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Acute Hospital Infection Prevention and Control …

Page 1 of 79 Acute Hospital Infection Prevention and Control Precautions for Possible or Confirmed covid -19 in a Pandemic Setting Note: If you have any queries on this guidance please contact the AMRIC team at Page 2 of 79 Date Changes from previous version Drafted by Specifies that vaccination service should be provided on at least 3 days each week Additional information on booster vaccination Information on vaccine in pregnancy Transmission based precautions are generally not required following incidental detection of most respiratory viruses (other than SARS-CoV-2 and Influenza A)

Precautions for Possible or Confirmed COVID-19 in a Pandemic Setting V2.11 07.03.2022 ... Updating of link to Self-assessment check list for Infection Prevention and Control (IPC) and related measures to manage the risk of spread of COVID-19 in the Acute ... surveillance & assessment for infection risk.....23 . Page 6 of 79 COVID-19 Positive ...

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Transcription of Acute Hospital Infection Prevention and Control …

1 Page 1 of 79 Acute Hospital Infection Prevention and Control Precautions for Possible or Confirmed covid -19 in a Pandemic Setting Note: If you have any queries on this guidance please contact the AMRIC team at Page 2 of 79 Date Changes from previous version Drafted by Specifies that vaccination service should be provided on at least 3 days each week Additional information on booster vaccination Information on vaccine in pregnancy Transmission based precautions are generally not required following incidental detection of most respiratory viruses (other than SARS-CoV-2 and Influenza A)

2 In an asymptomatic adult Update to information for patients who are being discharged while contacts Clarification re closure of multi-bed area or ward in context of a single cases of Hospital acquired covid -19 Updated information on testing requirements and restricted movement for patient contacts as per current public health requirements Updated information on healthcare worker contacts Additional guidance on testing for dialysis patients who are contacts if performance of self-testing is not confirmed Recommendation that respirator masks be used by all health care workers in patient facing role when caring for all patients Recommendation that respirator masks be provided to patients who are able to tolerate them Change to management of contacts attending dialysis AMRIC Correction to indicate requirement for testing includes those who have had covid -19 diagnosed in the previous 9 months Other changes reflecting reduced confidence in protection against Infection associated with

3 Vaccination or previous vaccination in the context of rapid spread of Omicron variant AMRIC Requirement for testing of all patients (including fully vaccinated) admitted overnight to Acute settings and at transfer to LTRCF Testing for fully vaccinated inpatient contacts generally required Update to reflect Government policy on restriction of movement for fully vaccinated household contacts Clarification regarding fallow period between surgical procedures in operating theatres Rewording to emphasise that healthcare workers must have access to FFP2 respirator masks at all times when caring for people with suspected or confirmed covid -19 AMRIC General

4 Editorial changes to reflect current terminology and emphasis Updating of link to Self- assessment check list for Infection Prevention and Control (IPC) and related measures to manage the risk of spread of covid -19 in the Acute Hospital setting Reference to extended primary vaccination and booster vaccination Clarification of interval for contact testing of non-vaccinated inpatients at 3 days Clear statement that repeated surveillance testing of fully vaccinated inpatients is not required as routine Interval for surveillance testing of inpatients (when required)

5 Changed to 3 to 5 days Reference to the role of testing for other respiratory pathogens in patients with suspected covid -19 and its avoidance in contact and surveillance testing Note that it is appropriate to report a test as not-detected or equivocal if the Ct value is so high that it is not possible to be confident that the result confirms detection of virus AMRIC Page 3 of 79 Date Changes from previous version Drafted by Statement that environmental persistence is unlikely to be a major source of transmission Removal of the recommendation for designated catering support for staff working in covid -19 cohort areas Reframing of statement of social interaction between staff Reframing of statement on face to face meetings when required for clinical purposes Removal of reference to frameworks 3.

6 4 and 5 Indication that wards/units where there is an outbreak can revert to essentially normal operation 14 days after detection of most recent cases Change to guidance on contact who is discharged home to reflect current public health guidance Clear statement that testing of fully vaccinated asymptomatic patients is not required in advance of scheduled surgery Statement of risk of Infection associated with valved respirator and PARP using during surgery Clarification that the requirement for extension of isolation period for people with covid -19 applies to people admitted to an Acute Hospital but not to nominated support partners or visitors and may be waived subject to risk assessment .

7 Fully vaccinated dialysis patient may share transport with one other fully vaccinated dialysis patient Indication that visits home are low risk for Acute mental health and community Hospital patients if fully vaccinated Change to Appendix 2 regarding transfer of contacts to LTRCF and implications of vaccination or restricted movements of residents and transfer Deletion of records of changes in previous versions Alignment of appendix 2 with covid -19 Normalising visiting in long term residential care facilities guidance Terminology change to fully vaccinated throughout Clarification of Contact testing Statement that all company representatives and staff working for external contractors in clinical areas should be fully vaccinated Consider additional protective measures for patients admitted who are not fully vaccinated Patients with suspected or confirmed covid -19 should be care for by staff who are fully vaccinated Addition of guidance on surveillance testing of children and a parent/guardian or

8 Carer who may accompany them to Hospital Update to doffing of PPE AMRIC Page 4 of 79 Table of Contents Introduction .. 7 Scope .. 7 covid -19 (SARS-CoV-2) .. 8 Transmission of covid 19 .. 8 Transmission in the Healthcare Setting .. 10 Vaccination .. 11 Testing .. 12 Interpretation of 14 covid -19 and Pregnancy .. 15 covid -19 and Immunity after Recovery .. 16 Survival in the 16 Staff .. 16 Limiting Exposure of Staff to covid -19 .. 16 Staff movement across facilities .. 18 Staff Uniforms/Clothing.

9 18 External Contractors & Product Representatives .. 19 Standard Precautions .. 20 Hand hygiene .. 20 Alcohol-based hand rub .. 20 Respiratory hygiene and cough etiquette .. 20 Safe management of linen (Laundry) .. 20 Management of blood and body fluid spills .. 20 Management of waste .. 20 Transmission-based precautions for covid -19 .. 21 Care for Patients in the Acute Setting .. 21 Cohorting and Streaming .. 21 Patient placement, surveillance & assessment for Infection risk .. 23 covid -19 Positive Patient Placement for Inpatient Care.

10 24 Page 5 of 79 Managing a cluster or outbreak of covid -19 in an Acute Hospital Setting .. 25 A suspected case of Hospital -acquired covid -19 in an inpatient .. 26 A confirmed case of Hospital -acquired covid -19 on a ward .. 28 Specific 29 Critical Care Setting .. 29 Operating theatres .. 30 Outpatient Department (OPD) or Day Service .. 31 Radiology .. 31 Dialysis .. 32 Maternity Units .. 35 Acute Mental Health Facilities/Units .. 37 Community Hospitals and Post- Acute Rehabilitation Facilities .. 38 Transfer.


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