Home Support CHW COVID 19 Education

Updated: April 15, 2020As recommendations may change, please update as needed regarding

COVID-19 safe practices.

Land Acknowledgement

We acknowledge that this workshop is being held on the traditional and unceded territory of the Coast Salish Peoples, including the homelands of the Musqueam, Squamish and Tsleil-Waututh Nations

Goals for this session

• Explain accurate COVID-19/pandemic information

• Learn how to screen clients, steps in Procura mobile

• Reinforce practical skills of proper hand hygiene

• Learn more about how Personal Protective Equipment (PPE)

• Practice/demonstrate how to put on and take off PPE

• Provide opportunity to ask questions or raise concerns

Where do I go for the right information?• BC Centre for Disease Control:

http://www.bccdc.ca/health-professionals/clinical-resources/novel-coronavirus-(covid-19)

• VCH – Infection Prevention & Control:http://ipac.vch.ca/Pages/Emerging-Issues.aspx

• VCH – Public Page: http://www.vch.ca/about-us/news/vancouver-coastal-health-statement-on-coronavirus

• VCH – Coronavirus updates [staff page]:https://my.vch.ca/news-discussion/novel-coronavirus-update

• https://my.vch.ca/news-discussion-site/Documents/COVID-19-VC-Memo-March-18-2020.pdf

WEBSITES – SOURCE OF TRUTH

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What is COVID-19?• A flu-like virus causing mild to severe respiratory symptoms

• Spread through droplets (not airborne)

• Can stay on surfaces – important to clean & disinfect frequently!

• Social distancing of 2 meters reduces transmission

What is a pandemic?• A term that refers to an outbreak of a disease that occurs over a wide geographic area and

affects a high proportion of the population

• Not an indication of how severe the disease might be

COVID-19: THE FACTS

GOALS OF INFECTION PREVENTION AND CONTROL

• Limit human-to-human transmission

• Reduce secondary infections

• Prevent transmission through amplification and large group events

How do I protect myself and clients?• Thoughtful and frequent hand hygiene (soap + water work perfectly!)

• Avoid touching face – portal of entry is mucous membranes, not intact skin

• Ensure *source of truth* for facts!

• At each visit with a client, the first point of contact with the client requires

CHW to ask the following screening questions:

1. Do you have a fever?

2. Do you have a cough?

3. Do you have shortness of breath?

4. Do you have nausea?

5. Do you have diarrhea?

• These screening question will be in Procura mobile for each client visit

• Schedulers will add the screening question during their intake process

SCREENING CLIENTS

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• CHW are going to be

asking 5 different

screening questions in

Procura

• CHW will call nursing

team if any one of the

questions are answered

“YES”

PROCURA MOBILE: SCREENING OUR CLIENTS

• CHW will answer the following questions in Procura Mobile after

client visit:

1. Did you don the standard PPE: mask, gloves and goggles?

2. Did the Client answer ‘yes’ to any of the screening questions at

the beginning of the visit?

3. If yes, did you don a gown?

PROCURA MOBILE: SCREENING POST-CLIENT VISIT

• Required to do before, during, and

after visit

• MUST use soap & water if hands are

visibly soiled

• Must lather hands for a total of 30 sec

• Ensure you turn off taps with paper

towel

2A. HAND WASHING

https://media.phsa.ca/home/iframe?url=BCCA/bccahealth%5cSoapAndWater_20200312http://ipac.vch.ca/Documents/Routine%20Practices/VCH.0014-%204%20Moments%20for%20Hand%20Hygiene1.pdf

IPAC site: for up-to-date posters and videoshttp://ipac.vch.ca/Pages/Emerging-Issues.aspx

• Just like hand washing

• Requires 1-2 pumps of product

and rub like handwashing

technique

• Do not use paper towels to dry

hands

2B. HAND RUBBING

https://media.phsa.ca/home/iframe?url=BCCA/bccahealth%5cABHR_20200312http://ipac.vch.ca/Documents/Routine%20Practices/How%20to%20Hand%20Rub.pdf

IPAC site: for up-to-date posters and videoshttp://ipac.vch.ca/Pages/Emerging-Issues.aspx

= PPE TO BE USED FOR ALL CLIENT VISITS

1. Surgical/Procedure Mask (keep on for entire shift)

2. Eye Protection

3. Gloves (remove gloves and clean hands between clients)

3. PERSONAL PROTECTION EQUIPMENT

4. Gown, if ‘yes’ to any screening question or known COVID-19 +ve

3. DONNING and DOFFING PPE - ‘HOW TO’

Please be sure to use the most up-to-date posters and video links when training

IPAC site: http://ipac.vch.ca/Pages/Emerging-Issues.aspx

3A. DONNING – ‘NO’ to all screening questions

🡪 Provide care (ENSURE mask, gloves and eye protection are ON)

