Covid-19 Policy

Rory Holliday Physiotherapy

COVID – 19 POLICY

WRITTEN June 2020

UPDATED June 2022

PURPOSE

In response to the COVID-19 Pandemic, Rory Holliday Physiotherapy (RHP) and Sherwood Wellness aim to reduce the risk of transmission of the virus within the working environment as far as practicably possible. This policy sets out the considerations and actions.

BACKGROUND

Epidemiology (taken from GOV.UK)

On 31 December 2019, the World Health Organisation (WHO) was informed of a cluster of cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province, China.

On 11 March 2020 WHO declared a global pandemic

Transmission

A zoonotic source of the outbreak has not been identified yet, but investigations are ongoing.

According to current evidence, the COVID-19 virus is primarily transmitted between people through respiratory droplets and contact routes.

In the context of COVID-19, the airborne transmission may be possible in specific circumstances and settings in which procedures or support treatments that generate aerosols are performed.

Clinical features

Symptoms of COVID-19, flu and common respiratory infections include:

  • continuous cough
  • high temperature, fever or chills
  • loss of, or change in, your normal sense of taste or smell
  • shortness of breath
  • unexplained tiredness, lack of energy
  • muscle aches or pains that are not due to exercise
  • not wanting to eat or not feeling hungry
  • headache that is unusual or longer lasting than usual
  • sore throat, stuffy or runny nose
  • diarrhoea, feeling sick or being sick

SCOPE

HSE no longer expects every business to consider COVID-19 in their risk assessment or to have specific measures in place. Employers may still choose to continue to cover COVID-19 in their risk assessments.

As we learn to live safely with coronavirus (COVID-19), there are actions we can all take to help reduce the risk of catching COVID-19 and passing it on to others. These actions will also help to reduce the spread of other respiratory infection, such as flu, which can spread easily and may cause serious illness in some people.

This policy applies to all clinicians working under the umbrella of Rory Holliday Physiotherapy & Sherwood Wellness.

This policy has been developed alongside guidance from Gov.uk: Working Safely During Coronavirus (COVID-19).

  1. Carry out a COVID-19 risk assessment 
    1. RHP has completed a risk assessment for practice of Physiotherapy and associated therapies. (SEE COVID-19 RISK ASSESSMENT). This incorporates guidance from: -
  • Health and Safety Executive
  • Chartered Society of Physiotherapy 
  • Public Heath England
    1. RHP will review the risk assessment annually and update as required.
    2. RHP will update Risk Assessment in line with National guidance and legislation from Gov.uk.
    3. RHP will update the risk assessment immediately following a related incident occurring.
    4. risk assessment results will be shared with all clinicians 

2. Cleaning, hand washing and hygiene procedures

2.1. Clinic equipment and surfaces will be cleaned between clients. See Appendix 1 for the cleaning protocol

2.2. Clinicians will follow hand hygiene procedures before and after seeing each client and after cleaning regimes.

2.3. Clients will be asked to perform hand hygiene on entering the clinic and before leaving. See Appendix 2a & 2b for hand-washing/gelling guidelines

2.4. PPE will be available for client contacts and cleaning regimes. The use of PPE will be risk assessed between therapist and client on an individual basis. See appendix 3 for PPE guidelines and Appendix 4 for Donning and Doffing procedure

2.5. Rubbish bags will be tied up at the end of the day and disposed of in line with guidelines See appendix 1.

2.6. Cleaning products will be stored securely in clinic rooms, not in public areas (with the exception of hand-wash and gel).

3.  social distancing, where possible

3.1. There are no longer guidelines for social distancing, however, RHP and Sherwood Wellness encourage distancing around the premises where practicable.

3.2. Clients will be asked to attend the clinic at their appointment time to limit number of people in shared areas e.g. reception.

3.3. Clinic rooms will be strictly one-in-one out unless a chaperone/carer is required.

3.4. Shared reception desks will not currently be used. Where communal areas such as entrance/exit cannot be avoided, a limited number of chairs will be provided.

4. PPE

4.1. PPE will be available for each client in line with the nature of the intervention.

4.2. Face Coverings

4.2.1. Face masks are recommended for all communal areas.

4.2.2. Surgical masks should: 

  • • cover both nose and mouth 
  • • not be allowed to dangle around the neck after or between each use 
  • • not be touched once put on 
  • • be changed when they become moist or damaged 
  • • be removed and placed in a lidded container if to be reused. Hand hygiene must be performed after disposal.

4.2.3. Surgical masks may be used for Sessional use (PHE describe this as between 2-6 hours depending on the specific clinical environment and whether the mask has become moist or damaged.)

    4.3. Gloves

Non-powdered, nitrile gloves are the most commonly recommended for healthcare.

