andrew st. family health centre
How to remove
How to remove
Dr. Tak demonstrating the most effective way to remove your gown while minimizing self contamination.
As cases increase in the community, one of the best ways to try and ensure the health of physicians and staff are to reduce the amount of patient traffic through the clinic.
This is a time where everyone needs to be on the same page to ensure safety to all.
Please read the following email for office policy and procedures.
ALL STAFF - if you feel unwell, please stay home and let Admin know right away.
PPE and Use:
When in office, staff and physicians must wear a mask. This mask may be kept and reused for the week or longer, if not soiled. Some physician keep it in their car, or we can try to find cupboard space for this as well.
When seeing patients for WBC, PN, non-Respiratory symptoms - we recommend as a minimum Shield, Mask, and Gloves. Some are currently choosing to wear a gown for these visits as well. (those wishing to wear a gown, you MUST wear the reusable cloth gowns)
When seeing patients with Respiratory Symptoms - Shield, Mask, Gloves, and Gown **we recommend using a reusable gown due to our limited number of disposable ones. If a disposable is used, please remove carefully, place in a bag, tie, and label with the date and your name**
Patients with Respiratory Symptoms MUST wear a mask as well.
CONSIDER A PARKING LOT VISIT AS WELL
Nursing is to wear full PPE as well, when patients are coming through the clinic. (Shield, Mask, Gloves and Gown)
We are trying our best to see all WBC and PNs in the morning, leaving the afternoon free for unwell patients coming in. If booking an unwell patient in to clinic, it is recommend they come in end of day 3-6 if possible, or if necessary to be seen earlier, check all other schedules to see who else may be in the office at that time. You can also assess this by speaking with Admin or Nursing.
ALL patients coming to office are required to call us from the parking lot, and they will be instructed when it is safe to come in and to proceed directly to Pod A or B, where they will be meet by a nurse and roomed right away. Morning PN, WBC call ext 106, Afternoon patients call ext 100. The ext lets them jump past the queue.
Pre-booked inpatient appointments are screened again at this time for possible COVID contact or symptoms. A booking instruction sheet will be access through our website to staff and physicians.
We are running now out of Pod A and Pod B. We are ensuring all available equipment is upstairs. The Pod B storage room has all OPEN PPE stock. This will be used up first before opening any new boxes. Government PPE reporting only requires us to report unopened stock and usage, so our count to the government will stay unchanged until all those open stock is used up. I will be doing an updated inventory tomorrow and will report to all of you the count of what we have on hand so you are aware.
We have removed certain items from the exam room to cut down on possible contamination. I met with Somer, and a donning station was set up in Pod A and Pod B, at this station as well are ear thermometers, O2 Sat Monitors, tongue depressors, etc. The physician can gather what they need before proceeding in to see the patient. Items are to be left in the exam room, and nursing will clean before returning to the bins. A few physicians have worked using this process, please let me know if you experienced any issues.
A reminder as well, Mariluz is our day porter. She is here every day from 9-4, when am PN and WBC clinics are running, she is in Pod B following behind appointments and cleaning each room. Other times, she is cleaning all touch points, door handles etc, and washrooms.
We still have evening and weekend cleaners as well. We have been putting signs on the door, so they are aware that a room has had an unwell patient in it so they may protect themselves, as well as throughly clean the room and instruments. We will make and attach signs to the door bins that can be flipped out to notify cleaners, and others to not use that room to stream line these process.
Donning and Doffing PPE
It is strongly suggested that you make time in clinic to practice putting on and off a cloth gown, practice helps. Auz has become very good at this, and has recorded a demonstration - see above
He recommends not tying the gown if possible, as to untie you could cause more contamination to yourself.
Donning should take place in the pod area by the sink. Doffing should take place in the exam room.(Exam Room 1 in Pod A and B) The gown should be removed first, rolling it in to itself and wrapping up in to a ball in the doffing process, this can than be placed in the laundry bin in the pod area. Than you can remove and dispose of gloves, and wash hands throughly. If seeing additional patients, physicians are leaving on shield and mask until visit are complete. Otherwise, remove and clean shield with a cavi wipe or spray. We were told that soaking them in soapy water is also good practice.
Below is the office policy of which visits we will continue to see in office:
WBC - 2months and under, 4months, 6months, 12months, and 15months
PN - 1st PN, 20weeks, 26weeks, mainly pertaining to AT and DE - 30weeks, 34weeks, 36weeks, 38weeks, and 40weeks
Injections - Allergy, Testosterone, Psych, Depo, Tdap in Pregnancy, INRs
Suture removal will still be seen
Admin will be going through schedules and cancelling all unnecessary visits.
PNs and WBCs will be booked in the AM in Pod B - this pod is for vulnerable patients
Non-Resp patients should be booked for the early afternoon, in Pod A rooms 5,6,7,8
Resp Patients should be booked for later afternoon, in Pod A rooms 2,3,4
Once room has been used, please flip the door marker/sign and close the door. Cleaners will address this in the evening when they come through.
Patients Unable to Successfully Treat by Phone
Patients that physicians feel need an in office appointment, should not be booked in to the clinic until the case has been reviewed with a colleague. If you both agree it needs to be seen, you may book them in, preferably as an afternoon appointment.
Another suggestion to cut down on direct patient interaction time is to take your history by phone, opposed to in office for PN and WBCs.
If you are booking anyone in with a rash, infection, cyst, boil, etc. that is not located in a private area, please ask them to email use photos prior to their phone visit
They can email my account [email protected] I will input in to the chart
We will be forwarding all nursing calls to one phone to cut down and numerous exts to check.
A reminder to everyone to hand wash frequently, and to clean your work station at the start and end of every day. Please be VERY CAREFUL cleaning keyboards, they are easily broken if they get wet. you may use a wipe on them after everything has been wiped and cloth is almost dry, or wring out the wipe first.
This is uncharted territory for all of us, and we are learning everyday. As everyone is falling victim to email fatigue, if you have other suggestions or ideas for the office please speak with Becky, a lot of plans have been put in to place, you may have missed the email or forget where to access the info.