STEP 1 STEP 2

STEP 3 STEP 4 STEP 5

Don gloves

At start of shift:

Keep a mask on for entire shift

Before screening questions:(2 meters from client)

3B. DOFFING – ‘NO’ to any screening question

IPAC site: http://ipac.vch.ca/Pages/Emerging-Issues.aspx

STEP 1 STEP 2

STEP 4 STEP 5

Don gloves

Move to exit door (2 meters from client)

Doff gloves

STEP 3

Doff eye protection Clean/sterilize eye protection

STEP 6 STEP 7

Doff gloves

3B. DONNING – ‘YES’ to any screening question

IPAC site: http://ipac.vch.ca/Pages/Emerging-Issues.aspx

STEP 1

STEP 2

STEP 3

STEP 4

STEP 5

Don gloves

At start of shift:

Keep a mask on for entire shift

Before screening questions: If ‘YES’ to any screening question:

STEP 6 STEP 7

STEP 9

STEP 10

Don gloves

STEP 11

Call LPN Supervisor to REPORT, hand

hygiene

STEP 8

Doff gloves

3B. DOFFING – ‘YES’ to any screening question

IPAC site: http://ipac.vch.ca/Pages/Emerging-Issues.aspx

STEP 1 STEP 2 STEP 3

STEP 6 STEP 7

STEP 4

Don gloves

Doff gloves

STEP 5

Doff eye protection Clean/sterilize eye protection

STEP 8 STEP 9

Doff gloves

STEP 1/2. DONNING MASK - ‘HOW TO’

IPAC site: http://ipac.vch.ca/Documents/Cleaning%20and%20Disinfection/Cleaning%20Protective%20Eyewear.pdf

At start of shift:• Hand hygiene• Don mask:

- Ensure a snug fit over the nose and under the chin- Molding the metal bar over the nose- Wearing the mask with moisture-absorbing side closest to

the face (i.e. blue side out)• A Mask STAYS ON for entire shift

DO : DO NOT:

Change the mask when it is moist, wet, dirty or damaged

Do not wear masks around the neck, or pull down then pull back up again

Change the mask when you need to EAT/DRINK

Do not touch the front of the mask

Do not put gauze or paper towel inside mask

Do not place used mask in pocket, work bag or other for future use

STEP 3/4. DONNING EYE PROTECTION - ‘HOW TO’

IPAC site: http://ipac.vch.ca/Pages/Emerging-Issues.aspx

At start of shift:• Hand hygiene 🡪 Don mask (keep on for entire shift)

At start of screening:• Hand hygiene• Don eye protection

🡪 NB: - Eye protection (i.e. goggles, face shield, mask with visor).- Wear a mask and eye protection to protect your mouth/nose/eyes.

DO : DO NOT:

Clean and disinfect reusable eye protection after each use

Do not use prescription glasses as a substitute for eye protection

STEP 5. DONNING GLOVES - ‘HOW TO’

IPAC site: http://ipac.vch.ca/Pages/Emerging-Issues.aspx

At start of shift:• Hand hygiene 🡪 Don mask (keep on for entire shift)

At start of screening:• Hand hygiene 🡪 Don eye protection• Hand hygiene• Don gloves

DO : DO NOT:

Change gloves after each client Do not wash gloves or use alcohol-based hand rub while wearing gloves

Change gloves between care activities for same patient, i.e. after working on contaminated body site

Do not wear gloves outside a client room/space unless transporting contaminated items or cleaning spills

Change gloves if damaged

Don gloves

STEP 6-10. DONNING GOWN - ‘HOW TO’

IPAC site: http://ipac.vch.ca/Pages/Emerging-Issues.aspx

At start of shift:• Hand hygiene 🡪 Don mask (keep on for entire shift)

At start of screening:• Hand hygiene 🡪 Don eye protection• Hand hygiene 🡪 Don gloves

If ‘YES’ to any screening questions:- remove gloves and dispose in regular garbage- call LPN Supervisor to report- hand hygiene, put on gown- fasten tie strings at neck and waist- make sure the sleeves cover wrists- put on gloves ensuring that gloves extend to cover wrists of gown

DO : DO NOT:

Remove soiled gown as soon as possible

Do not use gowns as a housecoat or jacket

Do not wear gowns outside client space unless transporting contaminated items

Do not reuse gowns

STEP 1-2: DOFFING GLOVES - ‘HOW TO’

