» Excerpts from Public Health Hertfordshire’s guidance
Page 6
On the basis that COVID-19 is circulating highly in the community (as confirmed by PHE on 12th April 2020), the COVID-19 infection prevention and control national guidance supersedes PPE specific guidance for specific settings (see Appendix A). This is a health and social care guidance document, but the principles for PPE are transferable to a range of settings. A summary of this can be found in Table 1.
Page 7
In summary;
– Where direct care is being delivered (< 2 metres) to well children and adults, specific PPE is advised under the likelihood that any person having COVID-19 is increased. In these settings, PPE requirements are apron, gloves, and fluid repellent mask (with the exception of some conditions like nurseries and special schools where a risk assessment for a mask is more appropriate) with the need for eye protection being risk assessed against anticipated/likely risk of contamination with splashes, droplets of blood or body fluids.
– Where direct care is being delivered to very vulnerable well children and/or adults or visiting households with very vulnerable children and/or adults, PPE requirements are apron, gloves and fluid repellent mask. However, the need for eye protection will need to be risk assessed against anticipated/likely risk of contamination with splashes, droplets of blood or body fluids.
– Where direct care is being delivered to symptomatic children and/or adults or direct care to any member of the household where any member of the household is symptomatic, PPE requirements are apron, gloves and fluid repellent surgical mask. The requirement for eye protection must be risk assessed against anticipated/likely risk of contamination with splashes, droplets of blood or body fluids.
– PPE is not required when care can be delivered to well or symptomatic children or adults whilst maintaining a reasonable distance of 2 metres.
Sessional (continuous) use of face masks and eye protection
There is no evidence to suggest that replacing masks and eye protection between each person would reduce risk of infection to you. Instead there may in fact be more risk to you by repeatedly changing your face mask/eye protection as this may involve touching your face unnecessarily. We recommend you use face masks and eye protection continuously until you leave for a break both to reduce risk of transmission and also to make it easier for you to conduct your routine work without unnecessary disruption.
When you take a break, you should remove your face mask and eye protection, a new mask should be used for the next duty period. If the item is re-usable then you must ensure it is appropriately cleaned before reusing it.
Page 8
Page 13
There are circumstances when you would need to remove and replace your face mask or eye protection before the end of your shift;
– if damaged
– if soiled (e.g. with secretions, body fluids)
– if damp
– if uncomfortable
– if difficult to breathe through
Page 18
Disposal of PPE
Home Based Care
Used PPE must be placed in a bag such as a carrier bag by the health/social care worker. This bag must be securely tied closed. It must be left in a safe place where it will not be handled in the clients home for 72 hours. The client / household member must be advised to place this bag in a second waste bag after 72 hours, and then place this in their usual
domestic waste stream. The PPE should NOT be placed in an orange clinical waste bag or be transported by health/social care workers.
Healthcare Settings & Nursing Homes
Waste (including used PPE) from a possible or a confirmed COVID-19 case must be disposed of as Category B infectious waste. The transport of Category B waste is described in Health Technical Memorandum 07-01: Safe management of healthcare waste.