Covid-19 transmission risk-reduction policy
GENERAL POLICY Coronavirus is thought to be primarily spread between people who are in close contact with one another (within about 2 metres), through respiratory droplets produced when an infected person coughs or sneezes. The virus is also thought to be passed on through surface transmission, when touching a surface or object that has some respiratory droplets on it and then touching your own face, mouth, nose, eyes, or someone else. Our risk assessment for transmission of coronavirus within Cotswold Chiropractic therefore addressed both close contact between individuals and touch of surfaces that may occur. Our policy for risk reduction is to implement measures to remove, minimise or mitigate each of the identified areas of risk.
POLICY FOR PATIENTS AND OTHER VISITORS • No ‘walk-ins’ – all appointments and enquiries must be made by telephone or email • Assessment of need for an appointment – potential patients will be screened to evaluate the level of risk to them of attending (do they belong to the vulnerable or extremely vulnerable groups), the level of necessity for care and their understanding of these factors. Patients and staff will make shared decisions, as to whether face-to-face appointments are appropriate, or whether remote consultations, no care, or referral for other care are indicated. • Informed consent – patients will be required to give informed consent for the decided course of action upon attending a face-to-face, or remote consultation. • Screening - patients will be screened upon booking and again prior to entry to the clinic for symptoms of Covid-19 or other reason requiring self-isolation. Possible or confirmed cases must not be admitted • Face masks – Patients will wear a face mask to reduce the risk of transmission to staff or to other patients or visitors within the clinic • ‘Clean upon arrival’ - Immediately upon entry, patients are requested to wash their hands. • ‘No-touch’ policy – No patient will need to touch a surface that has not been cleaned immediately prior to them doing so. Staff will wipe objects that it is necessary to touch (e.g. and hand weights/exercise equipment etc). Patients are given a surface wipe on arrival that they should retain and use to wipe any other surface within the clinic before they touch it. • Social distancing – the clinic layout is organised to enable a minimum of 2 metres to be maintained from staff or other patients within the reception area. The number of people within the clinic at any time is also limited to facilitate this. Social distancing will be maintained within the clinical care areas, as far as possible, however some clinical procedures are not possible without closer physical contact (staff and clinicians will wear appropriate PPE to reduce the risk of respiratory droplet transmission to patients where close physical contact in unavoidable) • Contact during clinical procedures - on treatment plinths patients will be requested to keep their own clothes on, wherever possible. Patients will keep their footwear on until they are seated on treatment plinths and replace this prior to getting off the plinth. Treatment plinths, equipment used and other hard surfaces in treatment rooms will subsequently be cleaned with chlorine-based product after every patient. • ‘Clean upon departure’ – Patients will be requested to wash their hands prior to exiting the clinic, thereafter no surfaces will be touched.
CLINICIANS AND OTHER STAFF • No entry if symptomatic or self-isolating – staff must not enter the clinic with symptoms of Covid-19 or other reason requiring self-isolation. • ‘Clean upon arrival’ - Immediately upon entry, all staff wash their hands. • Face masks – all staff will wear a surgical (type II) face mask to reduce the risk of droplet transmission to other staff, patients or visitors within the clinic. This may be sessional. Donning, doffing and disposal of masks and other PPE (see below) must follow correct procedures. • Sessional cleans – Hard surfaces must be cleaned, according to protocol, throughout the reception and common areas and within any consulting room to be used, prior to first use in any session (morning, afternoon or evening). Consulting room cleaning is the responsibility of the clinician who will be using it. Reception and common area cleaning will be the responsibility of reception staff, when they are present, but at other times will be the responsibility of the clinician. Sessional cleaning will be recorded and monitored. • ‘No-touch’ policy – Clinicians and other staff will not touch any surface or object that has not been wiped since potentially having been touched by another person. Surface wipes provided should be used by each individual, as required. Clinicians and other staff will also explain and remind patients of this. • Cleaning between patients – all hard surfaces within consulting rooms will be cleaned by each clinician after every patient. • Ventilation – all windows within the clinic will be open whenever possible to enable replacement of potentially virus-contaminated air • Social distancing – Staff will maintain a minimum 2 metres distance between themselves and other staff, patients or visitors in the reception and common areas. The number of people within the clinic at any time is also limited to facilitate this. Social distancing will be maintained within the consulting rooms, as far as possible, however some clinical procedures are not possible without closer physical contact (in which case clinicians will wear appropriate PPE to reduce the risk of respiratory droplet transmission to patients – see below) • PPE – in addition to sessional use of surgical face masks by all clinicians and staff, clinicians who may come within 2 metres of patients will also wear single-use disposable gloves and aprons, in accordance with Public Health England’s guidance for healthcare settings . PPE will be correctly donned, doffed and disposed of. Eye protection (unless performing aerosol-generating procedures) will not be required as face-to-face screening of patients for Covid-19 is not permitted or required. Single use filtering face piece respirators are required for aerosol generating procedures. • Screening of patients – All staff will ensure that patients or other visitors are screened for symptoms of Covid-19 or other reason requiring self-isolation using the intercom, before permitting them entry to the clinic. Possible or confirmed cases must not be admitted. • Emergency decontamination – should any individual who does have possible symptoms of Covid-19 gain entry to the clinic, they must immediately be asked to leave, other staff or patients within the clinic must be notified and evacuated or contained until decontamination procedures have been completed • Rik/benefit evaluation and consent – clinicians will evaluate the appropriateness of face-to-face consultations and of procedures requiring close physical contact on a case-by-case basis. Telephone or video consultations may be deemed sufficient/appropriate in some instances as an alternative. In deciding what level of consultation to provide, clinicians will evaluate the vulnerability status of the patient and their level of need for care. The options for care and their associated risks will be explained to the patient, ensuring that they have adequate understanding and are given the opportunity to ask questions, prior to obtaining signed consent for each visit (see example Covid-19 consent form) • Contact during face-to-face consultations – close contact of clinicians (less than 2 metres distancing) with patients will be avoided, if possible. Where procedures unavoidably necessitate close contact, this will be minimised in duration, ensuring that the patient has first confirmed their consent. • ‘Clean upon departure’ – staff will be wash their hands prior to exiting the clinic.