IPAC site: http://ipac.vch.ca/Pages/Emerging-Issues.aspx

After direct client care (within 2 meters):• Remove gloves

- pinch outer surface and remove the first glove- hold removed glove in gloved hand- slide fingers of ungloved hand under other glove at wrist- peel glove over wrist so it is inside-out- Discard gloves in regular garbage

• Hand hygiene

DO : DO NOT:

Change gloves after each client Do not wash gloves or use alcohol-based hand rub while wearing gloves

Change gloves between care activities for same patient, i.e. after working on contaminated body site

Do not wear gloves outside a client room/space unless transporting contaminated items or cleaning spills

Remove damaged gloves

STEPS 3-4: DOFFING GOWN - ‘HOW TO’

IPAC site: http://ipac.vch.ca/Pages/Emerging-Issues.aspx

After direct client care (within 2 meters):• Remove gloves• Hand Hygiene• Remove gown (if donned)

- unfasten ties at neck and waist- cross arms over chest and pull gown away from

neck and shoulders - turn own inside out and roll gown into bundle

🡪 Discard into regular waste (disposable gown)• Hand Hygiene

DO : DO NOT:

Remove soiled gown as soon as possible

Do not touch front of gown when doffing

Do not wear gowns outside client space unless transporting contaminated items

Do not reuse gowns

STEPS 5-9: DOFFING EYE PROTECTION - ‘HOW TO’

IPAC site: http://ipac.vch.ca/Pages/Emerging-Issues.aspx

After direct client care (within 2 meters):• Remove gloves 🡪 Hand Hygiene• Remove gown (if donned) 🡪 Hand Hygiene• Don gloves• Remove eye protection

- when removing eye protection ONLY touch the sides or elastic band🡪 Disposable: discard in regular waste 🡪 Reusable: - clean and disinfect from inside out with 1 ACCEL wipe

- use second ACCEL wipe to disinfect (total 2 wipes)- allow 1 minute to air dry- put eye protection into dedicated plastic bag for future use

• Remove gloves• Hand Hygiene

DO : DO NOT:

Clean and disinfect reusable eye protection after each use

Do not use prescription glasses as a substitute for eye protection

STEP 10: DOFFING MASK PROTECTION - ‘HOW TO’

IPAC site: http://ipac.vch.ca/Pages/Emerging-Issues.aspx

After direct client care (within 2 meters):• Remove gloves 🡪 Hand Hygiene• Remove gown (if donned) 🡪 Hand Hygiene• Don gloves 🡪 Remove eye protection• Remove gloves 🡪 Hand Hygiene• A MASK stays ON, unless wet/dirty/damaged

If need to remove a wet/dirty/damaged mask:• Remove ear loop or elastic from nape of neck• Lean forward • Gently remove elastic from crown of head without disturbing the mask

🡪 disposable: discard in regular garbage• Hand Hygiene

Cleaning and Disinfecting• Who:

• ALL health care professionals and workers including leadership

• What: • Equipment used between clients and user equipment i.e. mobile

devices, stethoscopes, etc. • Equipment and surfaces during client care

• When: • Between every client• Clean and disinfect daily and whenever visibly soiled, after contact

with client, end of shift

• Key points:• 2-step process:

• First Clean: Remove any foreign matter (dust, crumbs, feces, blood, sputum) Cleanest to dirtiest area.

• Second Disinfect: apply disinfectant (wipe)• 1 minute wet contact time.• Use friction and rub/scrub motion.

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CHW ACTIONS IN SUMMARY

WHAT IF I’M SICK?

Determine if you require testing

and self-isolate

• Call absence line

• Self-isolate for a minimum of 10 days from the time that your symptoms started

• Follow procedures for return to work

Testing…Who does NOT need to be tested for COVID-19?

• Clients without symptoms.

Who should be tested for COVID-19?

• Please go to VCH COVID-19 page to find most up to date information on testing criteria and arrangements for staff and clients:

• COVID-19 testing for staff

• COVID-19 testing for patients

QUESTIONS?

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• Train- the-trainer (slide deck on IPAC website)

• Community Care toolkit (IPAC website)

• PPE Recommendations (for HCW doing patient care) – Community (IPAC website)

• Hand Hygiene Posters: Hand Wash and Hand Rub

• PPE Donning/doffing (from IPAC website)

• Droplet and Contact Precautions Practice

• Guideline for Cleaning and Disinfecting Eye Protection

• Cover Your Cough Poster

• Low Level Cleaning and Disinfecting Practice

HANDOUTS AND RESOURCES

31IPAC site: http://ipac.vch.ca/Pages/Emerging-Issues.aspx

HOW TO LOAD IPAC MANUAL TO YOUR PHONE