COVID-19 resources on infection control

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Personal protective equipment (PPE): care workers delivering homecare during the Covid-19 response

Healthcare Safety Investigation Branch

This national intelligence report provides insight into a current safety risk that the Healthcare Safety Investigation Branch (HSIB) has identified, relating to the use of personal protective equipment (PPE) by care workers when visiting a patient at home. It documents how concerns raised by HSIB were responded to by Public Health England, the body responsible for the development of guidelines for the appropriate use of PPE. The report finds that there are multiple Covid-19 guidelines for different care sectors. PPE guidelines should be used in conjunction with other guidelines, such as infection control guidelines, so that care providers can develop protocols for care delivery. This is challenging when guidelines are updated, or new guidelines are issued and there is a risk that guidance may be missed. The report argues that there is an opportunity to introduce a document management system for guidelines to ensure that the latest information is available. This would involve the design of a usable navigation system so that all related guidelines relevant to a particular care sector are visible and can be checked for completeness.

Last updated on hub: 01 September 2020

Personal protective equipment (PPE): resource for care workers delivering homecare (domiciliary care) during sustained COVID-19 transmission in the UK

Public Health England

Guidance for those working in domiciliary care providing information on the use of personal protective equipment (PPE) during sustained coronavirus (COVID-19) transmission in the UK. It explains how PPE guidance applies to the homecare (domiciliary care) setting and is drawn from full infection prevention and control (IPC) and PPE guidance. The guidance is primarily for care workers and providers delivering care in visiting homecare, extra care housing and live-in homecare settings. [Published 27/04/202. Updated 7/10/2020]

Last updated on hub: 28 April 2020

Personal protective equipment (PPE): resource for care workers working in care homes during sustained COVID-19 transmission in England

Public Health England

This guidance provides advice for care workers working in care homes on the use of personal protective equipment (PPE) during the period of sustained transmission of the coronavirus (COVID-19). The guidance is also relevant for those providing residential supported living. This resource, which has been designed to be accessible to both care workers and providers, has four sections containing: recommendations on the use of PPE for a range of relevant contexts; explanation concerning recommendations and frequently asked questions; specialist advice relating to care for people with learning disabilities and/or autism; and case scenarios designed to illustrate appropriate use of PPE in practice. It should be read in conjunction with the full infection prevention and control (IPC) and PPE government guidance. [Published 17 April 2020; Last updated 7 October 2020]

Last updated on hub: 23 June 2020

Perspectives from the front line: the disproportionate impact of COVID-19 on BME communities

NHS Confederation

This report distils the findings of a research study into the underlying factors affecting the disproportionate impact of Covid-19 on black and minority ethnic (BME) communities. It is based on interviews with BME NHS leaders, clinicians, community organisations and service users, and a survey of over 100 members of the NHS Confederation’s BME Leadership Network. Topics covered include: inequalities and health; institutional racism; racial discrimination on the front line; communication; and the Black Lives Matter movement. Overwhelmingly, participants point to long-standing inequalities and institutional racism as root causes. Interviewees were united in the view that despite the wealth of data collected by the national bodies and numerous reviews on the relationship between health, inequalities and BME communities, the NHS and government had not taken sufficient action to address the underlying issues. To redress this, it will be crucial to treat long-term structural health inequities and institutional racism as critical factors when planning services and emergency responses. To break down barriers to accessing healthcare, the government should take immediate steps to review the potential for hostile environment policies to be a vehicle for promoting institutional racism. BME health and care professionals were reported to be more likely to take on high-risk roles, including working on COVID-19 wards, due to fear that contracts may not be renewed or shifts reduced – this was compounded by a bullying culture which meant that BME employees were less likely to raise concerns or share their experiences. The report argues that the health service should look to adopt a new model of leadership that welcomes and values innovators with roots in BME communities and a track record of anti-racism. Integrated care systems should lead the development of governance and human resources functions that facilitate diverse leadership in line with commitments in the NHS People Plan.

Last updated on hub: 04 January 2021

Pilot point prevalence survey of COVID-19 among domiciliary care staff in England

Public Health England

This pilot study provides the first estimate of the extent of COVID-19 infections among domiciliary care workers in England. A prospective descriptive survey of a sample of workers from domiciliary care providers was carried out in June 2020, using a sampling frame of all care providers in England registered with CQC. The findings provide evidence that the prevalence of COVID-19 among domiciliary care workers is in line with the general population as opposed to a higher prevalence as observed in studies of front-line healthcare workers and care home staff. It should be noted that this study took place post the peak of the first wave of the COVID-19 pandemic and as a result its findings are not directly comparable to those emerging from care home and healthcare worker studies.

