Infection Control Policy 12th Oct 2021

Introduction

The newly identified severe acute respiratory syndrome, coronavirus 2 (SARS-CoV-2), caused by the novel coronavirus 2019 disease (COVID-19) has highlighted the need to provide full infection controls in clinic.  This document will outline the procedures to ensure the safety of workers and patients alike.

Setting

This clinic is currently a single room within a barn building at Dare’s Farm.  The building consists of 4 units in total with communal use of the main entrance hallway, kitchen and washroom facilities.  This communal area can also be used by those renting the other business unit and visitors.

 

The Patient Journey

Booking Appointment

  1. Appointments booked by phone or online

  2. New patients sent New Patient Details form with confirmation email and Health Screening Assessment Questionnaire in reminder email

  3. Existing patients receive Health Screening Assessment Questionnaire only in reminder email

Pre-Screening Call

Practitioner ensures the patient has completed the Health Screening Questionnaire. If not, practitioner to call patient to work through the questionnaire.

  1. Have you been diagnosed with Covid-19 in the last 10 days? 

  2. Have you experience any of these symptoms in the last 7 days? Fever greater than 37.5 C; New Continuous Cough; Loss of taste or smell

  3. Has anyone in your household or anyone you have been in close contact with had any of the above symptoms in the last 10 days?

  4. Have you returned from a red list country in the last 10 days (please see full list of countries here https://www.gov.uk/guidance/red-list-of-countries-and-territories)?

  5. Have you returned from any other country in the last 10 days?

  6. If yes (other country), are you fully vaccinated? 

  7. Have you been asked to self isolate in the last 10 days? 

If patient answers “YES” to any of these questions, when travelled to another country but they are fully vaccinated, advise to stay at home and offer to assist via telephone or online consultation.

  • Reassure patient during the call

  • Ensure they understand what you will be wearing and the process for entering the clinic

  • Tell them you will be sending them the guidelines for entering the practice as confirmation of our conversation

Entering Practice

Once pre-screening call completed, patient sent guidelines for entering the practice as follows:

  1. Please only enter the building at your appointment time.

  2. Please wear a Face mask at all times in the building (unless you are exempt).

  3. Please do not bring any bags or coats into the practice and please have your mobile phone stored in your pocket.

  4. Please ensure you wash your hands with alcohol hand gel or soap and water in the facilities as you enter the building (men's on the left, women's on the right).

  5. Please limit the number of family members, carers and children accompanying you if possible.

  6. Please be aware that all appointments must finish on time to ensure full sanitisation between appointments.

  7. Payment by Card, Apple Pay, Android Pay, or online payments only (no cash or cheques).

  8. Please be aware that your practitioner will be wearing a mask, apron, and gloves throughout your treatment.

  9. You are welcome to bring your own towel for comfort, warmth, and privacy if you would like.

 

Completing the appointment

Once the appointment is finished either take payment via by card or send invoice by email

Remind the patient on exiting to use hand gel provided

 

Infection Control Measures

Ensuring Early Recognition

Ensure high level of suspicion with pre-screening telephone call and face-to-face triage

Use screening questionnaire

Post signs in public areas reminding patients about good hand and respiratory hygiene

 

Correct respiratory hygiene and hand hygiene

Encourage all patients to cover their nose and mouth with a tissue or elbow when coughing

Ensure all patients are cleaning their hands with an alcohol rub or with soap and water when they enter and exit the building

Airborne precautions

Ensure all patients are wearing a mask

Ensure the room is adequately ventilated with the windows open.

Do not use the air-conditioning unit or any fans if the windows are shut

Limit the number of people in the room to the absolute minimum

Limit use of treatment techniques that can be an aerosol-generating procedure (e.g. supine thoracic A-P thrust, deep breathing techniques)

Cleaning & Waste Management

Clean all touch points, door handles, keypads, clinic couch, and chairs between each patient with a disinfectant active against viruses

Cleaning must be conducted wearing PPE

All disposable PPE must be placed in pedal bin lined with heavy duty black bin liner to be double bagged at the end of the session and stored for 72 hours then disposed of normally

Staff uniform to be changed into on arrival at work

At end of session uniform is transported home in plastic bag, separately from other household items, loading not more than half the machine capacity and on the max temperature the fabric can tolerate then ironed

 

Personal Protective Equipment

Equipment

All the following items must be worn when in direct contact with the patient.  When typing notes the gloves should be removed and disposed of.

Mask

  1. Fluid resistant surgical mask or better (FFP2/N95, FFP3)

  2. Well fitted covering nose and mouth

  3. Not to be touched once put on

  4. Used for a session (usually a half-day) or when clinician leaves the care setting

  5. Replaced as soon as dirty, contaminated, damaged, damp, difficult to breathe through or uncomfortable

Apron & Gloves

  1. Disposable plastic apron to protect clothing from contamination

  2. Disposable gloves when providing direct patient care and when cleaning and decontaminating the area.

Donning and Doffing procedure

The order in which PPE is taken off and put on is essential for protecting yourself

Donning

  1. Mask

  2. Apron

  3. Gloves (after typing patient notes)

Doffing

  1. Gloves (before typing completion of notes)

  2. Apron

  3. Mask (at the end of the session)

Sequence

All equipment except gloves stored in cupboards in clinic room

Don mask at start of session

Don apron in clinic room before patient arrives

Don gloves in clinic room after typing initial notes before direct patient contact

Once direct patient contact completed, remove gloves and place in clinic waste bin (black bag) to be able to complete notes without gloves

Once patient leaves conduct full clean of all surfaces in the room including door handles, desk, chairs, card machine keypad, clinic couch

Remove apron and gloves, place in clinical waste and return to don for next patient in waiting area

 

Practice Health and Safety Measures

All surfaces cleared in waiting area and treatment room. No magazines, leaflets, toys, merchandise

No forms to be completed on site, all forms to be completed online prior to appointment

Contactless and card payments only, no cash or cheques

No linen to be used. Couch covers removed, towels removed, pillows covered in wipeable pillow covers

Patients encouraged to bring their own towel if they would like

Patients required to wear masks (homemade are fine)

Chairs in waiting area to be spaced apart

 

Contingency Procedures

What to do if a patient starts coughing or admits to having a temperature recently whilst being treated

  1. Question the client further on their symptoms

  2. Determine if they now fall into the high-risk category

  3. If they do ask them to leave

  4. Ensure full sanitation of the area

If the practitioner falls ill during clinical session

  1. Stop any further treatments taking place

  2. Inform any previous patients that have been seen in the last 2 days

  3. Ensure full sanitation of the area

Final Considerations

Patients will be anxious so help them understand the process and procedures put in place to ensure their safety, using positive and reassuring language. Remember whilst you are treating to continue talking reassuringly because facial expressions are not visible when wearing a mask.