COVID-19 resources for health care providers

General information regarding public health management of cases and contacts of COVID-19 in Ontario is available. Isolation period for test-positive cases and individuals with COVID-19 symptoms are outlined in Table 1 of this document.

Guidance provided by the MOH and other relevant Ministries or organizations may provide additional information about outbreaks and preventative measures in different settings (e.g., acute care, long-term care homes (LTCHs) /retirement homes (RHs), congregate living settings (CLSs), COVID-19 Provincial Testing Guidance). Instructions for COVID-19 cases and close contacts associated with LTCHs, RHs and CLSs is available in appendix D.

Resources

Environmental Cleaning – Clinical setting

Maintaining a safe, clean and hygienic environment and minimizing microbial contamination of surfaces, items and equipment within the health care environment is increasingly recognized as an essential approach to reducing the risk of health care-associated infections for all patients/residents/clients, visitors and staff within health care settings. The best practices set out in PIDAC’s Best Practices for Environmental Cleaning for Infection Prevention and Control provide criteria for cleanliness in health care settings that may be adopted by environmental service managers for their use or for the use of contracted services.

Other considerations:

Follow your ‘terminal cleaning’ protocol for cleaning of a patient's room after discharge, transfer or discontinuation of precautions. See Appendix 6 in the Best Practices for Environmental Cleaning for Prevention and Control of Infections in All Health Care Settings, 3rd Edition for a sample ‘terminal cleaning’ procedure.

Ensure rooms have minimal equipment or supplies to help facilitate the environmental cleaning process.

Infection Prevention and Control (IPAC) measures

As per IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID19 the recommended PPE when providing direct care for patients with suspect or confirmed COVID-19 includes a fit-tested, seal-checked N95 respirator (or equivalent or greater protection), eye protection, gown, and gloves. Other alternate appropriate PPE includes a well-fitted medical mask (surgical/procedure), or non-fit tested respirator, eye protection, gown and gloves for direct care of patients with suspect or confirmed COVID-19.

Staff in all clinical offices should collect triaging information on the phone at the time of booking, if appropriate (e.g., same day or next day booking). Information collected should be based on symptoms of communicable disease or acute respiratory infection (ARI), such as cough, fever, vomiting or diarrhea. Additional screening, in keeping with the patient population, (e.g., chickenpox in pediatric populations, conjunctivitis in ophthalmology populations) may be added. Further information regarding IPAC practices can be found in Public Health Ontario’s Infection Prevention and Control for Clinical office Practice.

Specific IPAC measures include:

Signage is displayed requesting patients with symptoms to wear a mask, perform hand hygiene upon entering the office, and practice cough etiquette.
Performing hand hygiene (i.e., using alcohol-based hand rub or washing hands with soap and water) before entering and after exiting the patient’s room, and after taking off and disposing of personal protective equipment.
Instruct the patient that if they need to cough or sneeze, to do so into a tissue and clean their hands or cough into their sleeve.
Instruct the patient to wear a surgical or procedure mask if tolerated.
In the community office setting, patients with suspected or confirmed COVID-19 should be placed immediately in a separate room with the door closed.
Conducting examination procedures that minimize contact with droplets or aerosols (i.e., sitting next to rather than in front of a coughing patient).
Wearing appropriate Personal Protective Equipment (PPE) when caring for a patient with suspected or confirmed COVID-19:

Wear eye protection (goggles or face shield).
Wear gloves and gown.
Wear a fit-tested, seal-checked N95 respirator (or equivalent or greater protection).
COVID-19 Guidance for the Health Sector - Ontario Ministry of Health and Long-Term Care - provides specific health care setting guidance for mask use.
Use Airborne Precautions when aerosol generating medical procedures (AGMPs) are planned or anticipated to be performed on patients with suspected or confirmed COVID-19.

All staff that are required to wear personal protective equipment (PPE) need to be properly trained in the recommended steps for putting on and taking off PPE.