Last updated on hub: 16 July 2020

Policy briefing: the COVID-19 vaccination and unpaid carers (England only)

Carers UK

Unpaid carers are included in the priority lists for the COVID-19 vaccine in the same way that they are for the flu jab. This briefing sets out the position in more detail and explores recommendations for deployment of the vaccine to unpaid carers in detail.

Last updated on hub: 13 January 2021

Potential impact of COVID-19: government policy on the adult social care workforce

Institute for Employment Studies

This report is the output of a research project to identify how government COVID-19 related policy may have impacted upon the adult social care workforce in England. The project had a particular focus on Test and Trace, and the ways in which policy changes may have enabled and incentivised the necessary behaviours of care workers. The working hypothesis has been that care workers’ behaviours are likely to be driven by a combination of commitment to those they care for, risks to themselves and their families from COVID-19 and impacts on incomes. Government policy changes were identified based on the assumed likelihood to impact on these factors. The key findings and observations include: the fragmented nature of the sector is likely to make it challenging to get information and support to the people that need it, and therefore ensure that the desired behaviour changes are happening; government guidance and measures appear to have been rushed, heavily focused on care homes and their workers, and impossible to find in one place on the internet; testing has been hard to access – this has been a disincentive to get tested, as is the fear of being unable to work if testing positive; a major concern for individuals is loss of income if having to rely on Statutory Sick Pay. The report makes recommendations for further research into the actual impact of policy on the workforce and suggestions for improving policy development, communication and implementation.

Last updated on hub: 29 September 2020

PPE guide for community health and social care settings: what PPE to wear and when: an illustrative guide

Public Health England

This resource outlines personal protective equipment (PPE) advice for health and social care workers in community setting to prevent the transmission of COVID-19. It shows: which PPE to wear depending on where and how staff are working; how to work safely using your PPE and safer working practices to protect staff and residents. The guide sets out five common scenarios community health and social care professionals might encounter, describing what PPE they should wear in each case. The scenarios include: personal care involving touching the person who is cared for; when professionals are within 2 metres of anyone who has a cough; when staff are within 2 metres of the individual being cared for but not touching them; when staff are caring for a person who is shielding; and when they are in the workplace and 2 metres away from people they are caring for. This guidance should be used in conjunction with local policies.

Last updated on hub: 10 August 2020

Practical steps to improve air flow in long-term care resident rooms to reduce COVID-19 infection risk

Journal of the American Medical Directors Association

The potential for spread of COVID-19 infections in skilled nursing facilities and other long-term care sites poses new challenges for nursing home administrators to protect patients and staff. It is anticipated that as acute care hospitals reach capacity, nursing homes may retain COVID-19 infected residents longer prior to transferring to an acute care hospital. This article outlines 5 pragmatic steps that long-term care facilities can take to manage airflow within resident rooms to reduce the potential for spread of infectious airborne droplets into surrounding areas, including hallways and adjacent rooms, using strategies adapted from negative-pressure isolation rooms in acute care facilities.

Last updated on hub: 13 November 2020

Preparing for a challenging winter 2020/21

Academy of Medical Sciences

This report considers a worst-case scenario for winter 2020/21 – a likely mix of COVID-19, bad seasonal influenza and cold weather; what this would mean for deaths, NHS capacity and social care; and the actions that would enable the health and social care system to better cope in the face of new winter pressures resulting from the pandemic. The need for health and social care undergoes large seasonal fluctuations, peaking in the winter, with the NHS and social care systems typically operating at maximal capacity in the winter months. The report identifies four additional challenges that have great potential to exacerbate winter 2020/21 pressures on the health and social care system, by increasing demand on usual care as well as limiting surge capacity: a large resurgence of COVID-19 nationally, with local or regional epidemics; disruption of the health and social care systems due to reconfigurations to respond to and reduce transmission of COVID-19; a backlog of non-COVID-19 care; and a possible influenza epidemic that will add pressure. The paper argues that there is a need for urgent preparation to mitigate the risks of a particularly challenging winter 2020/21, including: minimising community SARS-CoV-2 transmission and impact; organising health and social care settings to maximise infection control and ensure that COVID-19 and routine care can take place in parallel; improving public health surveillance for COVID-19, influenza and other winter diseases; and minimising influenza transmission and impact, including by maximising the uptake of influenza vaccination by health and social care workers. Includes a ‘Peoples perspective’ report in appendix, written by patients and carers, that calls for the actions to be developed through engagement with patients, carers and the public to ensure services, guidelines and communications work for people, rather than focusing plans on individual medical conditions.

Last updated on hub: 16 July 2020

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