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NEW COVID-19 ENHANCED PROTOCOLS

Posted by Dr. Alda Ngo



We are very excited to reopen on Monday, June 22nd, as part of Stage 2 of Alberta’s Relaunch Strategy!

In order to optimize safety of in-person visits, we will be maintaining infection prevention and control standards with Enhanced Protocols, that meet requirements set by AHS and our Regulatory Colleges.

Click Here for a Summary of What You Need to Know for Your In-Person Appointment

OVERVIEW

  • In-person services proceed when the anticipated benefits outweigh the risks to the client and the practitioner.
  • Practitioners and clinic staff must complete the screening survey for COVID-19 symptoms prior to each work shift to ensure they are safe and fit to work.
  • Practitioners and clinic staff must follow patient screening procedures prior to in-person services.
  • Appointment times are spaced to minimize the number of people in the clinic at any given time, and to allow time for cleaning and disinfecting procedures between clients.
  • Practitioners and staff must wear a mask continuously, at all times and in all areas of the workplace to safely provide in-person services. Clients are also asked to wear a mask while at the clinic.
  • Any instruments or pieces of equipment used in client care must be cleaned and disinfected after each use.
  • Practitioners must carefully consider if they are the most appropriate health professional to address the client’s needs. In-person services are not necessary when the patient’s condition can benefit from Tele-eHealth treatments. Clients must be referred to other healthcare practitioners if it is in their best interest.
  • If the clinic becomes aware of a client who has visited the clinic within 14 days of testing positive for COVID-19, Whole Family Health will call Health Link 811 to report and receive guidance.


SCHEDULING

  • Appointments will be scheduled in a way that minimizes the number of clients in the waiting and reception areas at any given time.
  • Appointments will be scheduled with ample time to clean and disinfect treatment areas between each client.
  • Clients will be asked to wait in their vehicles until their assigned treatment room is available, clean and disinfected. Administrators will phone clients to let them know when we are ready to receive them.


CLIENT SCREENING & INFORMED CONSENT


PRE-SCREENING

  • Clients must complete 2 required Pre-screen Self-assessment Surveys and will not be permitted to attend their appointment without completion of these 2 pre-screen surveys:
  • 48-hour Pre-screen Survey
    • All clients must complete a pre-screening survey that is emailed to them 48 hours prior to their scheduled appointment.
  • In-person Pre-screen Survey
    • Upon arrival, clients are required to complete a second pre-screen survey and have their temperature recorded before proceeding with their appointment.
  • If either survey indicates potential COVID infection, the client must cancel and/or reschedule their in-person appointment and they will be advised to self-isolate and call Health Link 811.
  • People who accompany patients, such as parents, caregivers, or companions, must be screened with the same questions as the client.

INFORMED CONSENT

  • COVID-19 Informed Consent to Treat Form
    • Clients are provided with a revised COVID-19 Informed Consent to Treat Form relevant while Enhanced COVID-19 Guidelines remain in effect.
    • This COVID-19 Informed Consent to Treat Form must be signed prior to their first appointment after June 22nd, 2020.
    • Clients must allow the disclosure of contact information in the event that a client has visited the clinic within 14 days of testing positive for COVID-19.

CLIENTS & COMPANIONS ENTERING THE CLINIC

  • Clients are asked to remain outside the clinic or in their vehicle and notify us by telephone once they have arrived.
  • We will call the client when we are ready to receive them, and their treatment room is available, clean and disinfected.
  • We ask that clients and companions wear a mask when they come to the clinic. If they do not have a mask, we will have a mask available for $2 + GST.
  • Clients and companions must use the hand sanitizer provided upon entering the clinic.
  • Clients and companions must complete the pre-screening survey and have their temperatures recorded upon arrival at the clinic.
  • If the client has not yet reviewed and signed the COVID-19 Consent to Treat Form, they must do so upon arrival for their first scheduled appointment after June 22nd, 2020.
  • Clients are encouraged to bring their own pen. If they don’t have one, we will provide a disinfected pen for use.
  • Clients are advised not to bring extra people to the appointment unless absolutely necessary. For contact tracing purposes, every companion’s pre-screen survey, full name, address and phone number must be recorded in the Clinic Registry. All clinic visitors must allow the disclosure of contact information in the event that a client has visited the clinic within 14 days of testing positive for COVID-19.
  • Clients are asked not to bring any unnecessary belongings into the clinic.

DURING APPOINTMENTS

  • Practitioners must wear a surgical/procedure mask continuously, at all times and in all areas of the clinic to safely provide in-person services.
  • Practitioners will follow AHS mask donning and doffing procedure guidelines.
  • If a pre-screened client is subsequently identified by the practitioner to exhibit signs and symptoms consistent with a respiratory illness, whether COVID-19 is suspected or not:
    • The client must wear a mask and disinfect their hands immediately.
    • The client must isolate from others in the clinic.
    • The in-person treatment will be discontinued and rescheduled.
    • The client will be instructed to self-isolate and to call Health Link 811.
    • Immediately following the client’s departure, the practice area will be cleaned and disinfected.
    • A record of all close contacts of the symptomatic client and other visitors and staff in the clinic at the time of the visit will be kept. This information will be necessary if the symptomatic patient later tests positive for COVID-19.
  • If the clinic becomes aware of a client who has visited the clinic within 14 days of testing positive for COVID-19, Whole Family Health will call Health Link 811 to report and receive guidance.

