This latest guidance ( Guidance: Covid 19 Personal Protective Equipment (PPE) Updated 2 April 2020 ) has been developed by Department of Health and Social Care, Public Health Wales, Public Health Authority Northern Ireland, Health Protection Scotland, Public Health England and NHS England.
It sets out the main changes to previous guidance as follows:
- enhanced PPE recommendations for a wide range of health and social care .(Table 2 sets out various care scenarios where people might have or are known to have Covid 19. These all require PPE including eye protection.)
- inclusion of individual and organisational risk assessment at local level to inform PPE use (the guidance states that ‘where staff consider there is a risk to themselves or to the individuals they are caring for they should wear a fluid repellent surgical mask with or without eye protection, as determined by the individual staff member for the episode of care or single session.’)
- recommendation of single sessional (extended) use of some PPE items
- re-usable PPE can be used. Advice on suitable decontamination arrangements should be obtained from the manufacturer, supplier or local infection control
- guidance for when case status is unknown and SARS-CoV-2 is circulating at high levels (This new guidance appears to be suggesting in Table 4 that where care/support is being provided to people who do not have symptoms or are not known to have Covid 19 but where care/support entails working within 2 metres of a person then PPE should be worn if there is known transmission of Covid 19 in the service.)
- recommendation on patient use of facemasks
The guidance goes on to summarise safe ways of working for all health and care workers:
- staff should be trained on donning and doffing PPE. Videos are available for training
- staff should know what PPE they should wear for each setting and context (the Tables included in the guidance have been designed to assist with this)
- staff should have access to the PPE that protects them for the appropriate setting and context
- gloves and aprons are subject to single use as per SICPs with disposal after each patient or resident contact
- fluid repellent surgical mask and eye protection can be used for a session of work rather than a single patient or resident contact
- gowns can be worn for a session of work in higher risk areas
- hand hygiene should be practiced and extended to exposed forearms, after removing any element of PPE
- staff should take regular breaks and rest periods
Health Protection Scotland is in the process of updating its existing guidance to accommodate this guidance and have developed a series of posters (A4 size and A3 size) for organisations to use to help explain when and what type of PPE should be used.
On 9th April, the Scottish Government with COSLA and the SJC Unions issued a joint statement in regard to use of PPE in social care settings (Jointly Agreed Statement on PPE), fully recognizing the guidance issued by Department of Health and Social Care, Public Health Wales, Public Health Authority Northern Ireland, Health Protection Scotland, Public Health England and NHS England.