How to Work Safely in care settings during covid19 pandemic

With the UK continuing to battle against a sustained transmission of COVID-19, as a Nurse, Carer, or Support Worker you have a key role in maintaining a safe and secure working environment. Regardless of whether the residents in your care show symptoms (as it differs from person to person and community); taking continued precautions to protect both yourself and the people you care for is vital.

Below is an overview of the latest recommendations by PHE to reduce the risk of transmission: a must-read for those who are returning to work or new to health & social care. Use this in conjunction with adult social care guidance.

PERSONAL PROTECTIVE EQUIPMENT

PPE in a health and social care environment can consist of aprons, gloves, face masks, gowns, and eye protection (visors or goggles). These equipments offer protection from exposure to harmful substances and are essential in helping prevent the transmission of infection from staff to vulnerable patients. At your workplace, you should have access to the right equipment and may have received training on its use. Here is a quick refresher on a few important points to bear in mind while using PPE.

Identify the correct use of PPE - What to wear and when?

Scenario 1

When providing close personal care and or when caring for residents with challenging behaviours OR are within 2 metres of any resident who has a cough even if you are not providing personal care to them. This applies to all staff (care workers, cleaners, etc) except aerosol-generating procedures.

You must follow these recommendations regardless of whether the person you are providing personal care to has symptoms or not. This includes all personal/direct care, for example, feeding, hoisting, tooth brushing, toileting, assisting with getting in/out of bed, applying the dressing, etc. This PPE also applies if the person is shielding.

Disposable Plastic Apron

Single-use

Disposable Gloves

Remember to wear the correct size.
Vinyl gloves should be sufficient for most low-risk tasks and everyday activities within a care setting. However, as they offer less dexterity, they can be more susceptible to tears and punctures.
If gloves are to be worn for an extended period of time and will be used in a task that requires a high level of durability, consider using nitrile gloves.
If you are changing gloves during a task, then it is essential to wash your hands after removal of the original gloves.

Fluid-repellent (Type IIR) surgical mask

These are designed for continuous use and you should not touch your face mask unless it is to put it on or remove it (e.g., for a break or at the end of shift). You can use the same mask between residents provided neither you nor the residents touch the mask.
Dispose of and replace the mask if it becomes damaged, visibly soiled, or uncomfortable to use.
You need a new mask when re-starting your duties after a break.
Make sure it covers your mouth and nose. It should not be allowed to dangle around the neck after or between each use.

Eye protection e.g., a visor or goggles subject to risk assessment

Can be used continuously while providing care until you take a break from duties. Decontaminate before next use.
Remove and discard the eye protection if damaged, visibly soiled, uncomfortable.
It is vital if you are using a reusable visor or goggles, you are aware of how to disinfect and store them. Speak to your Manager for more information.

Scenario 2

When you are within 2 metres of a resident but not delivering personal care e.g. performing medication rounds, preparing food for residents who can feed themselves without assistance, working in communal areas, assisting someone to stand up, etc. This applies to all staff (care workers, cleaners, etc.)

Type II surgical Mask

Make sure it covers your mouth and nose
Same recommendations as Scenario 1 applies to all masks

No apron and gloves are required unless you normally use them for these tasks. No eye protection required.

Scenario 3

In any other situation within a Care Home and 2 metres or more away from people you are caring for or supporting e.g. in staff rooms, kitchen, laundry room, etc.

This applies to all staff (care workers, cleaners, receptionists, etc.)

Type I or Type II surgical mask

Putting on and removing PPE correctly (for non-aerosol generating procedures or AGPs)

As discussed, PPE will only protect you and others if you know how to put it on and take it off correctly and dispose of it safely. The following gives you some general guidance, but specific PPE items vary. Your employer and registered staff in your Home will be able to advise you best.

Before putting on your PPE:

Make sure you drink some fluids
Tie hair back
Remove any jewellery – watch, bracelets, or stoned rings
Check PPE is in the correct size is available

PPE should ALWAYS be worn before entering the room where the patient is.

Putting on:

Start by cleaning your hands using soap and water or alcohol hand gel/rub.
Put on a disposable apron and tie at the waist.
Put on facemask – position upper straps on the crown of your head, lower strap at the nape of the neck. With both hands, mould the metal strap over the bridge of your nose, firmly pressing down both sides of the nose with your fingertips, and ensuring the bottom of the facemask should extend carefully over the chin.
Don your eye protection, if required.
Lastly, put on disposable non-sterile gloves.

What to remember when taking off PPE?

Should be removed in an order that minimises the risk of self-contamination.
Before leaving the room or cohort area where patients are being cared for, remove gloves and apron. Once outside the room, remove the face mask. Dispose of them as infectious clinical waste.

1.Remove gloves

Grasp the outside of the glove with the opposite gloved hand and peel off.
Hold the removed glove in the gloved hand.
Slot your finger under the lip of the remaining glove and peel it off, taking care not to touch the contaminated outer surface.
Dispose of the gloves in the clinical waste bin.

2. Clean hands with alcohol rub/gel or soap and water.

3. Remove your apron.

4. Remove eye protection

If worn, carefully remove them and clean them with an alcohol lens wipe before washing your hands. Allow the item to dry completely before re-using.

5. Clean hands with alcohol rub/gel or soap and water

6. Remove surgical facemask

7. Wash hands with soap and water.

How to use PPE if residents are shielding or clinically extremely vulnerable?

When delivering personal care to residents who possess serious health conditions; you should wear gloves, an apron, and a fluid repellent surgical mask. Additional precautions may be necessary to avoid transmitting infections, please check with your organisation and follow guidelines accordingly.

Uniform and work clothes

Regardless of wearing PPE, uniforms should be laundered separately from other household linen at the maximum temperature the fabric can tolerate, then ironed or tumble dried. We recommend you change into your uniform upon arrival at work and change out of it when leaving to keep contamination down to a minimum.

If you do not wear a uniform, then change your clothing as soon as you get home and wash the clothing used for work as described above. This does not need to apply to undergarments unless contamination from the resident’s body fluid (e.g., vomit, or fluids soaked through external items).

Follow Standard Infection Control Precautions (SICPs)

SICPs are embedded as a core element of professional practice to minimise the risk of healthcare-associated infections and are applicable across all COVID-19 pathways. These precautions must be used by all staff, in all care settings, at all times, and for all patients, whether the infection is known or not to ensure the safety of patients, staff and visitors.

SICPS include:

- Patient screening for COVID-19 symptoms

- Hand hygiene

- Respiratory and cough hygiene – catch it, bin it, kill it.

- PPE

- Safe management of the care environment

- Safe management of care equipment

- Safe management of healthcare linen

- Safe management of blood and body fluids

- Safe disposal of waste (including sharps)

- Occupational safety: prevention and exposure management

- Maintaining social distancing of 2 metres

Maintaining safety comes as a result of a combination of factors. PEE is only effective when worn properly, safely disposed of, and combined with: hand hygiene (cleaning your hands regularly and appropriately especially after removing gloves); respiratory hygiene, and avoiding touching your face with your hands while following standard infection prevention and control precautions. You must also ensure social distancing is practiced (keeping at least a 2 metres distance from residents, staff, and visitors) at all times and your residents are regularly monitored for symptoms.

Remember to take breaks and hydrate regularly.

reach24 is here to help!

Concerned about managing your staffing needs safely this winter? Use reach24 to fill your rota gap and keep your home COVID-secure

How to continue working safely in Care Settings during COVID-19

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