AFTER APPOINTMENTS

PAYMENT

  • Clients must use the hand sanitizer provided prior to processing payments.
  • No cash payments will be accepted at this time.
  • Clients are encouraged to pay using touch-less methods:
    • Tap-function of credit or debit cards to minimize touching the merchant terminal.
    • On-line payments through Jane App. Clients would need to have a valid credit card number on file, which are securely encrypted in the Jane App.


RECEIPTS

  • Electronic receipts will be emailed to limit the exchange of papers.
  • If papers are required, clients are encouraged to bring their own pen. If they don’t have one, we will provide a disinfected pen for use.


STAFF HEALTH SCREENING

  • Practitioners and staff must stay up-to-date with current COVID-19 guidelines and policies from their respective governing bodies, CAAA, NHPC, Public Health, and the Government of Alberta.
  • Under no circumstances will a practitioner or staff attend work if any of the following applies:
    • They are feeling unwell or exhibiting any symptoms of fever, cough, runny nose, sore throat, or shortness of breath.
    • They have travelled internationally within the last 14 days.
    • They have been in close contact with confirmed or suspected cases of COVID-19.
  • Practitioners and staff must follow self-isolation and quarantine requirements when the order (CMOH Order 05-2020) remains in effect.


DAILY PRE-SCREEN SELF-ASSESSMENT SURVEY

  • All Practitioners and staff are to record their temperature and complete a Pre-screen Self-assessment Survey prior to attending work.
    • If the survey indicates possibility of respiratory-related or COVID-like symptoms, the staff member does not attend work.
  • Screening questions for practitioners and staff of the clinic are:
    • Do you have any of the following symptoms: fever, cough, shortness of breath, difficulty breathing, sore throat, and/or runny nose?
    • Have you returned to Canada from outside the country (including USA) in the past 14 days?
    • In the past 14 days, have you been at work or elsewhere, while not wearing appropriate personal protective equipment.
    • Did you have close contact with someone who has a probable or confirmed case of COVID19?
    • Did you have close contact with a person who had acute respiratory illness that started within 14 days of their close contact, to someone with a probable or confirmed case of COVID-19?
    • Did you have close contact with a person who had acute respiratory illness who returned from travel outside of Canada in the 14 days before they became sick?
    • Did you have a laboratory exposure to biological material (i.e. primary clinical specimens, virus culture isolates) known to contain COVID-19?
  • If the answer is “YES” to any of the above, staff are not permitted to attend work and must self-isolate.


FACILITY REQUIREMENTS

  • Staff will be transitioned to home offices as much as possible.
  • Access to approved hand sanitizer will be increased.
  • A physical plexi-glass barrier has been installed at the reception desk.
  • Practitioners and staff must wear a mask continuously, at all times and in all areas of the workplace to safely provide in-person services.
  • Clients are also asked to wear a mask while at the clinic. If they do not have one, we will provide one for $2 + GST.
  • Seats in waiting areas have been removed to allow for safe physical distancing.
  • Safe physically distanced spots have been clearly demarcated on the floor in the reception area.
  • All items that cannot be disposed of, will be cleaned and disinfected between clients:
    • Pens, clipboards, POS terminal, call buttons, needle trays, etc..
  • Items that cannot be effectively cleaned and disinfected between clients have been removed from the clinic environment:
    • Magazines, toys and water dispensers from waiting areas
    • Chairs and other items with porous fabric upholstery (unless donned with vinyl coverings)
    • All non-essential items must also be removed
  • Signage with the following information will be visibly posted for staff and clients:
    • Physical distancing
    • Hand hygiene (hand washing and hand sanitizer use)
    • Help limiting the spread of infection
    • Safe donning and doffing of masks
  • These clearly defined COVID-19 prevention protocols and policies will be posted on our website and/or printed upon request.


HAND HYGIENE & PPE

  • Face protection protects the eyes, nose, and mouth from exposure to contaminated droplets.


MASKS

  • Practitioners must wear a surgical/procedure mask continuously, at all times and in all areas of the workplace to safely provide in-person services.
  • Practitioners will follow procedures on Donning and Doffing of mask according to Alberta Health Service website:
    • Wash hands before donning and doffing mask
    • Ensure a snug fit over the nose and under the chin
    • Wear the mask with the moisture-absorbing side against the skin
    • Change the mask when it is moist or soiled
    • Only touch the elastic or ties when removing the mask
    • Do not wear the mask around the neck
    • Discard single-use masks in a waste container
  • Any staff that do not work in patient-care areas or have direct patient contact are required to mask at all times in the workplace (a non-medical mask is acceptable).


