Guidance for home visiting and outpatient healthcare services
Home visiting and outpatient services should review models of care, and incorporate risk screening, assessment and mitigation processes consistent with the CEC response and escalation framework as follows:
-
Screening of patients for symptoms prior to attendance as part of routine clinical assessment.
- Measures to encourage physical distancing to ensure 1.5 metres of space between people where appropriate and practical whilst providing a service. Minimise the number of people present in the room in which the service is provided, (it is recommended that infants are accompanied by a parent/carer) and minimising close contact during the provision of service. Encourage 1.5 metres physical distancing in waiting rooms and at reception desks e.g. spacing chairs, floor markings and signage.
- Ensure all staff have completed infection prevention and control training, including personal protective equipment training where relevant. Measures to ensure standard infection prevention and control precautions should always be stringently followed, with transmission precautions applied in accordance with a risk assessment. The Clinical Excellence Commission COVID-19 Infection Prevention and Control Manual for acute and non-acute healthcare settingsand COVID-19 Infection Prevention and Control - Primary, Community and Outpatient Settings should be followed.
- Ensure availability of personal protective equipment for all staff conducting home visits or outpatient appointments, including hand sanitiser, cleaning wipes for reusable equipment and waste disposal bags.
- Use alternative models of care such as telehealth technology where appropriate, especially for people who are vulnerable to severe illness such as elderly or immunocompromised people or to include people in appointments who otherwise would have not been able to attend (eg second parent for child and family health appointments). Guidance in relation to telehealth is available at ACI - Telehealth.
- Mask wearing by staff and patients should be in line with current the
CEC Response and Escalation Framework and advice for
Home Care service providers, especially when undertaking aerosol generating procedures.
Screening of patients and staff
Patients and others present at appointment
Pre-screen all patients and others present at appointment (e.g. by phone call, SMS),
no more than 24 hours prior to the appointment. Screening should occur again at time of appointment.
When screening this group apply the 'COVID-19 exposure assessment - Visitors' found in the
COVID-19 screening at NSW healthcare facilities. When screening for delivery of healthcare in the home please interpret the use of the term "facility" as a home visit/appointment.
If there is a 'yes' response to exposure assessment:
- Support/advise patients who have symptoms to
get tested and isolate, if they have not already done so, and to seek medical advice from their general practitioner or HealthDirect on 1800 022 222 to manage their health symptoms.
- Consider alternate methods of conducting the appointment if appropriate (e.g. tele-health). If it is not possible and it is not clinically urgent, reschedule the appointment (if the patient has been asked to self-isolate refer to release from isolation to estimate the timing of a re-scheduled appointment).
Outpatient staff
Exclusion of staff from outpatient clinics should be based on the 'COVID 19 exposure assessment – Staff' in
COVID-19 Screening at NSW healthcare facilities.
Home healthcare staff
Exclusion of staff from home visits should be based on the
Advice to home care service providers.