Covid - 19 infection control policy - updated 24.06.21


1. All clients are triaged for suitability for their initial (new patient) appointment by telephone or email, and if not suitable (clinically extremely vulnerable, high risk, >28 weeks pregnant etc) are seen virtually via Zoom (as per government and CSP guidelines).


2. All existing clients are given the option to switch their appointment to virtual, or to postpone, during any lockdowns or if they feel uneasy about attending (for example due to local rises in case numbers).


3. If a face-to-face appointment is required (either for further assessment or if hands on treatment is indicated) due to a risk of deteriorating health, increased pain or worsening function without, then this can be booked, following risk assessment (client not in high risk group: over 80, more than 28 weeks pregnant or shielding due to being extremely clinically vulnerable to Covid-19).


4. Ambulatory outpatient clients in community settings are considered to be on the medium risk Covid pathway, unless they have had a negative Covid test in last 72 hours in which case they are low risk. If they have had a positive test in past 10 days or still have a fever they are considered high risk and will not be seen.


5. On booking the face-to-face appointment, all Covid-19 related procedures and requirements (outlined in this document) must be explained to the patient, as must the risks involved with direct contact over a prolonged appointment time. Informed consent is gained at this point and at the beginning of every appointment.


6. All patients must wait in their car or outside on arrival for their appointment to minimise potential for cross over with other clients.


7. I am testing myself (and my family) for Covid-19 twice weekly using a lateral flow device (LFD). If I (or any of the family) were to test positive, we would isolate as appropriate and appointments would be cancelled either for the full 10 days, or until a negative PCR test meant that was no longer required. 


8. For all appointments, I will be wearing clean theatre scrubs (sessional wear only), a type IIR surgical face mask (single patient use only), gloves (single patient use only, and changed prior to touching patient for assessment or treatment purposes), and a disposable apron (single patient use only).


9. All patients will be telephoned (or met outside) at the time of their appointment and screened for Covid-19 symptoms (do you have a fever, a new cough or a change in your sense of taste or smell?). They will also be asked whether they are a close contact of someone with Covid-19 or whether anyone they live with has any symptoms of Covid-19 – in which case they should be at home isolating. If anyone answers positively to any of these questions their appointment will be rescheduled.


10. Providing the answer is no to all screening questions, I will then meet the patient at the open door, and check their temperature with an infrared thermometer – providing temp is less than 37.5, we can proceed with appointment.


11. If it is necessary to touch the patient during the appointment, I first will remove the gloves I have been wearing since the beginning of their appointment (using standard infection control methods), wash my hands thoroughly (for at least 20 seconds using anti-bac soap), and apply a pair of fresh gloves prior to the procedure.


12. If performing a vaginal / rectal examination or myofascial release treatment, and it is necessary to swap the treating hand, gloves are removed, hands are washed, and new gloves are put on, as above (this is as per standard infection control procedures).


13. Gloves will be worn at all times for all manual therapy or for administering acupuncture.


14. After treatment, gloves are removed and hands are washed as above. Any equipment used (eg electrical stimulation unit, biofeedback unit, TENS machine, ultrasound scanner probes etc are wiped with Clinel wipes).


15. Following treatment the patient is asked to sanitise their hands prior to leaving the building. All doors are opened for them by me.


16. Clients are encouraged to pay for their appointment by BACS, and to not enter reception (Hadleigh clinic only). Subsequent appointments are booked by myself during the appointment again to avoid patient entering reception.


17. After the patient has left the building the clinic room is cleaned in the following way – the couch, pillows (they are covered in plastic), patient chair and hand sanitiser bottle is wiped down with Clinel wipes (plus any other surfaces the patient has touched – tissue box, clipboard, pen or door handles for example).


18. The door is left open to ventilate the room prior to the next appointment. There is a 15 min gap between appointments to allow for this.


19. The clinic room window is left open (only possible In Hadleigh). The air conditioning unit is not used at any time (Hadleigh only.


20. If a patient or myself needs to use the toilet, the door handle, lock, light switch, flush, taps and antibac soap dispenser are wiped down with Clinel wipes. The toilet is to be considered “closed” where at all possible (although this is acknowledged to be difficult for pelvic health clients, and some will inevitably need to use it, particularly those travelling long distances for their appointment).


21. Before and after a session, in addition to those things wiped down after a patient appointment, I will also wipe down the desk, therapist chair, therapist hand sanitiser, clipboard, pen, light switches and door handles with Clinel wipes.


22. I will maintain social distancing at all times with other staff members, and will wear a facemask should I need to enter reception (Hadleigh only).


23. I will socially distance as far as possible with all patients during appointments, although this will not be possible during physical assessment and treatment.


References:

https://www.csp.org.uk/system/files/publication_files/F2FCountrydocFINAL.pdf

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/910885/COVID-19_Infection_prevention_and_control_guidance_FINAL_PDF_20082020.pdf?fbclid=IwAR2MAQkNAu_EIBmKq_zUS29g5_NqOMNnqOpKVGpyprTCCvLRr1Jm8zhOyWw#page26


https://www.physiofirst.org.uk/uploads/assets/7c263eab-e753-4bfc-9329f4a263ee6a1a/Practicalities-checklist-updated-2310.pdf?utm_source=Lapsed+Members+%282016-2020%29&utm_campaign=bb20ae36fc-EMAIL_CAMPAIGN_2019_09_02_03_25_COPY_01&utm_medium=email&utm_term=0_7c0a6bdd85-bb20ae36fc-177336422


Author: Helen Forth

Helen Forth Physiotherapy

Pelvic Health Physiotherapy Specialist

For practice at Hadleigh Physiotherapy and Sherbourne Lodge Wellbeing Centre

Policy in operation since return to face to face practice 04.09.20

Updated 14.01.21, 26.04.21 and 24.06.21


Notes:

I was vaccinated with the first dose on 19.01.21. Two weeks later (so from 02.02.21) I felt I no longer needed to be concerned what type of face mask clients were wearing, provided they were wearing a well fitting face covering. I had previously requested a type IIR surgical face mask.

I received my second dose of the vaccine on 07.04.21, and so on 26.04.21 stopped wearing the additional face shield on 26.04.21.

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