EYE PROTECTION

  • Eye protection may also be worn, as it provides another layer of safety. This can include safety glasses, goggles, or face shields.
  • Practitioners and staff may choose to implement these measures.
  • Services offered around clients’ mouths, nose and eyes are currently strongly discouraged. However, if treatment in these areas is necessary, practitioners must don a face shield, mask, gloves and apron.


HAND HYGIENE

  • Practitioners must practice routine hand hygiene consistent with Alberta Health Services 4 Moments of Hand Hygiene:
    • Before contact with patient’s environment and/or patient
      • Prior to entering treatment room
      • Prior to physical contact with clients ie. pulse / acupuncture/ massage
    • Before clean/aseptic procedure
      • Prior to acupuncture or massage treatment
    • After body fluid exposure risk
      • After acupuncture or massage treatment
    • After contact with patient and/or patient’s environment
      • After pulse, acupuncture or massage treatment
      • Prior to leaving treatment room
  • Practitioners must also avoid touching their face and practice respiratory etiquette by coughing or sneezing into their elbow or covering coughs and sneezes with a facial tissue and then disposing of the tissue immediately.
  • All staff must wash hands for a minimum of 20 seconds with soap and water between each client, after handling shared items or cleaning and disinfecting, before donning gloves and after doffing gloves.
  • Clients will be asked to complete hand hygiene using the provided hand sanitizer at the following times:
    • Upon arrival to the clinic
    • Prior to processing payment
    • Prior to departure from the clinic


GLOVES

  • As long as appropriate hand hygiene protocols are practised, AHS does not require the use of single-use disposable gloves during treatment (unless the client requires treatment around the eyes, nose and mouth).
  • Individual practitioners and clients may prefer that the practitioner wear gloves during the treatment session as an extra safety measure.
  • If practitioners choose to wear gloves while practising, they must continue to follow hand-washing protocols and glove-wearing protocols.
  • Gloves are part of routine precautions and can be worn as a safeguard against exposure to blood, body fluids, secretions, excretions, and mucous membranes.
  • Otherwise, gloves must be worn in the clinic when:
    • Handling clean linens
    • Handling contaminated linens
    • Performing routine environmental cleaning in the clinic
    • Handling waste
    • Required by a health alert


ENVIRONMENTAL CLEANING AND DISINFECTION

  • Effective cleaning and disinfection are essential to prevent the spread of COVID-19, which is transmitted primarily through contact with respiratory droplets, or from contact with contaminated surfaces.
  • Whole Family Health will use the “wipe-twice” method to clean and disinfect: wiping surfaces with a cleaning agent to clean soil off first and then wiping again with a disinfectant.
  • All disinfecting will be accomplished using a Health Canada approved hard-surface disinfectant for use against COVID-19 (with a DIN number).
  • Patient care/patient contact items will be cleaned and disinfected between each patient/use including (but not limited to):
    • treatment tables
    • chairs
    • all contact surfaces
    • entire headpieces
    • pillows
    • therapeutic tools and devices (e.g. cupping tools and acupressure tools)
    • call buttons
    • pin pads used to process payment
    • reception area
    • clip boards
    • pens/ pencils
  • Highly touched areas in treatment rooms will be cleaned between each client including (but not limited to):
    • doorknobs
    • countertops / desktops
  • General highly touched areas will be cleaned and disinfected every 2-3 hours or whenever visibly soiled (including but are not limited to):
    • light switches
    • doorknobs
    • toilets
    • taps
    • handrails
    • counter tops
    • touch screens/mobile devices
    • phones
    • keyboards


LINENS

  • Any cloth items, such as towels, sheets, headrest coverings, etc., that are used in the clinic will be laundered in hot water (above 60°C) with regular laundry soap before being dried and used again.
  • Gloves will be donned when handling these items for both dirty and clean laundry processing.
  • Staff must always use new gloves when handling clean laundry.


RECORD KEEPING

  • Clear documentation records are essential to ensure the successful implementation of COVID-19 prevention protocols and policies.
  • Whole Family Health will keep the following accurate and up-to-date records:
    • Pre-screening questions for symptoms of COVID-19 for all staff, clients and client accompanying companions
    • COVID-19 Consent to Treat Forms
    • Actual appointment dates and times (arrival and departure)
    • Up to date addresses and phone numbers of all patients and companions
    • Specific treatment rooms used
  • In addition, separate files must be kept for the following information:
    • Practitioners’ and staff’s daily health screening records and up-to-date contact information
    • Daily cleaning and disinfection records
  • A registry of all people entering the clinic, including the Practitioners, staff, people in the clinic aside from clients (e.g. repair people, guardians accompanying a client, etc.).
    • At a minimum, the following information should be included:
      • Name
      • Phone number
      • Date
      • Arrival time
      • Departure time

THANK YOU

We thank everybody for your support and cooperation with helping us to adhere to these Enhanced Guidelines, in order to keep our staff, clients and broader community safe and healthy.

We are happy to provide you with a printed copy of these Enhanced Guidelines upon request.

Please feel free to contact us for any additional information.