 1 hour after the procedure has ended.
  • AGPs in room or bay with ventilation– airborne precautions is required during the procedure and up to 20 minutes after the procedure has ended.

Air conditioning  units must remain TURNED OFF if a suspected or confirmed COVID patient is in the bay/room

 

Care of the dying patient – immediate family should be allowed to attend for a short period of time and can wear apron, gloves and mask.

Funeral Director’s Guidelines Click Here:

HSeLanD

HSeLanD has created a dedicated Covid-19 page. that brings together resources related to COVID–19

Personal protective Equipment (PPE )

PPE and the importance of workplace risk assessments highlighted by the SoR  Click Here:

Putting On/Off PPE There are two E-learning modules available on HSeLanD followed by an assessment for PPE in acute and community settings. HSELAND LINK

  • Putting on and taking off PPE in acute healthcare settings’ is for nursing and clinical staff in acute hospitals and support staff who are identified as being required to use PPE working in acute hospital settings.
  • Putting on and taking off PPE in community settings’ is for any staff member, including GPs, nursing and clinical staff in community services plus residential services, GP clinics and patients’ homes who are required to use PPE
  • HPSC Videos on how to put on and take off PPE  Click Here:
  • UK Guidance for Radiographers and RTs on PPE  Click Here:

Health Protection Surveillance Centre  Provides latest guidance for clinical and non-clinical settings on Covid-19 . Video resources include how-to put-on PPE , decontamination of clinical rates, dealing with suspected Covid-19 cases. Click Here:

Additional Resources on HSeLanD :

  • Hand Hygiene for HSE Clinical Staff
  • Hand Hygiene for HSE Non-Clinical Staff
  • Breaking the Chain of Infection

 

Infection Prevention &Control Weblinks

ECDC European Centre for Disease Control and Prevention  https://www.ecdc.europa.eu/en

ECDC works in partnership with national health protection bodies across Europe to strengthen and develop continent-wide disease surveillance and early warning systems. By working with experts throughout Europe, ECDC pools Europe’s health knowledge to develop authoritative scientific opinions about the risks posed by current and emerging infectious diseases.

CDC Centres for Disease Control and Prevention Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings Click Here:

Covid-19 UK Guidance for infection prevention and control in healthcare settings

Issued jointly by the Department of Health and Social Care (DHSC), Public Health Wales (PHW), Public Health Agency (PHA) Northern Ireland, Health Protection Scotland (HPS) and Public Health England as official guidance

This was adapted from Pandemic Influenza:  This document outlines the infection prevention and control advice for healthcare workers involved in receiving, assessing and caring for patients who are a possible or confirmed case of COVID-19.  It is based on the best evidence available from previous pandemic and interpandemic periods and focuses on the infection prevention and control aspects of this disease only, recognising that a preparedness plan will consider other counter measures.  The infection prevention and control advice in this document is considered good practice in response to this COVID-19 pandemic. Read More:

American College of Radiology (ACR)Publishes Resources for COVID-19 Pandemic

ACR has also published guidance for radiology departments to support adaption of work flow practices, particularly in relation to infection control.In an effort to help radiologists make the safest, most informed decisions during the COVID-19 outbreak, the American College of Radiology (ACR) published guidance and resources Tuesday that can help providers offer the best patient care possible during the pandemic. The ACR stressed the resources are not intended to be comprehensive medical guidelines.

As information about COVID-19 and its spread continues to emerge, radiologists are urged to operate under the following recommendations.

Read More:

National Institute for Health and Care Excellence (NICE)  

NICE has published its first 3 rapid COVID-19 guidelines. They will cover the management of:

Patients in critical care
Patients who are having kidney dialysis
Patients who are receiving systemic anticancer treatments. Read More:

Society of Radiographers (SoR) UK

The Society of Radiographers (SoR) UK has information on the following : Click Here:

  • Workforce, Governance and Regulations
  • Infection control and PPE
  • Education and students
  • Radiotherapy
  • Diagnostic Radiography (FAQs)