    4.4. Disposable aprons

  1. STAFF

5.1. Any staff with symptoms of COVID-19 will be asked to follow government guidelines.

5.2. Staff will be encouraged to have a vaccination against COVID 19

5.3. Drinking water is available in clinics to ensure workers are appropriately hydrated during prolonged use of PPE which can lead to dehydration, fatigue and exhaustion.

5.4. Staff will be asked to familiarise themselves with this policy and all the accompanying documentation relating to COVID 19

5.5. Staff will be expected to watch the PHE Donning and Doffing Video 

5.6. staff will be expected to ask patients to perform hand-washing/gelling pre and post-treatment sessions

5.7. Staff will be expected to report any concerns to RHP immediately.

5.8. Ventilation is provided via electric extractor fans

5.9. Staff will be expected to clean clinical areas between each client.

6. Exposure to COVID-19

6.1. If a staff member or client tests positive for COVID-19, they will be expected to follow government guidelines.

REFERENCES

  • COVID-19 INFORMATION

https://www.gov.uk/government/publications/wuhan-novel-coronavirus-background-information/wuhan-novel-coronavirus-epidemiology-virology-and-clinical-features

https://www.nhs.uk/conditions/coronavirus-covid-19/symptoms/

  • INFECTION CONTROL: 

https://www.england.nhs.uk/south/wp-content/uploads/sites/6/2017/09/catch-bin-kill.pdf

How to wash your hands - NHS (www.nhs.uk)

  • PPE

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/877658/Quick_guide_to_donning_doffing_standard_PPE_health_and_social_care_poster__.pdf 

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/878677/PHE_11606_Putting_on_PPE_062_revised_8_April.pdf

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/878678/PHE_11606_Taking_off_PPE_064_revised_8_April.pdf

  • MENTAL HEALTH RESOURCES

https://www.mind.org.uk/information-support/coronavirus/

  • WORKING SAFELY

https://www.gov.uk/guidance/working-safely-during-coronavirus-covid-19/5-steps-to-working-safely

https://www.hse.gov.uk/simple-health-safety/risk/index.htm

Maintaining safe services: supporting you to make safe decisions about patient contact | The Chartered Society of Physiotherapy (csp.org.uk)

Coronavirus (COVID-19) – Advice for workplaces (hse.gov.uk)

Reducing the spread of respiratory infections, including COVID-19, in the workplace - GOV.UK (www.gov.uk)

Appendix 1 cleaning protocol

Rory Holliday Physiotherapy & Sherwood Wellness 

Infection Control and Cleaning Protocol

1st June 2022

Before treating a Patient:

Wash your hands before applying PPE

Put a paper towel on a plinth.

During Treatments:

Limit the use of towels (use paper roll if possible), used towels should then be put in the laundry bin

Patient equipment which cannot be adequately disinfected such as elastic loops and bands should be purchased by the patient for their use only and not shared within the clinic.

Avoid touching your face during treatment.

Pillows with wipe clean pillow cases.

Protocol For Cleaning Between Patients:

Between each patient, we will allow 15 minutes to clean all surfaces using soap spray and wipes provided.

Clean your hands with soap and water after removing PPE.  Change gloves for cleaning.

Using soap spray and paper roll clean:

  • The plinth, paying attention to the nose hole area and metalwork underneath it
  • Pillowcases
  • Chair handles

Anti-viral wipes/sprays are then used to wipe down the face hole, door handles, iPad, any pens used, switches and sockets, and door handles in the reception area. 

Wipes to be used to clean down any equipment used eg gym ball, reflex hammers, massage lotion bottles.

Taps and soap dispenser to be wiped down with anti-viral wipes/spray including those in patient toilet.

Used wipes to be put in a normal bin along with couch roll and PPE.  Remove gloves used for cleaning and wash hands thoroughly with soap and water. Don PPE before seeing the next patient.

General Notes:

All doors to be left open where possible to avoid touching handles.

Pens are not to be shared, therapists to bring their own to every session.  Appointment cards are not given if able to receive appointment confirmation via email.  Receipts are also to be sent electronically where possible.

Flooring to be mopped at least once per day.

If taking cash, this should be placed in an envelope/box and put away so it only needs to be handled once at the end of the day, followed by hand washing.

Bin to be tied at the top and removed at the end of the day 

Laundry bin to be taken home for washing at 60 degrees or above.

Put in a new bin bag and then wash hands. 

Appendix 2a & 2b for hand-washing/gelling guidelines

How to wash your hands - NHS (www.nhs.uk)

Appendix 3 for PPE guidelines 

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/877658/Quick_guide_to_donning_doffing_standard_PPE_health_and_social_care_poster__.pdf 

Appendix 4 for Donning 

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/878677/PHE_11606_Putting_on_PPE_062_revised_8_April.pdf

Appendix 5 Doffing procedure

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/878678/PHE_11606_Taking_off_PPE_064_revised_8_April.pdf