COVID-19: infection control in residential care settings

Standard Infection Control Precautions (SICPs)

  • Acts as the basic infection prevention & control measure necessary to reduce the risk of transmission of infectious agents
  • Interrupts the transmission of COVID-19 by stopping the route of transmission via contact & droplets

Safe ways of working for all health and care workers

  • Staff should know what PPE they should wear for each setting and context. More information can be found here for Northern Ireland and here for Scotland.
  • Staff should have access to the PPE that protects them for the appropriate setting and context – we know this can be a problem and we urge you to discuss it with each individual setting, or discuss it with us.
  • Gloves and aprons are subject to single-use with disposal after each patient contact.
  • Fluid repellent surgical mask and eye protection can be used for a session of work rather than a single patient contact (if appropriate)
  • Hand hygiene should be practised and extended to exposed forearms after removing any element of PPE

Use of PPE

  • It is always vital to wear PPE when completing any care interventions in the community environment, however, in these times it is essential that PPE is worn. The level of PPE will be determined depending on the environment. For non-symptom displaying service users, gloves and aprons are required for any patient care. Ensure that you wash your hands for at least 20 seconds in warm water with soap before and after applying PPE.
  • PPE should be put in the hallway or reception area of the home.
  • The recommended PPE required to be worn where a possible or confirmed case has been identified as disposable gloves, disposable apron and fluid resistant surgical face mask and potentially eye protection. Where a service user is coughing and there is a risk of splashing the use of a visor should be considered and risk assessed.
Aerosol Generating Procedures

The current AGPs in the nursing/residential care setting are:

  • Tracheostomy procedures – insertion, removal or open suction
  • Non-invasive ventilation (BiPAP or CPAP)
  • Ventilation via a tracheostomy
  • Cough Assist

Further information on the PPE requirements can be found here for Northern Ireland and here for Scotland.

 Procedure for a suspected case of COVID-19 within the care facility:

  • Isolation within a care home for a known/suspected case of COVID-19 can be achieved in the resident’s own bedroom
  • Residents should remain in their own rooms with the door closed
  • Only essential staff should enter the room wearing the appropriate PPE

Hand Washing

  • Essential in reduction of transmission
Safe Management of Linen
  • All laundry should be laundered in line with local policy for infectious linen
  • It should be placed in an alginate bag then a clear bag before being removed and placed into the laundry bag
  • All linen used by the individual should be treated as infectious
Use of clothing at work
  • Do not travel to work in the clothes that you will be wearing during your shift
  • If possible, change into your ‘work clothes’ on commencement of shift
  • Use different footwear when at work – this will prevent you from potentially spreading the virus outside of the work environment
  • Prior to leaving the shift, change back into travelling clothes, place work clothes and footwear into a plastic bag
  • When home, wash your clothes immediately at 90 degrees
  • Avoid shaking your clothes out prior to putting them into the washing machine
Personal Protective Equipment (PPE)
  • Assess the likelihood of exposure & adequateness of PPE for risks associated with the procedure that is to be undertaken.
  • Stay in line with the local policy and procedures of the hospital.
Masks

Please use local guidance. For more general information on using masks please follow HSE guidance here.

Occupational exposure

There is a risk that you will be exposed to a service user with COVID-19. All staff should remain vigilant for any new respiratory symptoms during the incubation period, which can be up to 10 days following last exposure to a confirmed case, and should NOT work if you have a fever, cough or loss of smell or taste. If you develop a fever or cough, contact 111 or your GP for further advice and self-isolate.

Stay up to date with the latest NHS advice here.

Stay up to date with the latest HSE advice here.